Wellness programs are all about the bottom line

McClatchy Newspapers (MCT) - Jan Mason is a 50-pound-lighter testimonial to the power of workplace wellness programs.

Mason's boss, Ken Sigman, president of HBS LLC, a health care consulting company in Leawood, Kan., gave his six employees free memberships to Center for Health & Human Performance at the Jewish Community Center of Greater Kansas City.

"We realized we better walk the walk with our own employees instead of just talking about wellness with our clients," Sigman said.

Employers nationwide are coming to Sigman's realization. For some, employee wellness initiatives _ and the goal of a healthier workforce _ are their last, best hope to rein in ever-increasing employee health benefit costs.

A survey of National Association of Manufacturers and ERISA Industry Council members found that 71 percent of the member companies offered employee incentives this year for participating in health and wellness or disease management programs. That was up from 62 percent of their memberships in 2007.

According to Hewitt Associates, 88 percent of companies it surveyed this year "plan to make investments in longer-term solutions aimed at improving the health and productivity of their workforce over the next three to five years, up from 63 percent last year."

Fit workers are a worthy goal in itself. But the increase in corporate wellness programs is driven by the bottom-line.

The American Journal of Preventive Medicine estimates a return of from $3 to $6 in health care cost savings for every $1 invested in a corporate-based wellness program over a two- to five-year period.

So far, only about one-fourth of companies that have implemented employee wellness incentive programs have said in recent surveys that they've been able to track and document specific cost savings, but those who have are happy with the bottom line.

Health2Resources this year found that eight out of 10 employers who calculated their returns on investment in 2007 "more than broke even" with their wellness programs.

The manufacturers' association survey found that the average incentive value (such as health insurance premium cost reductions or gift cards for employees who participate in wellness programs) was just under $200 per participating employee.

HBS spends about $800 a year per employee on its wellness initiative, which includes a bit more than the JCC memberships, Sigman said.

Mason, the HBS employee, signed up for the Jewish Community Center's wellness program in February. She began working out under professional supervision, and now can walk up a flight of stairs without wheezing, something she couldn't do before.

"As America's battle of the bulge continues and other health concerns grab headlines, it's no longer a secret that obesity, tobacco use and stress are the most common hazards to health in the American workforce," said Jack Bastable, health and productivity management national practice leader at CBIZ Benefits and Insurance, based in Leawood.

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Since the 1980s, Bastable has been one of the Kansas City area's pioneers in spreading the corporate wellness gospel. Currently, he works closely with John Mullin, health enhancement department chairman for St. Luke's Health System, which has contracts with 22 major Kansas City area companies, law firms, school districts and municipalities to provide wellness counseling and programs.

"Coast to coast, wellness programs are growing exponentially," Mullin said.

He and Bastable espouse a corporate culture that goes "beyond water bottles and T-shirts," Mullin said. "We work for a corporate culture that's more allied with well visits to physicians, exercise habits, thinking prudently about diet, and managing disease. Employees who participate will be rewarded in discounts in their premium costs or deposits into health savings accounts."

Such employer-sponsored wellness initiatives get resistance from some workers who don't want their bosses to have a role in supervising their personal health or fitness.

In the recent Hewitt survey, only 12 percent of employees said they thought their companies had a role in helping them understand how to stay healthy.

Employers who have wellness programs also need to be careful not to violate nondiscrimination provisions of the Health Insurance Portability and Accountability Act. Simply put, health information obtained in wellness programs shouldn't be shared with employees' supervisors or co-workers.

The federal government also does not sanction wellness programs that fail a "reasonable" test. In other words, the rewards or incentives (such as reduced health insurance premium costs) can't require meeting a fitness or participation standard that would be considered unreasonable.

Navigating through the privacy concerns and legalities hasn't deterred a growing number of companies.

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One corporate approach to wellness steamed through the summer at the Epiq Systems Inc. headquarters in Kansas City, Kan. Fitness trainer Greg Justice, owner of AYC Health/Fitness, designed a 12-week fitness "boot camp," given onsite at Epiq. Twenty-five employees, or about one-fourth of the headquarters' staff, signed up.

"Doing it onsite creates a much greater adherence rate than if employees have to go offsite," Justice said. "Epiq has a state-of-the-art gym onsite, so that made it easy."

Epiq covered the $249-per-person cost, as long as the employee showed some fitness or weight-loss improvement at the end of the session, Justice said. Enough positive outcomes were recorded to spark the beginning of a fall boot camp at Epiq, which, like the first, takes place over the lunch hour.

Because some Epiq workers travel, the fitness program included an online component to help them keep up with suggested exercise and diet programs.

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Lockton Benefit Co. contracted with Front Door Fitness, another Kansas City fitness company, to subsidize the cost of onsite personal training for employees.

In the year since Lockton began the program, more than three-fourths of Lockton employees have participated in at least one part of the fitness package, which has ranged from motivational fitness presentations to one-on-one counseling and training.

At law firm Shook, Hardy & Bacon, chairman John Murphy said about 500 lawyers and other employees are participating in the "A Healthier You" program sponsored by Blue Cross and Blue Shield of Kansas City.

The firm is discounting the cost of health insurance premiums for employees who participate in the wellness program, which offers health screenings, a health risk appraisal and connects employees with health coaches.

"It's really raised awareness that they can change behaviors to improve their health," Murphy said, noting that the benefits go beyond lower health care costs: Employees seem more productive.

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Kansas City-based Polsinelli, Shalton, Flanigan, Suelthaus, a 550-employee law firm, began a wellness program in March 2007, supervised by St. Luke's. The incentive for employees to participate is a discount on their monthly insurance premium if they complete their target program recommended after their health risk appraisals.

Like many wellness programs, individuals can be asked to focus on losing weight, lowering cholesterol, stopping smoking or getting health screenings such as mammograms, bone density tests, fecal occult blood sampling, vision or skin cancer screenings.

A wellness effort doesn't have to be intensive or invasive. At Creative Consumer Concepts in Overland Park, Kan., the company this summer handed out pedometers to encourage employees to track their steps over a six-week period.

To round out the program, the company treated participants to a visit from a massage therapist and supplied nutritional snacks.

Wellness advocates note, though, that even baby steps toward employment-based wellness can be rejected by some employees who either aren't motivated or don't want to entwine personal health concerns with their employment.

A Hewitt survey of employees who had taken health risk questionnaires offered by their employers found that only 40 percent had taken any actions based on specific recommendations.

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OF NOTE

_ Research by Hewitt Associates finds that 51 percent of employees or their dependents have a chronic health condition that requires ongoing care. Those needs have caused 74 percent of 248 large and midsized companies surveyed to implement disease management programs as part of employee wellness programs.

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_ Ceridian LifeWorks, a provider of human resource services, reports that a company's medical and absenteeism costs increase an average of $917 a year for employees who are 30-60 pounds overweight, and $2,256 a year for employees who are 60-100 pounds overweight.

_ One of the more severe wellness initiatives around the country is found in companies that fire and refuse to hire smokers.

_ An unusual wellness effort is marketed by Steelcase, which sells "WalkStations" that allow workers to walk on treadmills while at their computers.

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WELLNESS PROGRAM STARTER IDEAS

_ Sponsor confidential health risk assessments for employees.

_ Offer nutritious vending machine and cafeteria food.

_ Form weight-loss, walking or exercise teams with prizes for motivation.

_ Offer lunch-hour fitness classes onsite.

_ Subsidize gym or exercise class costs.

_ Provide incentives (such as reduced health insurance premium costs) to encourage participation.

BUT KEEP IN MIND ...

To not run afoul of HIPAA law, employee wellness programs must meet five criteria:

_ Rewards or incentives that do not exceed 20 percent of the cost of employee-only health insurance coverage or 20 percent of the cost of employee-plus-dependents coverage.

_ The program must be "reasonably designed" to promote health or prevent disease.

_ Employees must be allowed to participate or qualify for rewards at least once a year.

_ Rewards must be uniformly available to all "similarly situated" employees.

_ The plan must publicize a "reasonable alternative standard" in all materials describing the initial standard.

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© 2008, The Kansas City Star.