Written by Alison Johnson
More companies big and small are adding programs to help employees stay healthy – and, hopefully, save everyone money on medical costs.
Sherrie Harris freely admits that she hates going to the doctor. That she hasn’t gone for regular check-ups in the past. That her health–her blood pressure, cholesterol and weight, along with her diabetes management–has suffered because of those missed appointments.
But Harris, who works as a patient advocate at Sentara Obici Hospital in Suffolk, doesn’t avoid her doctor anymore. She also fills her prescriptions promptly, eats more fruits and vegetables, watches her sodium and sugar intake and walks regularly, tracking her daily steps with a pedometer. Some of that is newfound self-motivation. The rest is a health coach and financial incentives that cut her medical bills, both central pieces of her employer’s corporate wellness program, Mission: Health. The results have been dramatic: Harris has lost a significant amount of weight, gotten off several medications and seen her blood pressure drop from 176/136 to 108/76 since 2008.
“My coach will call and email me to see how I’m doing and encourage me,” says Harris, a 48-year-old Portsmouth resident. “I don’t want to disappoint my coach. I look better. I feel better. I used to go home with headaches and that doesn’t happen anymore. I have more energy and I’ve noticed that I don’t catch colds. I’m so proud of myself.”
Harris is a poster child for why more and more businesses are adding corporate wellness programs to their roster of benefits for employees. Faced with rapidly rising health care costs, companies have found that supporting and rewarding workers for healthy behaviors has the potential to help everyone involved. Healthier employees tend to be happier, more productive and less likely to take sick days. Companies with well-run programs, in turn, may see significant decreases in medical and workers’ compensation claims: an average return of $3 for every $1 spent on wellness initiatives, with a high of $15 per dollar, according to the American Institute for Preventive Medicine. Theoretically, savings should continue long-term if employees can avoid or better manage high-cost chronic conditions such as diabetes and heart disease.
Wellness programs can vary widely by company. Initiatives might include personal health coaches and nurse advice lines; on-site exercise classes, medical screenings or clinics; weight loss competitions; nutrition counseling and cooking demonstrations; and smoking cessation, substance abuse and stress management programs. Many companies build on their efforts each year; Bon Secours Virginia, for example, added a nicotine-free hiring policy to its already comprehensive program late last year. The health care company, which has more than 12,000 employees statewide, now tests all applicants for the presence of nicotine and encourages those with positive results to quit smoking and reapply for open positions in six months.
Most companies have found the best way to entice employees to participate is with incentives, generally in the form of discounts on medical expenses. Genworth Financial, a Richmond-based financial security company, gives employees a 10 percent discount on medical premiums for the following year just for taking an annual health risk assessment survey, or up to 20 percent off if they’re in good health or have improved on a previous year’s score. This year, Genworth also is offering a $100 discount on medical deductibles for employees who visit a primary care physician to discuss identified risk factors. Employee spouses can get a similar reward. That’s on top of free clinics and fitness centers at company offices in Richmond and Lynchburg, each home to about 1,200 employees.
“We’re just trying to build a whole culture of wellness,” says Matt Turner, Genworth’s vice president of compensation and benefits. “We can see the changes in our population: at first people were a little reluctant to get on board, but now they’ve really embraced it. It’s starting to engrain as part of our way of life, and that’s making a tremendous difference.”
Growing Efforts
Corporate wellness programs have steadily increased over the past three years nationwide, according to Metropolitan Life Insurance Company’s annual study of employee benefit trends. About 45 percent of all companies and 72 percent of businesses with more than 500 employees had some type of effort in place in 2010; of those, 72 percent reported them effective at reducing medical costs, while 76 percent cited improved employee productivity.
Not only big national businesses are diving in. Icelandic USA, a Newport News-based seafood processor and distributor with about 450 employees, has worked with the American Heart Association over the past three years to add healthier items to vending machines, offer onsite exercise classes–yoga is this year’s plan–and encourage regular walking via posted signs and emails. A sign hanging in one well-traveled hallway details an approximately mile-long walking route near its offices. Debra Zartman, director of human resources, now walks that route regularly each week. “It helps relieve any stress and gets me refocused on work, especially if it’s a particularly stressful day,” Zartman says.
In 2009, Icelandic also launched a “Biggest Loser” competition, awarding cash prizes ranging from $100 to $1,000 to the six employees who lost the largest percentage of body weight over a three-month period. Close to 20 percent of the staff signed up, says Mike Thome, vice president of finance and chief financial officer. “I can say for sure that it’s good for morale,” Thome says. “It’s a fun rallying point for everyone.”
Elizabeth Hedrick, a 24-year-old human resources assistant, won $400 in last year’s contest–she dropped 18 pounds and placed fourth–by changing her eating habits, cutting soda and exercising more. “The extra incentives definitely helped push me,” Hedrick says. “I wasn’t going to do it on my own.” She plans to compete in Biggest Loser again, and she’ll have two chances this year: Icelandic plans to offer contests in January, when weight-loss resolutions are at their peak, and August, when school is about to start and parents often have more time for exercise.
A common goal for wellness programs is make healthy living an easier choice. Time-crunched Genworth employees have flocked to its new medical clinics, which opened last spring. The clinics are open 40 hours a week, staffed by nurse practitioners who can prescribe medication and handle everything from acute illnesses such as flu to closer management of chronic diseases. The Richmond site also includes a pharmacy delivery service. “We want to eliminate the barriers to people getting the care they need: time, money and access to care,” Turner says. On-site fitness centers do the same for employees looking to fit exercise into their days. Tom Topinka, Communications Leader at Genworth, goes to the Richmond gym four or five days a week, combining cardiovascular and strength workouts with yoga. “I haven’t had a sick day in eight years,” Topinka says. “I’m pretty sure a lot of it has to do with being able to work out almost every day with a minimum of travel time and inconvenience.”
Businesses also aim to reach employees who have a serious, expensive chronic illness such as diabetes or heart disease or multiple risk factors such as high blood pressure or cholesterol. After discovering 20 percent of its employees were producing 80 percent of its health care costs, Sentara began offering Mission: Health – created by Optima Health, its insurance carrier–to all 11,200 benefit-eligible employees in 2008. Employees who filled out a personal health profile and had few risk factors qualified for reduced premiums. Those with several risk factors or a chronic illness could earn rewards if they agreed to certain steps, including quarterly phone calls and emails from health coaches, regular preventive care and treatment compliance. At stake in 2012 is anywhere from $600 to $1,060 a year in credits or savings toward medical expenses.
More than 90 percent of eligible employees currently participate in Mission: Health, and Sentara is only planning to expand its offerings, says Karen Bray, vice president of Clinical Care Services at Optima Health. Next year, for example, Sentara will pay for prescription medications for smokers looking to quit, boost support for obese employees who undergo gastric bypass surgery and expand disease management services to employees’ spouses. “It has been a big success story,” Bray says.
Promising Numbers
How big? While Sentara’s health care costs initially increased as more employees filed claims–often to begin medication for underlying conditions that had gone untreated–the company ultimately saw $3.4 million in savings in 2009 compared to 2008 (it is still analyzing more current cost data). Statistics also have shown a real improvement in employee health. The first year employees completed personal health profiles, 25 percent surveyed tested “healthy,” defined as having no or only one major risk factor for a serious illness (that covers high blood pressure or cholesterol, smoking, being overweight and not exercising regularly). By 2011, that figure had climbed to 61 percent. “When people take better care of themselves, they’re going to face fewer unexpected health problems,” Bray says.
Genworth also has data showing an annual improvement of overall employee health, Turner says. The company’s detailed health risk assessment–which includes 100 questions and measurement of body mass index, blood pressure, cholesterol and blood sugar–calculates an aggregate score from 0 to 100, with 100 the best. Employees scored 75 percent the first year, and that has risen by a point each year to today’s score of 79. Perhaps partially as a result, Genworth recently announced its medical premiums would increase just 2 percent this year. By comparison, the average annual premium for employer-based family coverage rose 9 percent nationwide in 2011, up from 3 to 5 percent in previous years and double-digit figures before that, according to the Kaiser Family Foundation, a non-profit research group. “We certainly are beating the national averages,” Turner says.
Wellness programs do have their critics. Most common: They’re heavy-handed and a threat to employee privacy; tend to benefit employees who are already healthy and aren’t as fair to lower-income employees who may have a harder time earning incentives; and, without more definitive data to link programs directly to cost savings, may not be a good use of resources, particularly in a down economy. No one will argue that many employees start out resistant to changes, momentum can be hard to maintain and not every idea works. Icelandic dropped on-site Zumba classes when people stopped attending regularly; the business is hoping for more success with yoga. Sentara is currently struggling to sell a new incentive for employee spouses who agree to management of a chronic illness. And even successful initiatives require continued follow-up, Bray notes. “For example, we don’t want people to lose weight, meet their goal and then put the weight right back on,” she says.
Still, even local companies that don’t have firm proof of savings remain fans of promoting good health, if only for the morale boost. “It’s very difficult to talk about savings, because we’re just at the beginning stages of our wellness program,” says Thome, of Icelandic. “But my feeling is that if we can give a little push and impact even one, two or three people, it’s worth it to me.”
Sherrie Harris is one person who doesn’t plan on going back to her old ways. She calls the financial benefits of working with her health coach “very generous”–she has a card to cover co-payments and medications–and the mental boost equally powerful. “I feel like I’m getting all the tools I need to change my life,” she says. “I know I wouldn’t have done as well on my own.”