You know what’s behind stratospherically increasing health costs in this country? Not just more expensive equipment, drugs and procedures, but a population—even a working-age population—with one or more chronic health conditions. I’m talking about diabetes, hypertension, cardiovascular disease, arthritis, congestive heart failure, depression, asthma, and more. Manage these medical conditions with lifestyle changes and, where necessary, medication, and we can save billions. But let them get out of control and we’re spending billions on emergency department care, hospitalizations, surgeries, and more intensive acute medical care.

One place where the focus on chronic disease management is particularly important is the workplace. Yet I was disappointed to read a recent report from Towers Watson Consultants on employee wellness, which found that just 59% of the 3,099 employees they surveyed said that managing their health is a top priority, down from 69% in 2008. The survey also found fewer employees participating in lifestyle management programs, with just 59% saying they were taking actions to significantly improve their health, compared to 65% in 2008.

But, and here’s the rub, just a third of employees said their employer offered programs designed to help them live a healthier lifestyle. We know the percentage is far higher. We also know, as you may have read in one of my earlier blogs, large corporations also surveyed by Towers Watson said they were making significant investments in their employees’ health and wellness and reporting good returns on that investment. In fact, nearly 90% of US companies said that health and productivity is a core component of their organizational health strategy. The report also found that spending on health management programs in the US has grown 50% in the past two years.

So what does it take to get employees more interested in their health? Well, increased deductibles and copayments is one option. After all, if it costs a $150 copayment to be seen in the ER for an asthma attack versus a $10 copayment to see your doctor for education and management, which do you think cash-strapped employees will choose?

Your job as an employer is to help them understand the differences and the fact that they have control over the outcome. Staying with the asthma example, show them the potential costs savings over time, how to use maintenance medication, track their lung function, and implement their action plan at the start of any breathing difficulty—not when they are having so much trouble breathing they need to be seen in the ER.

Conversely, offering reduced premiums to employees who meet certain health-related parameters—losing weight, controlling their blood sugar, quitting smoking—provides a “carrot” approach also shown to be quite successful.

Also ask yourself how well you’re marketing your wellness programs. The reality is, these programs should be marketed just as aggressively to your employees as you market services and products to your customers. It really takes employers to be very intentional about changing the behavior of their employees and dependents. If they are not, very little will change with respect to their healthcare spend.

So, how are you marketing your wellness programs, and what kind of participation are you getting? Are you getting the kind of results you would like?

Bob Fabbio
President and CEO
WhiteGlove Health, Inc.

In my last blog, I told you about data showing the benefits of employer wellness programs. But how, exactly, do you go about developing a successful employee wellness program? Here are some top-line tips based on WhiteGlove’s experience with our clients, as well as evidence-based research on employee wellness programs.

• Determine a baseline. Survey your employees to gather baseline information about the state of health in your company. Typical questions include information about weight, eating habits, physical activity levels, chronic illnesses, stress, etc. This will highlight specific areas on which you need to focus. Employees should be able to provide this information in a completely confidential manner.

• Identify what success looks like. Once you choose which programs to start with (such as smoking cessation, weight loss, increased physical activity, stress reduction, etc), identify metrics of success. Initially, you might start with the number of employees who participate; eventually, those markers might be more specific to the health outcome, such as percentage of body weight lost, or number of cigarettes smoked per day. Other metrics to consider are sick days, employee turnover, presenteeism (coming to work sick), and workers’ compensation claims.

• Incentivize your employees. The reality is that simply putting the program out there is not enough. You also need to provide either a carrot (reduced healthcare premium, prizes, extra vacation days, money) or sticks (higher deductibles or premiums).

• Champion the program at the top levels of the organization. If you’re pressuring your employees to eat better, exercise more, and lose weight, they need to see that you’re doing the same. If you offer gym discounts or have an on-site gym, let your employees see you working out there. Change the cafeteria offerings to more healthful fare and let your employees see you eating it. Send out e-mails and post blogs on the company intranet updating your progress and the progress of the organization as a whole (i.e., “Our employees have lost a total of 1,500 pounds in the past 3 months!”). The idea is to create a “culture of health.”

• Publically celebrate success. Every month or so hold a recognition ceremony for employees who met their personal wellness goals. Also publish articles and photos in the company newsletter/blog.

And be patient. You are not going to see the immediate return-on-investment you might gain from, say, purchasing more fuel-efficient vehicles. Many negative health behaviors took years to develop and will take time to improve.

The key is taking the first step: deciding to improve the health of your employees. Once you do that, I can promise, you will also improve the health of your business.

Bob Fabbio
CEO
WhiteGlove Health, Inc.

Employers have crunched the numbers and realized that wellness programs can provide a substantial return on investment with healthier, more productive employees. However, we also know that there are numerous companies out there that have yet to embrace these efforts for their employees.

Both groups, those who offer wellness programs and those who don’t, should be interested in a recent report I just read from the National Business Group on Health (NBGH). The nonprofit organization is devoted to representing large employers’ perspective on national health policy issues and providing practical solutions to its members’ most important health care problems.

Every year NGBH commissions a survey from Towers Watson to evaluate employer efforts in the area of employee health. I found the 2011-2012 Staying@Work report just fascinating. As the consultants summed up on the opening page: “This year’s survey results show a strong link between highly effective health and productivity strategies and strong human capital and financial results.”

How strong? Companies that offer highly effective health and productivity programs report industry-adjusted average revenues per employee 40% higher than low-effectiveness strategy companies, a difference of $132,000 per employee.

The survey also found that companies with highly effective health and productivity programs:

• Report they perform better than their top competitors
• Save more than $1,000 per employee in annual health care costs
• Lose fewer days due to unplanned absences and disability. Combined with the health care cost savings, these indirect savings can increase a company’s benefit savings by “considerably more” than 30%.
• Experience employee reductions in at least some health risks (tobacco use and sedentary lifestyles/physical inactivity)
• Have lower voluntary turnover rates

The survey also finds more US employers use penalties as well as rewards to incentivize their employees to participate in wellness programs, while about a third only provide the rewards after employees participate in multiple activities, not just when they enroll.

Rewards pay off, with participation rates averaging 46% in companies that use them vs. 19% in those that don’t.

Room for Improvement

The survey also highlighted several areas ripe for improvement. For instance, average participation rates in disease management programs for chronic conditions hover at just above 14% and are not very responsive to incentives.

One clear message from this year’s survey: Senior management needs to get more involved. Just a quarter of firms surveyed said managers and/or senior leaders volunteer to be “health champions;” less than a fifth have senior leaders who share their own health stories; and fewer than 20% of managers participate in periodic employee health communication.

The survey also found that a key differentiator for high-effectiveness programs was offering easy access to preventive and other health care services, like those that WhiteGlove provides. In fact, WhiteGlove’s clients have made us an integral part of their wellness initiatives and have reaped the rewards of doing so.

In my next blog, I’ll report on some of the specific employee wellness findings. Hint: the biggest opportunity lies in changing employee behavior.

Bob Fabbio
CEO
WhiteGlove Health, Inc.