Wellness screenings are important programs to identify chronic disease in their early stages. Once identified, wellness intervention programs can help prevent a disease from progressing. Working with local hospitals and other corporations, you can get information on offering assessment and intervention programs that might improve your employees’ health and save your corporation money in absenteeism, treatment for disease complications, and reduced productivity. Below are some ideas to help get you started.

Based on your Employee Needs & Interest Survey and the demographics of your workplace, consider offering periodic screenings to find specific health risks such as:

• Blood Pressure (BP) Checks to identify employees with pre-hypertension or hypertension (elevated blood pressure),
• Cholesterol Screenings for total, HDL (good cholesterol), LDL (bad cholesterol) and/or Triglycerides
• Blood Sugar Screenings fasting or non-fasting to screen for possible diabetes,
• Body composition, such as body mass index (BMI) or body fat measures
• Bone density for potential risk of osteoporosis,
• Cancer screenings such as, skin examinations, mammograms, or PSA screenings,
• Vision checks for glaucoma, or visual acuity
• Other wellness screenings depending on your worker population and needs

Your local hospital, corporation physician practice, or health department may support assistance. However, if you have staff members you may want to concentrate on programs that will keep them healthy rather than screening for early identification of chronic disease. The focus of your wellness program might be healthy lifestyle practices to cut risk and prevent disease.

In addition to the health screenings, consider offering a Health Risk Appraisal / Health Risk Assessment to all workers. The Health Risk Appraisal / Health Risk Assessment will help to identify factors that may lead to additional risks, such as smoking history, stress levels, image of health, family history, job satisfaction, support systems, and mental health. Often the assessment results are included on the Health Risk Appraisal / Health Risk Assessment, which provides a more all-inclusive snap shot of health risks. The summary results offer the important information to plan appropriate interventions.

Employee Wellness Program Interventions

The key to the performance of screenings and Health Risk Appraisals / Health Risk Assessments is the interventions or follow-up programs. The data collected during the screenings increases awareness and frequently motivates employees to consider making healthier changes. It’s the follow up interventions that support the essential reinforcement and assistance needed for employees to actually make and maintain those changes. The interventions have the potential to include individual follow-up and ongoing counseling, individual or group health coaching on the risk factors, behavior change programs, and/or employer reinforcement. Examples include:

• Strategies to lower Blood Pressure
• Managing diabetes
• Taking care of your heart
• Healthy eating
• Weight loss ideas
• Increasing physical exercise
• Smoking Cessation

Naturally, this is for individual information only. Any follow-up interventions planned by the corporation would be based on interest expressed by the employee.

Based on the results and your Worksite Health Promotion Program Committee objectives you have the potential to plan the best strategies for your employer and staff members. Consider the area resources available to support services, such as health associations, hospitals, medical care providers, and/or public health agencies.

The program design options hinge upon the objectives and desired outcomes of your program.  If your goal is to help workers modify behavior, cut risk factors, or save medical care money then your wellness program would be designed to accomplish those outcomes and a budget would be crucial to support that design.  

There are different wellness program design levels depending on desired outcomes and budgets.  Each level has pros and cons.  The intentions or results are quite different, are not interchangeable in terms of obtaining similar results, and therefore should not be confused.  For example, scheduling activities such as an employee health fair or lunchtime education sessions, or having brochures available do not usually result in behavior modification, but may expand awareness on a topic.  If the intention is behavior modification then a different design is required, such as Lifestyle/Behavior Change Programs and Company Support.  The outline below describes the wellness design levels with a short explanation.

Awareness Programs:  At this level a company makes health information available and accessible to employees.  This type of program often includes pamphlets on a variety of subject matters, wellness articles in newsletters, bulletin board displays, e-mail health messages, etc.   Also, most health and wellness fairs are designed as awareness programs with vendors providing information and providing wellness screenings to employees.  

Awareness programs are cheap and do not require extensive employee or organization time commitments.  Nevertheless, these programs do not usually yield behavior change.  Growing awareness isn’t usually enough to generate lifestyle changes for most American citizens, unless used to arouse employees to register for a program being provided at the organization or community on the topic.  An example of this would be offering information on the harmful effects of smoking and inviting employees who smoke to register for a smoking cessation class.

Education Programs:  Educational programs frequently support more information on a topic and are able to also provide time for Q & A, but are similar to awareness programs.  An example is lunch-n-learn sessions on a health related topic.  These cost the company a modest amount more than awareness programs; however, they are still inexpensive and do not require a great deal of time for planning or attending a session.  Again, expanding awareness and providing information may not yield the desired behavior change unless ongoing backing or rewards and incentives are also planned.

Lifestyle/Behavior Change Programs:  These programs are designed as 4 to 12 weekly sessions or seminars to provide wellbeing and health education, address barriers and provide opportunities to practice the desired skills.  Behavior change programs therefore require more business resources, cost more, and also require more employee responsibility, time and effort.  The results are often the desired beneficial lifestyle change, which if sustained can lead to potential cost savings.  

Examples include smoking cessation classes, weight loss and weight management meetings, or an ongoing exercise program.

Environmental and Business Support:  Environmental support is often considered the highest and most valuable level to include when starting your wellness program in order to support and maintain healthy behaviors.  These types of design options include policy changes such as:

• Creating a smoke-free workplace
• Designating a walking path,
• Creating worksite fitness centers,
• Ensuring healthy vending machines selections,
• Offering healthy meal choices in the cafeteria, and/or
• Organizing flex-time policies.  

Other examples include subsidizing healthy snack machines or cafeteria choices; reimbursing fitness center or weight loss and weight management program memberships; or offering insurance incentives and rewards for healthy behaviors.

Ideally, the wellness program design would include some of each of these options.  The more integrated the approach, the more successful the results will be.  By way of example, a company can have smoking cessation information available; can schedule a one hour awareness session on the harmful effects of smoking and how to quit; can enable an worksite smoking cessation program, supply self quit smoking kits, or support staff members to go to a area program; and/or on an environmental reinforcement level can establish a smoke-free workplace and grounds, offer lower health insurance for non-smokers, or provide pharmacological quit smoking aids for free.

Company Health Promotion Program: Components for Success

There are many important parts that need to be considered to see to the performance of your Employee Health Promotion Program or Employee Health Promotion Program.  These include:  

• Upper Management Support & Employee Participation
• Active Company Wellness Program Committee
• Program is Based on Employee Needs & Interests
• Goals and Objectives are Established
• Detailed Action Plan Based on Resources & Budget
• Program Implementation & Internal Marketing
• Assessment of Outcomes and Program

Major advantages of healthy workers include:

• Lower Healthcare expenses
• Reduced Injuries
• Diminished Rates of Absenteeism
• Increased Morale and Loyalty
• Higher Productivity
• Lowered Use of Medical Care Benefits
• Diminished Workers’ Comp/Disability
• Positive Image in Community
• Diminished Turnover
• Improved recruitment for able workers

What is NOT Having a Workplace Health Promotion Program Costing Your Corporation?  

Consider the health risk factors that are contributing to chronic diseases for adults:

• 59 percent of Americans are overweight or obese
• Greater than 60% of Americans do not exercise regularly
• More than 75 percent of American citizens do not consume the minimum recommendations for fruits and vegetables
• Cardiovascular disease is the leading common cause of death and the # 1 cause of death in smokers
• 26 percent of employees stated they were frequently or very frequently burned out or stressed by their occupation  

Health Care expenses are Increasing:  Health Care expenditures are at a record high of $1.7 trillion with no signs of holding steady, let alone decreasing.  The average expense of yearly health care spending is over $5,000 per person and including dependents almost $10,000.  Recent data shows that health care related expenses now cost North Carolina employers thousands of dollars per employee, each year.

Most Illnesses Can Be Avoided:  Although it sounds unbelievable, experts estimate that avoidable illness makes up 60 percent – 70 percent of the entire burden of illness in the U.S..   In North Carolina, it is estimated that more than 53 percent of all deaths are avoidable, and that 2/3 of all avoidable deaths are due to tobacco use, physical inactivity, and poor nutrition.

Stress Levels are On the Rise:  As corporation resources dwindle and companies adopt less-costly work practices, the effects of absenteeism and productivity lost have a more powerful impact.  In a current national poll, 78 percent of American citizens described their jobs as stressful, and the majority believe that stress levels have worsened over The previous decade.  Moreover, high levels of corporation stress are able to negatively affect a corporation by growing injuries, absenteeism, and healthcare expenditures while decreasing productivity.  Simple solutions such as stress management education, flexible work schedules, quality social interaction, and increased participation in corporation decision-making are able to improve stress levels in the workplace.

What is the Upfront Cost and Time Investment for a Corporate Wellness Program?

The cost depends on the type of Workplace Health Promotion Program implemented.  There are several options to reward employee health with advantages and disadvantages of each.  The program design depends on the goals and objectives of the wellness program, the company resources, and the area resources available.  

Improving dietary practices, expanding physical movement levels, managing stress or addressing work life balance problems, and reducing/eliminating tobacco use, are primary strategies for preventing many of the most common preventable chronic diseases. The possibilities of how your organization addresses these problems are endless and can range from expanding employee awareness, which may include purchasing a few pamphlets on a variety of topics, and measuring walking distances around your facility, to starting organization backing such as funding a full-time occupational health professional or building an onsite fitness center.  

When well-planned and based on your objectives, any of these programs are able to help you succeed.  Refer below to Employee Wellness Program Design Options for additional ideas.

A Worksite Wellness Program is a multi-faceted program to assist and support workers in adopting healthier lifestyles.  This could possibly include increasing employee awareness on health topics, scheduling behavior change programs, and/or adopting organization policies that support health-related objectives.  Programs and policies that reward increased physical movement, tobacco use prevention and cessation, and healthy food selections are a few examples.  

Dimensions of Wellness

Wellness is much more than fitness alone.  In addition to physical fitness, the dimensions of optimal health include:

   • Spiritual Dimension of Wellness,
   • Emotional Wellness,
   • Social Dimension of Wellness,
   • Intellectual Dimension of Wellness

These dimensions are often portrayed as a “life wheel” with examples of health components that include fitness, nutrition, purpose in life, monetary planning, social connections & backing systems, stress management, mind-body health, career planning and ongoing learning.   The key for personal health is keeping the “life wheel” in balance.  A comprehensive workplace wellness program addresses most, if not all, of these dimensions.

Why Workplace Wellness Programs?

staff members spend much time working, and the reality is that our traditional work-week is increasing.  In fact, the everyday American now works about 47 hours every week.  In addition, innovations such as modems, laptops, cell phones, voice and email have confused the work-life boundary.  These realities cut down on the amount of time that the average person is able to spend on health & wellness pursuits, and yet staff members are expected to be at top performance when at work.

A recent study by the American Association of Occupational Health Nurses saw that workplace wellness or Employee Health Promotion Programs are successful in helping workers to make positive health changes due to several factors such as convenience, environmental reinforcement, and co-worker or social acceptance.  

What’s the Association between Wellness and the Workplace?

Programs and policies that promote healthy lifestyles can make a sizable difference on employee wellness AND impact the employer’s bottom line.  Studies have found that for every dollar invested by employers in Employee Wellness Programs/wellness programs, there were savings ranging from $1.49 to $4.91 with a median savings of $3.14*.  In employer vocabulary, that’s more than a 3:1 minimum ROI – a number that is hard to disregard, and a best practice that should draw serious consideration from employers.  In fact, a Employee Wellness Program literature review published in Health Promotion Practitioner Journal saw:

   • 19 studies found a 28.3 percent decrease in sick leave
   • 16 different studies determined a 5.6:1 return on investment
   • 23 showed a 26.1% reduction in medical expenditures
   • 4 observed a 30 percent decline in direct healthcare and workers’ compensation claims

There is little doubt that a all-inclusive wellness program created to meet a company’s specific needs can save money by lowering absenteeism, decreasing medical care costs, decreasing employee turnover, and building productiveness.

• The U.S. Department of Health & Human Services, 2003

After cost, poor employee program engagement and inadequate discussions and support are listed as the greatest challenges for corporations administering any health benefi t program.22

By law, companies are required to explain any benefits or explicit conditions of employment to all staff members – this is called “due process,” and it usually takes the form of a packet of information that new staff members are asked to review and sign during orientation or, in the case of existing staff members, a brief communication during open enrollment periods.

Organizations that only participate in the minimally necessitated due process communication of a Company Health Promotion Program, however, do a disservice to the initiative and the business.

Opinions about Healthcare in companies represent one of the largest disconnects between management and employees. In discussing the need for savings, most companies (70 percent) believe their organization effectively communicates about increasing Healthcare costs, while only 34 percent of employees feel increasing Healthcare costs effect their business’ ability to succeed.23 When it comes to actions, 74 percent of companies believe their employees must be held largely accountable for improving, managing and maintaining health, yet only 4 percent of companies think that employees take part in these activities.

Under the proposed rules, the four requirements to be a bona fide Worksite Wellness Program are:

- The total reward that may be given to an individual is limited. The departments invited comments on the appropriate level of the reward, suggesting that a limit of ten% to twenty% of the total cost of employee-only coverage may be appropriate.
- The program must be reasonably designed to promote great health or prevent disease for people in the program.
- The reward must be available to all similarly situated individuals. More specifically, the program must allow any individual for whom it is unreasonably diffi cult due to a medical condition to meet the Worksite Wellness Program standard (or for whom it is medically inadvisable to attempt to meet the Worksite Wellness Program standard) an opportunity to satisfy a reasonable alternative standard.
- All plan materials describing the terms of the program must disclose the availability of a reasonable alternative standard.
Source: American Department of Labor Employee Benefits Security Administration

As Northwestern Memorial’s Kathryn Krivy says, “The most fundamental failure in any Company Wellness Program is not communicating. You need to tell people what you’re doing and why you’re doing it. You have to get workers engaged and educate them of what’s going on.”

A properly started Worksite Health Promotion Program is designed to save a organization more money with better participation. Nevertheless, a organization must match its focus on program design with an equally strategic investment in efforts to engage employees in the initiatives.

Lay out your case – Despite widespread recognition of increasing Healthcare costs, employees remain skeptical that the concern affects employer operations. In fact, only 53% of employees even believe what their employer communicates about the subject.24 Organizations need to be more candid and forthcoming about the amount they spend on Healthcare and how that relates to larger budgetary constraints and potential investments.

Says Motorola’s Saenz: “We share with staff members that we have been able to maintain Motorola’s Healthcare spend trend below national average over the past several years due to their participation in our various Employee Wellness Programs. This transparency is necessary to keep reminding people the reasons for our actions.”

An effective strategy is to focus on the cost savings and overall health benefi ts to the employee and not the company. By personalizing the information in this way, it creates a win-win scenario instead of presenting the program as a sacrifi ce on the part of the employee. Information ought to be presented through multiple channels, constructed in a way that makes sense to all levels of staff members, and provided to staff members, dependents and retirees.

Make it your own – Every Corporate Health Promotion Program will be different, and should reflect the culture of a company. While program areas will be determined by analyzing employee health risks, the actual offerings should be shaped by the nature of the company. Younger, more active employee communities may be attracted by different programs than an older or technicaloriented employee. Additionally, a global company with mobile employees will have different needs than a company with one central location.

As noted earlier regarding PepsiCo’s HealthRoads, one strategy is for companies to brand their Employee Wellness Programs. Union Pacifi c Railroad (HealthTracks), General Motors (LifeSteps) and Caterpillar (Healthy Balance) all adopted this approach to help create recognition and a larger meaning around their efforts. Having a branded plan helps staff members and other stakeholders see the larger goals/objectives of the Employee Wellness Program, instead of focusing on isolated offerings.

Say it loud, say it proud – As a potential cost-saving initiative, Employee Health Promotion Programs must be given the same executive substructure and internal commitment as any comparable organization effort. Companies must not approach wellness as simply a preventive, financially-motivated program, but rather as an opportunity for the organization to distinguish itself and become more competitive.

Jeffrey Treem, analyst, Edelman Change and Employee Program Engagement Group, says that effective communication about Employee Health Promotion Programs must be integrated into existing organization communication channels and vehicles. “This covers executive communication to external stakeholders,” he notes, “because this sends a powerful message back to workers about the significance of the programs. Employee Health Promotion Programs must not be treated as merely an additional employee perk, but rather a progressive and strategic effort to lower costs and create a healthier work environment.” Talk among yourselves – The most powerful champions of any Employee Health Promotion Program will be the participants.

Businesses ought to discover ways to facilitate discussions about the program among staff members. This could take the form of support groups, interactive media and the sharing of success stories.

However, since Employee Health Promotion Programs touch on potentially private health issues, it is valuable communication remains positive and inclusive, while not pressuring staff members. Discussion of wellness issues must be voluntary, though companies may consider providing incentives and rewards for those willing to contribute. Motivation and information from peers is likely to carry more credibility and significance than messages from management.

———-

Even in an at-will employment environment, people are still guarded from discrimination (including wrongful termination) by virtue of belonging to a protected class. Prior to starting a Company Wellness Program, companies need to be alert to the relevant legal restrictions and the potential affects these measures can have on benefi ts and employee behavior programs.

Title VII of the Civil Rights Act of 1964 – Prohibits employment discrimination based on race, color, religion, sex or national origin.

This means that standards and offerings need to be applied equally (or possibly proportionally) to all protected classes. In other words, if a corporation is offering access to fitness centers, it should ensure that men and women have equal access to facilities. Organizations should also consider whether a person who may live in areas heavily populated by one race, religion or ethnicity also have access to facilities and programs. The easiest way to address this concern is to supply on-Site Corporate Wellness Programs whenever possible. This not only ensures equal access, but according to Northwestern Memorial’s Krivy, also improves participation.

Companies must also be aware that particular health topics may disproportionately affect protected classes. Health Risk Assessments and any incentives/rewards put in place may really should be personalized to account for non-lifestyle related differences.

The Equal Pay Act of 1963 (EPA) – Protects men and women who perform substantially equal work in the same establishment from sex-based wage discrimination. Benefits, incentives/rewards and programs need to be applied equally to men and women. A business cannot set a weight goal for men and not for women, even though a business can set health parameters by job function. The Age Discrimination in Employment Act of 1967 (ADEA) – Protects individuals who are 40 years of age or older from discrimination based on age.

Policies not only need to be available to people of all ages, but program goals/objectives, restrictions and incentives and rewards need to be designed with age appropriateness. While older workers (or retirees and dependents) may inherently pose a higher health risk, their behaviors ought to be judged in terms of demographically appropriate measures.

Title I and Title V of the American citizens with Disabilities Act of 1990 (ADA) – Prohibits employment discrimination against qualified people with disabilities in the private sector, and in state and local governments. Similar to other workplace offerings, any Employee Wellness Programs, such as a fitness center or health clinic, would have to make reasonable accommodations for staff members with disabilities.

One area of ambiguity is whether corpulent workers qualify as disabled. The concern is complicated because weight is caused by several factors (genetics, environment, behavior), some of which may be out of the employee’s control. Generally, for workers to qualify for disability based on weight, the condition must signifi cantly impair their physical or mental ability to perform their job. This determination would need to be made by a qualifi ed physician. Although this label may affect the types of incentives and program requirements provided, it likely would not affect the overriding implementation of behavioral-focused initiatives.

Civil Rights Act of 1991 – Provides monetary damages in cases of intentional employment discrimination.

This legislation authorizes people to sue companies for improper treatment. Compensation can be in the form of actual damages such as lost or expected wages, compensatory damages for a circumstance that causes public embarrassment, or even punitive damages meant to send a message to a business for egregious or habitual violations.

While these laws govern all corporation activities, there are even more stringent restrictions with regard to Medical Care problems. Most policies, communications and data collection regarding employee health are governed by the Health Insurance Portability and Accountability Act of 1996 (HIPAA). Under HIPAA organizations cannot deny eligibility for benefits or charge a higher premium on the basis of:

• Health status
• Medical condition (including both physical and mental ailments)
• Claims experience
• Receipt of health care
• Health history
• Genetic information
• Evidence of insurability (covers activities such as riding a motorcycle, skiing, snowmobiling and other similar pursuits)
• Disability

Still, because wellness programs may not incorporate health care treatment or be insurance related, and may instead be confined to behavioral initiatives, HIPAA’s nondiscrimination provisions do not completely apply. To address this, in 2001 the American Department of Labor, the Internal Revenue Service and the American Department of Health and Human Services jointly issued a proposed regulation to help clarify the lawful provisions of a “bona fi de Wellness Program” in the context of HIPAA’s existing language (See Box p. 14). Although the regulation is not yet final, employers that comply with the measure will be viewed by the government as making a good-faith effort to avert discrimination in wellness programs.

Comprehensive Workplace Health Promotion Programs are still relatively new to corporate America and the legal implications of implementation and enforcement are not completely known. By their very nature, these programs potentially expose employers to discrimination lawsuits, disengaged staff members and detrimental public relations. Nevertheless, employers that make a good-faith effort to comply with current Healthcare-related laws, discover ways to engage staff members, and communicate strategically, will be able to minimize these risks while finding plenty of room to develop a creative and effective Workplace Health Promotion Program.

For many employers, a smoking ban would not even apply to all workers. That is because currently 30 states and the District of Columbia prevent employers from banning off-duty smoking.21 In Addition, 13 states prevent employers from banning alcohol use away from work. Only six states have broad statutes that prevent employers from prohibiting any lawful behavior. Michigan is the only state that expressly prohibits discrimination on the basis of weight, however the cities of San Francisco and Santa Cruz, Calif., also have this provision (San Francisco makes exceptions for police offi cers, fi refi ghters and the San Francisco 49ers football team). When creating Employee Wellness Programs, employers must keep in mind local statutes as well as established common law.

Savings of Voluntary Worksite Wellness Program = (number of participants x savings per participant) – (expense of program)
Savings of Incentive-based Workplace Health Promotion Program = (number of participants x savings per participant) – (cost of program + cost of incentives/rewards)
Savings of Mandatory Workplace Wellness Program = (number of participants x savings per participant) – (cost of program + cost of policy-related turnover + cost of limited talent pool)

Constructing Corporate Wellness Program policies in a corporation that employs unionized workers can pose unique challenges. Corporate Wellness Programs may be perceived by some unions as a condition of employment and therefore would be subject to collective bargaining between the parties. Still this circumstance can represent an opportunity for both groups, as a policy agreed upon between union leadership and management is likely to be received more favorably by workers. The United Auto Workers and General Motors worked together to create and position a joint Corporate Wellness Program which has successfully reached more than 800,000 participants. (See Case Studies, UAWGeneral Motors LifeSteps Corporate Wellness Program, p.21).

Unless specifically stated otherwise, most employer-employee relationships in the United States are governed by the principle of at-will employment. Under this system a employer, or the employee, can terminate the relationship without any necessitated showing of cause. This at-will standard gives private companies substantial power in governing the behavior of workers. In this environment, companies can Finding Wealth Through Wellness 10 creatively design Corporate Health Promotion Programs based upon their specifi c corporate culture. Corporate Health Promotion Programs generally take three main forms:

Voluntary Corporate Health Promotion Programs – The most popular form of employee Corporate Health Promotion Program, in most cases they are made available to staff members but participation (or lack thereof) is not linked to any type of consequence. Due to ineffective communication, frequently staff members are either unaware of these offerings or confuse them with insurance-based healthcare. Incentive-based – Corporate Health Promotion Programs based on incentives reward staff members for participation in Corporate Health Promotion Program activities. Incentives frequently comprise lower Medical Care premiums, health club membership or customized support offerings. In these programs, employees’ behavior can be linked to a particular reward.

Mandatory Corporate Health Promotion Programs – Some organizations require, or ban, certain health-related conduct. These can take the form of mandatory Health Risk Assessments for staff members and restrictions on smoking or alcohol use. While mandating behavior is an effective method to eliminate high-risk behavior, the cost savings must be measured against the potential message sent to existing and prospective staff members. Given that staff members are already under various levels of scrutiny in the workplace, individuals may resist attempts by organizations to regulate off-duty conduct. Additionally, some staff members may fi nd it diffi cult to comply, forcing organizations into the uncomfortable postion of punishing an otherwise constructive employee.

In the short-term a mandate-based Workplace Wellness Program can guide to an increase in turnover, as staff members either choose to leave or are fi red for noncompliance. In the long-term, the policy may prevent the employer from hiring an otherwise qualifi ed applicant, or may serve as a deterrent for individuals considering the employer. Limits in recruiting, for instance, led CNN to rescind a 13-year ban on hiring smokers.18

Businesses need to make sure that Company Wellness Programs are aligned with the values and culture that drive corporation operations. If a corporation emphasizes trust and individual responsibility, then a mandate-based program will likely cause more dissension than it would in a corporation that already heavily regulates corporation conduct. Moreover, a work environment with a large disengaged population will likely have poor participation in a voluntarybased program. When calculating cost savings, employers need to take a wider view and consider the effects on long-term employee program engagement.

In 2005, Michigan-based insurance benefits provider Weyco instituted a smoking ban for all of its nearly 200 staff members. Workers are subject to random testing and if they fail a mandatory breathalyzer test, they will be fi red. It is believed that Weyco is the first business to use testing to enforce a smoking ban – most corporations ask staff members to self-report behavior. Four staff members (more than 2 percent of the total labor force) left Weyco as a result of the policy. A year prior to the ban the business implemented a $50 smoking fee, which would be waived if a employee passed a nicotine test or agreed to take a smokingcessation class. Weyco’s president Howard Weyers published that 20 staff members quit smoking through this program.20 Workers were told they had one year before the total ban would go into effect. Under the new Workplace Wellness Program, Weyco does offer $35 a month for staff members who want to use a fi tness center and another $65 a month for staff members who meet fitness objectives and goals.

1. Undertake a utilization assessment – While corporations cannot get medical information on individual workers, insurance providers will supply corporations with reports that detail patterns and rates of employee use for things such as physician visits, hospital stays and drug use. This information is essential for a employer to set a benchmark of its current health risk status. Data from human resources(HR) can be integrated with benefits information to support a complete picture of employees’ health-related costs. Then, corporations can determine the specific level of behavior change necessary to result in cost savings. The utilization assessment helps a employer identify the areas in which it should focus its Company Wellness Program to reap the greatest benefits.

2. Build a business case – Once a utilization assessment is in place, employers are able to quantify the Healthcare cost savings that will result from specific levels of lifestyle transformation and risk reduction. This can be done by setting goals/objectives in terms of reductions in identifi able insurance utilization, attendance or disability variables, or by aiming for reductions in health risks and projecting the associated cost savings. Effective estimates factor in the expense of the Workplace Health Promotion Programs as well as the necessary internal marketing efforts that will surround the program. Says Betty-Jo Saenz, American Healthcare Strategy lead for Motorola, “When we started our programs, our focus was on the 20% of employees that made up 80% of the costs. We’ve discussed that, and now we’re paying attention to those who are active and Finding Wealth Through Wellness 8 keeping them healthy. Wherever you are on the continuum, there are opportunities.”

3. Establish a cross-functional wellness group – Organizations need to identify potential group participants who can be champions of wellness within the employer. It is significant that the group is representative of the demographic and functional diversity of staff members so that it can credibly address any specific needs groups may have. This group will serve as the voice and face for the Workplace Wellness Program within the employer. Best practice employers integrate participants from human resources, communications, employer development and upper management. Using the utilization analysis as a guide, the wellness group ought to evaluate what programs would be most effective within each particular corporate culture, aligning health-risk priorities with initiatives that staff members will be receptive to.

4. Build buy-in from upper management – The most effective Worksite Health Promotion Programs have substructure from the highest levels of a business. Support from management, both in words and in action, sends the message that Worksite Health Promotion Programs are a priority for a business. The utilization analysis can be a powerful tool to build the business case for Worksite Health Promotion Programs and convince executives that initiatives are worthy of investment and attention. Meaningful wellness-related messages are integrated into business talks and aligned with corporate objectives.

5. Create a all-inclusive Employee Program Engagement plan – The most brilliantly conceived Employee Wellness Program is meaningless if no staff members participate. Effective wellness communications emphasize both health and monetary benefits at the personal and corporation level. According to a 2004 survey by Towers Perrin, only 28 percent of staff members say their corporation communicates about Healthcare topics other than cost. In addition, wellness-related information ought to be a part of existing corporation communications efforts and not coupled solely with benefits communications. This helps elevate the significance of Employee Wellness Programs and align initiatives with corporation objectives.

Moreover, discussions around Corporate Wellness Programs can share personal success stories and provide company progress updates. Successful organizations not only use existing communications channels to generate discussion around activities, but also consider more interactive tools like message boards, forums, blogs and wikis. This helps personalize initiatives and authorizes for the sharing of best practices within the company.

Many companies involve medical experts to advise in the construction, communication and backing of the program. The use of outside authorities such as these will broaden the credibility of the Worksite Wellness Programs as well as combat skepticism from staff members who may view the company’s motives as merely selfserving.

Another strategy available to corporations is to brand their Corporate Health Promotion Program. This move can increase the visibility and acceptance of the offering. Branded wellness programs are most common when corporations are also promoting an external campaign around Corporate Health Promotion Programs. An example of this is PepsiCo, which launched its HealthRoads Corporate Health Promotion Program internally along with a consumer campaign, Smart Spot, that puts special labels on healthier food and drink options.

These efforts are more effective when they are not owned solely by the internal communications department, but rather when managers serve as leaders of, as well as participate in, Worksite Wellness Programs within businesses. This produces more immediate accountability and motivation.

6. Measure constantly and consistently – At every step of implementation, a Company Health Promotion Program must be able to demonstrate its value to a organization. Company Health Promotion Programs must be designed to allow organizations to set benchmarks and evaluate behavior modification. Measurement ought to consider not only quantitative health measures, but also qualitative measures of stress and employee program engagement. Less than 10% of organizations do extensive management of healthcare expense, employee health risk status or employee satisfaction with benefit offerings, and less than half of organizations do any measurement in these areas at all.16

Measurement is only useful if a organization explicitly specifies what data would constitute success. Potential measures of success comprise:

• Participation rates
• Increased employee engagement
• Lowering of risk status
• Lowering of direct health costs
• Decreased absenteeism
• Reduced disability claims

Motorola’s Saenz advises administrators of Worksite Health Promotion Programs to track as many measures as possible from the start, even if management only needs one, because it is very difficult to retrieve data later. She notes that even if leadership begins by looking at participation rates, they will eventually want to know about reductions in claims and costs.

Frequent assessment is the only way to build backing among management and workers. Nearly half of companies feel a lack of useful data is a top barrier to their ability to manage employee health, and at least 20 percent of companies don’t know how effective existing Corporate Wellness Programs are regarding various outcomes. Companies must lead utilization analyses each year and reevaluate Corporate Wellness Program priorities based upon changes. In Addition, progress must be shared with the wider business community to build backing for initiatives. Managers and executives throughout a company are likely to backing a program that can prove increased productiveness among workers. Effective Corporate Wellness Programs are designed to be fl exible so they can respond to changes in both company objectives and goals and larger health variations.

Company Health Promotion Programs first became popular during the economic boom of the late 1980s and early 90s. Programs featured onsite gyms and massages, and were used as recruitment tools for young workers searching for nontraditional work environments. Still, when the tech bubble burst, so too did the willingness to spend money on perceived perks, and corporations returned to a more old-school benefit structure focused on managed medical care.

In recent years, as Healthcare costs have spiraled out of control, organizations have explored the potential of Worksite Health Promotion Programs as a cost-saving strategy. Employers such as Johnson and Johnson, General Motors, Motorola and Union Pacifi c Railroad have all seen a signifi cant return on investments in employee health (See Case Studies, p.20). Worksite Health Promotion Programs can help reduce the costs associated with:

Medical Care premiums – The cost a corporation pays for healthcare insurance: According to a 2005 study by Hewitt, the Medical Care cost per employee in the American in 2006 will average $8,046, with corporations absorbing nearly two-thirds of that cost.

Pharmaceutical costs – The price of a prescription drug plan: According to a 2005 study by Mercer, the average annual prescription drug costs for sizable companies grew 11.5%, making it nearly a decade straight of double-digit increases in cost.

Short-term disability (STD) – The cost of offering short-term disability insurance to staff members: According to a 2004 study by insurance provider Cigna, the average short-term disability claim results in $13,094 in direct disability payments and healthcare costs. The report also found that 26% of claims related to medical events were a result of chronic conditions that could likely be mediated through Company Wellness Programs, and that these cases amount for 56% of the STD-related healthcare costs.

Absenteeism – The price of missed work: Absenteeism cost businesses $660 per employee in 2004, with nearly one-third of businesses characterizing the trend as a weighty issue.

Presenteeism – The price associated with workers who work at decreased productiveness levels: Sixty percent of the total cost of employee illnesses come from presenteeism, according to a 2004 study by the Institute for Health and Productivity Studies at Cornell University.

The evidence is clear that strategically designed Worksite Health Promotion Programs can decrease both direct and indirect Medical Care costs. A 2004 review of Worksite Health Promotion Programs revealed that, in total, an investment of $1 by a business in Wellness Programming returned a median cost savings of $2.05 to $4.64.