Posts from — March 2009

Conducting an Employee Fitness Challenge at your workplace is a fun and exciting way to raise awareness among staff members about the effect of beginning and sustaining an physical activity program. It is a concentrated effort in which to engage them in physical activity for a specific time period that, hopefully, will help them begin a healthy habit that will last a lifetime.
Still, it is valuable to take part in wellness year-round. This section provides a inclusive list of Corporate Wellness Program ideas that have been implemented within wellness programs.
All ideas presented in this section have been thriving for one or both of the entities. Each activity/idea is able to be used as a stand-alone event, even if you don’t conduct a fitness contest, or is able to be held in conjunction with your Employee Fitness Contest.
You may want to choose some of the ideas you think will work for your workers or come up with others and begin your program to foster a better state of health.

Studies have repeatedly determined that all-inclusive Workplace Wellness Programs, or Workplace Wellness Programs, can decrease healthcare and insurance expenditures, decrease absenteeism, and improve success and work rate. Other advantages determined in studies include improved ability to attract and retain key personnel, greater employee allegiance, and improved public conception of the business.

Medical Care and Insurance costs

A number of studies provide evidence of decreased medical and insurance costs for participants in Employee Health Promotion Programs, particularly wellness programs involving exercise.

For $30 per person, the Bank of America started a Workplace Wellness Program for retirees using a risk assessment questionnaire, self-care books and other mailed materials. Insurance claims were reduced an average of $164 per year in this group while they increased $15 for the control group. Since they were able to document significant changes in risk behavior, they anticipate greater savings in future years.

Pacific Bell’s FitWorks participants claim $300 less per case for a 1-year savings of $700,000. Savings for conditions related to a sedentary lifestyle are $722 per case.

Coca Cola reported a decrease in medical|medical|medical care|healthcare} claims with an exercise program alone, saving $500 per employee per year for the employees (60%) who joined their HealthWorks physical activity program. Prudential Insurance Company reports that the business’s major medical expenditures dropped from $574 to $312 for each colleague in its wellness program.

Decreased Rates of Absenteeism

Absenteeism has been established to be impacted by wellness programs. The evidence indicates a significant reduction in absenteeism and resultant dollars saved as a result of employee physical activity programs.

Pacific Bell’s FitWorks program decreased absent days .8 percent to save $2 million in one year. FitWorks participants also spent 3.3 days less on short-term disability for an additional savings of $4.7 million.

Focusing Corporate Wellness Program efforts on elevated-risk staff members is able to lead to better results. A national manufacturing employer reports a decrease of 12.2 percent in illness days for these staff members.

A two-year study by The DuPont Corporation of the effect of its all-inclusive Worksite Wellness Program on absences among staff members reports that blue-collar staff members at intervention sites had a 14% decline in disability days vs. 5.8% decline for controls. There were a total of 11,726 fewer net disability days.

Enhanced Performance, Productivity and Morale

A number of employers with Company Wellness Programs report documented improvement in job attitude, work performance, energy level, and/or overall morale among program participants–all essential factors in enhancing productiveness.

A Johnson & Johnson study observed that employee attitude changes were greater at Workplace Wellness Program intervention sites with significant positive attitude changes noted in the categories of business responsibility, supervision, on the job conditions, job competence/security, and pay/benefits.

In a Canadian government study, the Canada Life Assurance Business experimental group realized a 4% growth in work rate after starting a organization exercise program, compared to the control group. Further, 47% of program participants published that they felt more alert, had better rapport with their co-employees, and generally enjoyed their work more.

Swedish investigators saw that mental success was significantly better in physically fit workers than in non-fit workers. Fit workers committed 27 percent fewer errors on tasks involving concentration and short-term memory, as compared with the success of non-fit workers.

The Bottom Line

The following sample of Worksite Health Promotion Programs wellness program results have been published by individual employers:

Company: Dollars Saved/Dollars Spent

• Bank of America (Fries): $5.96/$1
• PacBell: $3.10/$1
• Wisconsin School District Insurance Group: $4.47/$1
• Prudential Insurance: $2.90/$1
• Bank of America (Leigh): $4.73/$1
• General Mills: $3.50/$1

Summary

There is growing evidence that a large portion of the billions of dollars currently invested by employers on health-related expenditures is avoidable by means of Corporate Wellness Programs. Well-planned, accross the board Corporate Wellness Programs (Corporate Wellness Programs and Corporate Wellness Programs) have been established to be cost-effective, especially when the Corporate Wellness Programs is matched to the health problems of the specific employee.

Free Workplace Health Promotion Programs and Low Cost Health Management Alternatives

Create a no cost Employee Health Promotion Program or run a successful health management program in the workplace for little or no cost to your employer. The advantages of workplace wellness and learning how to start a health management program at work are many. The articles on health management have generated a variety of questions, mostly from wellness providers but also from corporations trying to start their own wellness workplace programs. There are a number of things to do to start a successful health management program at work.

Ideas for Starting a Free or Low Cost Corporate Health Promotion Program

Prior to starting a low cost or no cost wellness program for your business, learn more about what staff members want. Survey staff members to learn more about their wellness issues. Keep the survey confidential to protect employees’ identities. Typically the most popular workplace wellness issues are smoking cessation, weight loss issues and heart and cholesterol health.

Look for Corporate Wellness Program Freebies

Look for who will come in for free to talk to workers and explore partnerships with outside agents linked with workplace wellness. For example, contact a local branch of a well-known weight loss business and ask if someone is able to come in and talk to workers. Seek agencies that are willing to come in and talk about subject matters related to wellness at no expense to workers, in exchange for something from you.

Find Employee Health Promotion Program Partnerships

Working with a weight loss employer to set up a speaking engagement for employees is the perfect opportunity to explore a potential wellness partnership. The weight loss employer may say that if 10 employees join the program, they will have weekly meetings at employer headquarters for the people who joined. The weight loss group also might offer employer employees a discount if multiple people join the program.

Nonprofits an Untapped Health Leadership Resource

There are also plenty of nonprofit agencies who would be thrilled to visit a company to discuss health management. But it’s up to you to offer them something in return. For example, if the MS Society came in and talked about the signs of MS, the company might offer to organize an MS walk (in keeping with company health management goals, right?), or an auction with employee and company-donated items where the proceeds go to MS. The people at the nonprofit agencies would be glad to open a dialog with your company and to talk about what they would want in return for a speaking engagement. In many cases, they won’t need anything at all for a first meeting.

Collecting Data and Analyzing Company Wellness Program Results

Collecting data and analyzing results of a Workplace Health Promotion Program can be tricky because of HIPPA laws. However, if at least ten workers joined the weight loss program, or 20 people participate daily in the all-new “Let’s Walk a Mile at Lunch” program, that sort of progress can speak strongly to senior staff. And, corporation successes will potentially give senior staff more incentive to support money for additional health management and Workplace Health Promotion Programs in the future.

Small business wellness programs are catching on. A well-designed wellness program can boost work rate, boost morale and vitality, cut stress, cut absenteeism, and control preventable medical care costs within a business. The beauty of it is that you’re simply assisting staff members to make smart choices so the costs of implementing a wellness program are minimal in comparison to the benefits.

Employee health is a primary concern for small business owners. In a small business, even a few sick employees can disrupt the flow of the workplace and bring the operation to a standstill.

Instead of sitting back and hoping for the best, some small organization owners are taking the matter of employee health into their own hands by launching Employee Wellness Programs. Here’s how they work.

Overview of Corporate Health Promotion Programs

Employee wellness programs are programs instituted by the corporation to better the overall health of their labor force and to help individual staff members overcome specific health-related hurdles. These programs are able to be provided in a variety of formats: In mandatory employee training sessions, as voluntary classes, or through an outside provider offering a wide-range of Employee Assistance Program(EAP)s.

In every case, however, the employer foots the bill for the programs because an investment in employee health is a employer investment that directly impacts the employer’s bottom line.

Why offer Workplace Wellness Programs?

Apart from the obvious issue for the health of your staff members, there are numerous other reasons why Corporate Health Promotion Programs make sense for small businesses. From the get-go, your business will profit from the decreased level of absenteeism that goes hand in hand with a healthy workforce.

Workplace Health Promotion Programs will also reduce the number of injuries that occur in the workplace, not just from accidents, but also from repetitive motion and other recurring sources. Since even a minor blip in worker attendance is able to have a large impact on a small employer, a more reliable workforce will finally translate into a smoother work cycle and a more robust bottom line.

Corporate Health Promotion Program Features

Employee Wellness Programs are able to cover a broad range of health-related topics. Based on your staff members’ needs, it’s completely up to you to determine the kind of programming you wish to offer. Nonetheless, most Employee Wellness Programs offer some at least some programs in the following areas:

• Nutrition. Diet is able to significantly effect an employee’s ability to do their job effectively. Nutritional programs educate staff members about meal options and equip them to make healthy dietary choices.
• Physical Fitness. In addition to diet, exercise is an significant factor in a healthy lifestyle. Workplace Health Promotion Programs generally provide staff members with opportunities to incorporate exercise into their daily lives.
• Tobacco Cessation. Statistics prove that smokers tend to fall ill more generally than their non-smoking peers. Since sick staff members disrupt the workplace, smoking cessation programs are a no-brainer for both employers and staff members.
• Physiological Testing. Many employers offer physiological as a regular part of their wellness programs. Cholesterol tests, Blood Pressure (BP) screenings, and other simple exams can offer early warning signs for more somber issues.
• Stress Management. Stress itself takes a toll on employees. However, stress is also linked to other health concerns such as depression, cardiovascular disease, diabetes, and obesity. Corporate Wellness Programs that help employees deal with stress better not only the mental health of your employees, but their physical health as well.

Establish a Corporation Company Health Promotion Program for Your Workers Today

The advantages to starting a workplace health and wellbeing program are abounding.

A few corporate health and wellness tips to get staff members started on the path to a healthier lifestyle:

1. Look around, and determine if staff members lead a healthy lifestyle before launching an Corporate Health Promotion Program. How many staff members dash outside at lunch for a smoke break? Would a smoking cessation program help? How often do the junk food-laden snack machines must be replenished? Is anyone exercising or taking advantage of local walking trails as part of their healthy living goals? The answers to these questions will give corporations a better idea of the Corporate Health Promotion Program that’s right for them.

2. Survey workers to determine their healthy lifestyle habits. Are they exercising regularly? Eat three square meals a day? Have regular physicals? Really? Then what planet are they on? Because we would love to visit! A corporate wellness program benefits most companies because workers don’t have the time or energy to stay on top of health and wellness concerns at work or when they leave the office to go home.

3. Give Company Health Promotion Programs a tremendous kick-off with a healthy living “fair.” Provide employees no cost flu shots, Blood Pressure checks, blood lipid screenings, body/fat ratio assessments, tobacco cessation programs and no cost mammograms- and contact the local hospital, because there’s plenty more where this came from. Corporations keep their employees hopping during the week. Give employees a chance to amp up their healthy lifestyle on the employer dime. A corporate health and wellness program is an additional benefit that employees get for working for the employer!

4. Incent to live- offer cash money for workers to lose weight, commit to a tobacco cessation program and generally enjoy a healthier lifestyle. Encourage humankind’s innate competitive nature by offering prizes for wellbeing and health employee “winners.” And, promote a healthier lifestyle by sponsoring workers who wish to enter a local 5K for charity race, run a marathon or play a sport.

Introduction to Employee Wellness Programs

The previous ten years has brought big changes in corporation attitudes toward Worksite Health Promotion Programs. Interest in self-help and self-care programs has increased as growth in healthcare costs have encroached substantially into profits. Changes in the corporation structures of healthcare facilities, in particular the growth of the for-profit healthcare sector, and the need to contain costs are changing the ways in which purchasers of healthcare plans are viewing their own efforts toward provision of worksite healthcare programs and facilities. Projections for the next decade indicate that worksite health programs will continue to become valuable factors in the provision of healthcare, including prevention activities, for both government and private industry. In companies with existing Worksite Health Promotion Programs, administrative rationale for sponsoring these activities ranged from improving employee health (28%) to improving employee morale (9.7%). Programs include interventions associated with safety, health risk assessment, smoking cessation, Blood Pressure (BP) control, nutrition programs and stress management. Benefits cited range from improved health and productivity to reducing healthcare costs.

Demographics of the U.S. Workforce
• 110 million American citizens composed the civilian labor force in 1981; by the year 2000 the civilian labor force is expected to be nearly 140 million.
• 44% of the 1984 labor force was female; ten% was Black.
• The median age of the workforce is 32 years and is expected to increase to 32 years by 2030.
• 57.9 percent of all employees work in businesses with between 2 and 500 employees; 45 percent work in businesses with fewer than 100 employees. An additional 7.5 million Americans are self-employed and 3 million are farmers.
• 18% of all wage and salaried workers in 1985 were union members.
• 45 percent of all staff members are employed in offices.

Prevalence of Workplace Wellness Programs Activities

Based on a 1985 survey, almost 66% of worksites with 50 or more staff members had Workplace Wellness Programs activities in 1985.  The frequency of workplace-based activities by selected categories in 1985 was:

Activity

Smoking Control       35.6%
Health Risk Assessment    29.5%
Back Care             28.6%
Stress Management       26.6%
Exercise             22.1 percent
Off the Job Accidents    19.8 percent
Nutrition             16.8 percent
Blood Pressure (BP) Control    16.5%
Weight Control          14.7%

Worksite size is the strongest indicator of program prevalence.

Most workers believe the advantages of their Employee Wellness Programs activities outweigh the costs, even though few formal evaluations exist.

The most usually given reason for starting programs and perceived advance from programs is improved employee health.

At most worksites with activities (85.4%), all staff members are eligible to take part. 30% of worksites with activities offer them to employer dependents, and an equal percent offer them to retirees.

When worksites seek outside program assistance, they turn to voluntary, not-for-profit companies (57.1%), private for-profit providers-consultants (50%), local hospitals (44%), and insurance companies (43%).

Smoking Cessation Programs

Smoking related health problems cost U.S. organizations $26 billion per year in lost productiveness and $7 to $8 billion in smoking-related health care expenditures.

Staff Members who use tobacco are 50 percent more likely to be hospitalized than non-smokers, have 2 times as countless job-related accidents as non-smokers and have absenteeism rates approximately 50 percent higher than non-smokers.

People who smoked an average of one or more packs of cigarettes per day had 118% higher medical costs than non-smokers.

76 percent of current smokers and 80 percent of former smokers and people that do not use tobacco feel that businesses ought to restrict smoking to certain areas.

In 1985, 65% of smokers, 85% of people that do not use tobacco and 78% of former smokers, felt that tobacco users must refrain from smoking in the presence of people that do not use tobacco.

In 1986, 17 states had laws regulating smoking in offices or workplaces either in government-controlled offices or offices of private employees.

Examples of tobacco cessation intervention program used by companies include:

• providing non-smokers a discount of health and life insurance;
• paying full or partial fees for smoking cessation programs;
• offering cessation programs on organization or shared time;
• making available cash payments to quitters after 6 of 12 tobacco-free months;
• participating in national quit smoking days; and
• adopting a smoke-free company policy and setting deadlines for implementing the policy.

Physical Fitness Programs

An active 55-year-old man can lead as vigorous a lifestyle as a sedentary 35-year-old.

Differences in work-related activity has been shown to provide a two- to three-fold difference in cardiovascular deaths between active staff members and their more sedentary counterparts.

In addition to improving strength, balance, and flexibility, exercise programs are able to lower the probability of back injuries among certain occupational groups.

93 million workdays in the United States are lost each year due to back concerns.

Research findings support the notion that worksite exercise programs better fitness and help lower other health risks, although results related to improved productiveness are weak due to lack of methods for accurately measuring productiveness.

A very small percentage of worksites have on-Site physical fitness facilities.

The majority of staff members sponsored exercise program involve skills training such as aerobic dance, low impact aerobics, weight training, preand post-natal physical activity classes, and walking/jogging groups.

Some businesses subsidize employee participation in neighborhood “Ys,” health clubs or other neighborhood programs if no onsite facilities are available.

Job Site exercise program may decrease expenditures to employers by lowering employee medical care claims and expenditures.

Participants whose weekly exercise was equivalent to climbing less than five flights of stairs or walking less than a half mile, spent 114 percent more on health claims than those who climbed at least 15 flights of stairs or walked 1 1/2 miles weekly.

Healthcare costs for obese people are roughly 11% higher than those for thin people.

Nutrition and Weight Control

One-third of this country population is obese to the extent of decreasing their life expectancy.

Improvements in eating habits have the potential to lower the risk of weighty health issues such as elevated Blood Pressure and blood lipid levels and is instrumental in the control of non-insulin-dependent diabetes.

The workplace offers several advantages for diet education; support and influence of co-staff members and upper management, availability of a daily eating situation, and opportunities for follow-up and monitoring.

Job Site diet programs can be grouped in 6 broad categories:

• cafeteria programs;
• multi-component programs;
• weight management programs;
• blood lipid reduction programs;
• programs for pregnant and lactating women; and
• other diet education issues.

Men are less likely to take part in weight-loss programs than are female workers.

Stress Management

Estimates suggest that 50 percent to 80 percent of physician visits are able to be attributed to psychosomatic or stress-related origins.

Company pays many of the expenditures related to employee stress, both directly in the form of medical expenditures and in decreased productiveness.

Job factors which are associated with stress include:

• not allowing staff members to take part in decisions about the work process;
• positions which require more or less skill than the employee has;
• changes in work demands;
• lack of clarity about expectations and standards; and
• conflict with co-workers or supervisors.

Most workplace stress management programs are implemented as a result of requests from employees.

Stress management programs focus on three types of skills: relaxation skills, coping skills, and interpersonal skills.

Worksite stress management programs are often delivered in one of three formats:

• classes conducted by trained professionals;
• self-learning tools; and
• personal teaching to assist  with self-assessment, planning for changes, learning new skills and responding to life crises.

The two major techniques used in worksite stress management programs are:

• teaching people to lower the negative physical effects of stress; and
• teaching people to recognize and control sources of stress at work and in personal life.

Safety Belt Usage

Motor vehicle accidents are the largest single cause of lost work time and on-the-job fatalities of United States business.

Motor vehicle accidents account for 27 percent of all work-related deaths and 45 million days of lost work annually.

Greater than 36% of the 11,300 accidental work deaths in 1983 involved motor vehicles.

Staff Members who routinely fail to use seat belts may spend up to 54% more days in the hospital.

Traffic accidents caused about 3 times as many days of restricted exercise as any other type of disability.

Motor vehicle crashes cost $15.2 billion in lost productiveness, 88% of which is attributed to losses from workforce activities and future earnings.

In work settings where safety belt policies, requiring use of belts by anyone riding in a organization vehicle or using a private vehicle for organization business, have been enforced, 60 percent to 90 percent use has been stated.

Incentive programs, accompanied by education and use requirement restrictions have resulted in 40 percent to 70 percent initial usage rates.

Factors influencing the sources of workplace safety belt programs include:

• active commitment on the part of senior staff;
• clearly defined and well enforced policy of necessitated belt use on the job;
• beneficial rewards and incentives; and
• ongoing education and training programs.

Case Studies of Company Wellness Programs

Based on an extensive assessment of its inclusive employee Worksite Health Promotion Program, LIVE FOR LIFE, Johnson & Johnson reported the break-even point for the program occurs in year 3 and by year 5 they have a net benefit of $316 per employee. Their year 9 projected benefit is $677 per employee.

employees at four Johnson & Johnson employers who were exposed to the Worksite Health Promotion Program increased their daily energy expenditure in vigorous activity by 104 percent compared to a rise of 33 percent among employees at employers that were provided only an annual health screen.

Participants in the United Methodist Publishing House’s Corporate Wellness Program submitted more claims (1.14 per participating employee and .82 for the control in 1984, 1.44 and 1.3 respectively in 1985), but the average cost per claim was less for participants ($316 for participants and $567 for control, in 1984, $262 and $602 respectively in 1985, $270 and $566 respectively in the first four months of 1986).

The United Methodist Publishing House attributes some of the reduced than projected use in medical care costs for 1985 ($902,116 projected with actual costs $142,884) to the Employee Health Promotion Program even though the results are not conclusive.

In 1985, the Adolph Coors Organization conducted a phone interview of a random sample of its 10,000 staff members to determine changes in health practices since the introduction of an employee Corporate Wellness Program 4 years earlier. The sample of 495 staff members was stratified to match the business profile in terms of age, sex and job description. The survey reported that 65% of respondents started exercising in The previous 4 years, 37% had improved their diets, 20% were regular users of the wellness center, 9% had stopped smoking as the result of the business’s tobacco cessation program and active participants of the wellness center miss an average of 1.96 workdays every year due to illness or injury compared to 3.08 days for non-participating staff members.

The Coors Business also saw a cost savings from a cardiac rehabilitation program that was launched in 1981. In 1980 workers were out of work 7.2 months after a heart attack or bypass operation. In 1984, cardiac patients were out an average 1.9 months saving $152,000 in lost work time and in 1985 cardiac patients missed an average of 2.6 months, saving $125,000 that year.

Company Physical Activity Programs Plans Improve Employee Health and Wellness

Instituting a Worksite Wellness Program improves the health of staff members, decreases employee absenteeism and saves the organization money, too. Learn more about starting an Worksite Wellness Program in the office.

Benefits of Employee Wellness Programs

• A corporation cost of $100-$150 per employee each year to participate in an Employee Health Promotion Program can save employers $300 to $450 for each employee every year, according to Ron Goetzel, Director, Cornell University Institute for Health and Productivity Studies. The savings have the potential to take a few years to actualize, says Goetzel, and are seen in decreased health expenditures.
• The Wellness Councils of America stated a $24 return for every $1 spent on a Corporate Wellness Program for small organizations.
• According to a 2005 survey by The Art of Health Promotion, organizations who instituted Employee Wellness Programs realized a 30% reduction in healthcare and absenteeism expenditures in less than four years.

A thriving Employee Health Promotion Program starts with Senior Leadership. Company owners should lead by example, taking part in their business’s fitness program and working closely with a wellness coach. Senior Leadership should make sure workers are well alert to their wellness efforts, displaying weight loss results or smoking cessation results on business intranet or bulletin boards for everyone to see.

Corporate Health Promotion Programs that Really Work

• Encourage staff members to kick start their own wellness programs by visiting their doctor. A complete physical ought to include information about blood glucose, blood lipids levels and general health.
• Target specific health-related issues in a corporate fitness program. Information about how to fight obesity, smoking, alcoholism and prescription abuse must be at the forefront of an Company Health Promotion Program, along with related conditions.
• Hire a wellness coach to instruct staff members on how to lead a healthy lifestyle.
• Reward staff members for taking part in company wellness plans. Let staff members accrue wellbeing and health points that they can redeem for prizes. Make the prizes healthy, too- a no cost massage, private training session with the company’s wellness coach or health meal gift certificate encourages even healthier lifestyle choices.
• Acknowledge employee health and wellbeing leaders in employer newsletters, in posted bulletins and on the employer intranet.

Employee Health Promotion Programs Yield Big Results

For organization owners who want to broaden employee participation in a Company Wellness Program, consider Johnson & Johnson’s approach. Faced with only 26% of workers participating in their employee wellbeing and health program, Johnson & Johnson offered workers a $500 discount on health care insurance expenditures if they completed a health risk profile. The number of workers participating in the Johnson & Johnson organization physical activity program jumped after they offered the incentive — to more than 93%.

Ron Goetzel encourages those looking to pitch a corporate exercise program to Senior Management to use basic facts about the advantages of Workplace Wellness Programs as part of their argument. Keep it simple, and share results from other company’s employee wellness plan success stories.

Five reasons to have a wellness program

1.   The U.S. spends more dollars on healthcare than any other country yet we are not the world’s healthiest
   • Largely sedentary
   • Tobacco use is still popular
   • Stress is at epidemic levels (WHO)
   • Alcohol continues to take its toll on Americans

2.   Much of the illness in America is avoidable
   • Tobacco and alcohol are leading causes of death
   • As much as 70% of the cost of medical care is driven by avoidable illness

3.   Healthcare expenditures continue to rise
   • Medical Care premiums continue to rise and to be passed on to the employee
   • Medical Care expenditures are usually the number one benefit cost to most employers

4.   The worksite is an ideal setting to address health and well being
   • Most Americans work
   • Poor health habits take a toll on American Employers
   • Employers have a vested interest in health related issues.

5.   Research validates that Workplace Health Promotion Programs have the potential to better health, save money, and even produce a ROI.
   • Aldana,S.G. (1998). Financial impact of Workplace Wellness Programs and methodological quality of the evidence. The Art of Health Promotion. Vol 2, Number 1.
   • Wilson, M.G. (1996). A all-inclusive review of the effects of Company Wellness Programs on health related outcomes: An update. The American Journal of health promotion. Vol 10, Number 6.
   • Wilson, M.G. (1996). A comprehensive review of the effects of Employee Wellness Programs on health related outcomes: An update. The American Journal of health promotion. Vol 11, Number 2.
   • Chapman, L.S. Proof Positive: An analysis of the cost-effectiveness of worksite wellness. 3rd ed. Seattle: Summex Corporation, 1996.
   • Pelletier, K.R. A review of the health and cost-effective outcomes studies of comprehensive health promotion and disease prevention programs at the worksite: 1993-1995 Update. The American Journal of Health and Promotion. Vol. 10, Number 5.

   
Key Components of a Company Wellness Program

Physical Wellness – Focuses on the development, maintenance, or improvement of one’s physical fitness

Sample Physical Workplace Wellness Programs / Workshops
• Annual health evaluation
• Regular physical exercise
• Smart safety habits

Emotional Wellness – Focuses on all aspects of mental fitness

Sample Emotional Workplace Health Promotion Programs / Workshops
• Stress management courses
• Accepting aging
• Addictive behaviors
• Parenting

Financial Wellness – Focuses on improving the quality of life of employees by assisting families and people in becoming monetarily stable

Sample Financial Company Health Promotion Programs / Workshops
• Financial management
• Savings and Investing
• Credit and Purchasing
• Insurance and Estate Planning

Spiritual Wellness – Focuses on promoting a healthy inner self

Sample Spiritual Corporate Health Promotion Programs / Workshops
• Encourage daily devotional readings
• Give regular service opportunities
• Provide a daily/weekly/monthly chapel (meditation) time during work hours

Nutritional Wellness – Will see to the needs of the employees through group and individual nutritional services

Sample Nutritional Workplace Health Promotion Programs / Workshops
• Individual nutritional Assessment
• Individual and group counseling
• Instructional classes
• Weight loss programs

Many employers, as part of their efforts to contain rising healthcare expenditures, are implementing worksite programs variously described as Company Health Promotion Programs, lifestyle programs, health and productiveness management, population health management and, simply, wellness programs.

The purpose of this article is to consider whether such programs improve health. If so, do they in turn decrease utilization of healthcare services and decrease healthcare expenditures?

The popular media have done much to reward the concept of business wellness. Last year, In Business: Madison magazine printed a story accompanied by a table reporting an impressive range of returns on investment (ROI):

Return on Investment (Per dollar ROI for lifestyle programs)
• Coors $6.15
• Kennecott $5.78
• Equitable Life $5.52
• Citibank $4.56
• General Mills $3.90
• Travelers $3.40
• Motorola $3.15
• PepsiCo $3.00
• Unum Life $1.81
Source: 2004 T.E. Brennan Employer, as published

Would these ROIs stand up to thorough empirical analysis of the data? What factors create such disparate returns among these programs? And does the published literature, subject to peer review of scientific methods, support the ROIs published here?

Health and Productivity Leadership

Illness and injury associated with an unhealthy lifestyle or potentially-modifiable risk factors is stated to account for at least 25% of employee healthcare expenditures. The most significant of these risk factors are stress, tobacco use, overweight or obesity, physical inactivity, excessive alcohol use, and poor nutritional habits. Over the past two decades, a variety of groups at the local, state, and national echelons have promoted the concept that health risk reduction and care management programs have the potential to improve employee health, and that worksite health education, health risk management, and benefit counseling must complement standard medical insurance benefits.

The intensity of Workplace Wellness Programs range from bulletin board, pamphlet or newsletter information to worksite fitness facilities, health risk reduction classes, and personal lifestyle change coaching.3 Workplace Wellness Programs today often include a health risk assessment (HRA) to evaluate each employee’s modifiable risk factors of disease. Program coordinators then target interventions to those that are at increased risk through personal talks and individual follow-up.

All-Inclusive Company Wellness Programs may include classes on health risk reduction and job safety, fitness and exercise activities, health club memberships, and reductions in co-payments or premiums for workers who adhere to recommended medical assessment instructions.

Along with this, some employers are restructuring health benefits and encouraging employees’ cost-sensitivity when accessing medical.5 These changes are intended to lower employees’ need for and utilization of medical, provideing reduced group medical costs. Demonstrated reductions in medical expenditures should then support employers with a powerful bargaining chip in negotiating decreased health care insurance premiums during future terms.

Evidence basis: A range of return on investment estimates

The empirical research has produced results as varied as the popular media on return on investment. Nonetheless, evidence continues to grow that well-designed and well-resourced Employee Wellness Program and disease prevention programs provide multi-faceted payback on investment. Peer-reviewed evaluations and meta analyses show that return on investment is achieved through improved worker health, reduced benefit expense, and enhanced productiveness.

• Goetzel and colleagues, in their meta-analysis of two dozen articles summarizing economic evaluations of health and productivity management programs, reported an average return of $3.14 per $1 invested in traditional Worksite Wellness Programs. The ROI estimates for the individual programs ranged from $1.49 to $13.7,8
• Aldana reviewed 72 articles and concluded that Company Health Promotion Programs achieve an average return on investment of $3.48 when considering medical care expenditures alone, $5.82 per $1 when examining absenteeism, and $4.30 when both outcomes are considered.
• Ozminkowski and collagues conducted a 38 month case study of 23,000 participants in Citibank, N.A.’s health management program and reported that within a 2 year period, Citibank realized a ROI between $4.56 and $4.73.10  Follow-up studies saw improvements in the risk profiles of participants, with the high-risk group improving more than the “usual care” group11 as a result of more intensive programming.
• Chapman’s 2004 meta-assessment of 42 research studies, ranking central validity of the research studies, reports cost-benefit ratios from $2.05-$4.64.

In addition to immediately quantifiable cost reductions, researchers have published a variety of spin-off benefits: greater productiveness, intellectual capacity, and reductions in disability12 and absenteeism.9,13,14,15 Such programs may also have beneficial effects on employee perceptions of the company14 and worker morale, even among nonparticipants. 13 These outcomes go beyond savings in direct healthcare costs to provide non-health related return on investment.

Tailoring program to maximize ROI Worksite Wellness Programs aim to cut the health risks of employees at high risk while maintaining the health status of those at low risk. A variety of disease management interventions are available to fit the specific risk profiles of various worksites. Insurers and organizations now seek to calibrate their interventions in order to achieve optimal risk reduction and costeffectiveness.

In 2001, University of Michigan researchers published on stable trends in medical costs for over 2 million current and former staff members in an 18 year data set. The mean cost increase per risk factor gained ($350) was found to be more than double the mean cost decrease per eliminated risk factor ($150). In other words, increases in costs when groups of staff members moved from low risk to high risk were much greater than the decreases in costs when groups moved from high risk to low risk. Their conclusion: Programs designed to keep healthy people healthy will likely offer the greatest return on investment.

On the other hand, Pelletier’s meta-analysis16 and other program evaluations18 suggest that individualized risks reduction for high-risk staff members within the context of all-inclusive programming is the vital element in achieving beneficial clinical and expenditure outcomes in workplace interventions.

Dose-Response?

Several factors might affect the impact of various programs and the ultimate return on investment, including cultural and environmental factors, workforce demographics, level of participation and longevity of the program.

Most cost-benefit studies have been conducted in large organizations with more than fifty employees. But researchers have demonstrated that similar results are able to be obtained by small organizations with as few as five employees actively involved in a well-managed program.

Various studies also suggest that even relatively modest levels of participation have the potential to achieve substantial program influence. Contrary to reports by the popular media that such programs require more than 70% participation, published reports of at least one case showed beneficial return on investment with 51% participation.

Length of intervention appears to be a more salient variable: an impact on healthcare costs generally requires three-to five years of programming.

Future developments

Despite the abundance of positive program evaluations, several caveats remain. Negative results are less likely to be reported or published, thus biasing the ROI upward.

Uncertainty persists regarding the specific impact of the various program components. But as these programs take hold, further research and assessment will enable fine-tuning of program investments.

Meanwhile, the preponderance of data and the strength of the published research stand in favor of a beneficial ROI for Worksite Health Promotion Programs. Indeed, the organization case for such programs is now well enough defined that some insurance brokers offer discounted rates to employers that institute or subscribe to wellness programs.

Future questions will focus on how best to combine accross the board and focused interventions, the intensity of components, and how to calibrate the dose-response model to achieve a target ROI. Here, employers, employees, and researchers will need to collaborate to define mutual objectives and goals in terms of both clinical and cost outcomes.

As businesses today continue to compete in the worldwide economy, expenditure containment strategies will be increasingly valuable. Controlling the rising expenditure of employee sickness is becoming a priority for corporate leaders. The emerging corporate culture in this country is one which has an employee population centered in health, safety and wellness.

Establishing a corporate plan for Worksite Health Promotion Programs and disability management makes great organization sense. The following eight-step process ensures a strategic, integrated, needs-driven and results-oriented approach.

The following process works best in organizations with strong leadership and a long-term commitment to employee health.

1. Identify Your Company Health Promotion Program Champion

This person ought to be a leader in your organization and a strong advocate of health. Most frequently this is an individual who actively pursues his or her own personal quest for good health.

The program champion must have the resources and authority to propel the program forward. The program champion’s key role is to make sure the strategic plan for health is aligned with the corporation’s objectives, strategic focus and corporation values. By way of example if the organization promotes that “our strength is our people” the wellness program must corroborate how drives will nurture and protect that important resource.

2. Form Your Employee Health Promotion Program Strategy Team

The Workplace Health Promotion Program Strategy Team ought to include decision makers and stakeholders from sections of the corporation that are able to impact health and the company’s bottom line. These areas may include; finance, human resources, training and development, health services, compensation and benefits, employee assistance services (EAP), marketing, facilities, health and safety, rehabilitation, cafeteria or food services and the union. A team of six to eight representatives is recommended.

The role of the Strategy Team is to cultivate and enable the strategic plan, look for opportunities to reward health, ensure the program is integrated into key areas of the organization, streamline efforts, maximize employer resources and program evaluation.

3. Complete an Organization Health Audit

The purpose of an Corporation Health Audit is to evaluate your existing programs and services, physical environment and policies & procedures that support health. It is also important to look at your employer culture or “how things are done” around the employer.

Members of the Strategy Team complete the Audit independently and then meet to discuss their assessment. During the assessment process, health issues and opportunities are discussed in preparation for the development of the strategic plan.

4. Analyze Your Organization’s Cost Pressures

Cost pressures are identified by analyzing a number of areas including; benefit expenditures, Workplace Safety Insurance Board (WSIB) claims, drug usage, type of paramedic claims, absenteeism data and EAP utilization. This process helps to target areas that can be positively impacted by a Workplace Wellness Program and to provide a baseline for evaluating change.

5. Conduct a Health Risk Appraisal or Employee Needs & Interest Survey

The next step is to determine your employee’s health risks, interests and readiness to change. A confidential health risk appraisal can accomplish countless objectives and goals. It provides a baseline from which to measure personal lifestyle changes, provides employees with relevant health information, motivates employees to take charge of their health and assists in program planning. Most health risk appraisals offer individual reports and a corporate report identifying high-risk areas in the company.

Many organizations opt to administer customized needs and interest survey to evaluate employee needs. The benefit of this approach is that the organization is able to gather information on the employees’ perceived wellness needs and program interests. This information can be incorporated into the strategic plan. Administering a survey also has the added benefit of fostering a sense of employee ownership to the program.

6. Develop Your Strategic Plan for Wellness

The strategic plan ought to incorporate information gathered from the Organization Health Audit, your organization’s expenditure pressures, and health risk appraisal data or employee survey results. The strategic plan ought to include your program mission, three or four objectives and several drives under each goal. The strategic plan provides a framework to encourage, support and evaluate “best health practices.”

It is also valuable that the plan align itself with the vision, goals of the organization.

The sample strategic plan that follows was developed for blue jeans maker Levi Strauss & Co. (Canada) Inc. Levi Strauss & Co.’s mission statement and aspirations (how employees interact with each other in a business environment) guided the development of the plan.

Levi Strauss & Co.’s aspirations include the following statement: Most importantly, we want satisfaction from accomplishments and friendships, balanced personal and professional lives, and to enjoy our endeavors. The wellness program plan included a number of components to make sure that it embraced this statement including the following:

1. A vision statement, which tied in with the company’s aspirations.
2. An incentive system to encourage and reward the accomplishment of healthy milestones.
3. A recognition system to applaud success.
4. Friendly competitions between Levi Strauss & Co. locations to ensure a fun environment.
5. Opportunities to participate in small group educational programs to develop group backing.
6. Initiation of support groups for employees completing wellness programs (i.e. smoking control support group).
7. Programs concerning work and family balance.

Other information that was analyzed and used to cultivate the plan included:

1. Employer demographics
2. Focus groups
3. Cultural audit
4. Top prescription report
5. EAP utilization
6. Employee benefit services report
7. Health and dental claims
8. Operational performance summaries
9. Health risk appraisals
7. Prepare a Corporation Case to Support Your Plan

Your company case for wellness provides the necessary details for approval at the senior staff level. The company case includes:

1. The Strategic Plan for Health
2. A proposed program budget
3. Marketing strategies
4. Program leadership options
5. An implementation plan
6. Evaluation methodology.

In presenting the strategic plan it is significant to highlight how the plan aligns itself with the strategic direction of the organization.

The program budget ought to include educational resources, marketing costs, rewards and incentives, leadership costs and supplies.

Marketing strategies must address how the program will be promoted and rolled out to various groups within the organization i.e. decentralized locations, elevated risk workers, older workers.

Program leadership must address how volunteers will be used, internal resources  and whether consultants have been proposed. All play an equally important role in the implementation of your wellness program.

The program implementation plan must incorporate the following types of programs that help foster awareness of beneficial health practices, support  employees in making lifestyle changes and drives, which support long-term change.

Awareness programs establish an awareness of the importance of healthy lifestyle practices and arouse workers to take the next step. Examples of awareness programs include posting educational posters, newsletter articles and lunch and learn courses.

Lifestyle change programs are more inclusive and longer in duration. They are designed to assist  workers in changing behavior. Examples of lifestyle change programs are nutrition education programs, stress management programs, back care classes and smoking control programs.

A supportive corporate environment encompasses everything from corporate policies & procedures, the physical environment and creating a corporate culture that supports great health practices. Follow-up sessions and support groups for staff members who have completed 6-10 week wellness programs also support a supportive environment for long-term change.

Reviewing the effectiveness of a Company Wellness Program is ongoing. A formal assessment ought to be conducted annually and may include; re-administering steps three to five, program participation statistics and a year end survey to revisit “soft” problems such as morale, program satisfaction and future program direction.

8. Solicit Input and Communicate Your Plan

Employee input is critical to the long-term effectiveness of your program. An Employee Advisory Committee should be formed to roll out the plan. Another key responsibility of this group is to solicit feedback from all echelons of the organization to ensure buy-in. Front line Manager’s Information Sessions and focus groups are also significant. This group needs to buy-in to the notion that they play a key role in supporting positive health practices. Regular meetings are advised with front line managers to receive ongoing input, address concerns and orient new managers.

Conclusions

The World Health Organization’s definition of health is “a state of complete physical, mental and social wellness and not merely the absence of disease and infirmity.” In order for us to set up healthy workplaces, wellness drives must have a program champion, have employee ownership, be upper management supported, outcome driven and strategically aligned with the central employer objectives of the organization.

Wellness plan that embrace these qualities will have a positive effect on an organization’s bottom line. Canadian research points to a myriad of case studies where workplace programs have resulted in decreased absenteeism, reduce claims and increased productiveness.

Employers who have embraced wellness as part of “how they do business” have one thing in common. They verify a commitment to their most important resource – their people. They be aware of the increased pressures associated with downsized organizations, a rapidly changing workplace, an aging work force and the challenge of balancing work and family obligations. And they share a common belief that healthy workers are happier, absent less and more beneficial.

References:
Design of Workplace Wellness Programs by Michael P. O’Donnell. 1995. Published by the American Journal of Health Promotion.
Pro Fit-ability by Veronica Marsden. Group Healthcare Management. May 1997.
Meeting Expectations by Laura Mensch. Employee Health and Productivity. August 1999
7 Steps to Health Promotion by Daphne Woolf and Veronica Marsden. Group Healthcare Management. February 1996.
Published in The Journal of Health Promotion for Northern Ireland, Issue 9, March 2000