Stephenie Overman

Many offer basic wellness initiatives, few track results

By: Stephenie Overman

he majority of organizations surveyed by the International Foundation of Employee Benefits Plans do offer some type of wellness initiative, at least basic education programs, but many don't know if the efforts are paying off.

Organizations tend to start with "almost informal programs," says foundation senior information specialist Kelli Kolsrud. "They start modest, almost patchwork, then evolve into more formal, integrated programs."

Sixty-two percent of the 464 respondents offer some sort of wellness initiative, either in a stand-alone program (36%) or as a part of their group health plan (26%). Just over 43% of the 53 Canadian organizations in the survey offer some form of wellness initiative.

Forty-six percent of those organizations that offer wellness programs use in-house staff, 11% hire outside vendors, 4% rely on employee volunteers and 39% use a combination.

The most prevalent initiative offered by employers, according to the survey, is wellness education/resources at 80%, followed by health screenings (74%), subsidized flu shots (70%), health risk assessments/appraisals (68%) and smoking cessation programs (60%).

More than 80% of those responding said they have an average employee participation rate of 50% or below.

Only 13% of the organizations surveyed give cash incentives, while 35% reported that they give merchandise, often wellness-related items such as water bottles and gym bags, Kolsrud says. And 25% give gift cards or certificates, again often to sports-related stores.

Improved employee health (44%) was the benefit most often cited by the organizations polled, followed by improved employee morale (43%), lower health care claims or costs (29%) and reduced absenteeism (18%).

Fewer organizations listed higher productivity (15%), reduced workers' compensation claims or costs (7%) and reduced turnover (6%). "There are lots of variables that go into turnover and productivity," Kolsrud says, making them difficult to measure.

Forty-one percent of the respondents don't know what advantages their organization derives from their wellness program. Part of the problem, according to Kolsrud, is that many organizations "don't do a lot of benchmarking to start. They don't do data-gathering before they start to get a good comparison, even though they are spending money" on these programs.

Educating health care consumers

IFEBP survey participant Elaine Johnson came to appreciate the importance of basic wellness education several years ago when she began looking into consumer-driven health insurance for Lake County, Ill. government workers. She realized the county's 2,800 employees weren't ready.

"The key to success is employees being consumers, in their being educated," says Johnson, the county's employee services manager. "I did a survey and found our employees were not educated." They generally didn't know, for example, the true cost of prescription drugs.

"Before we could go into a new plan, we had to do new communication and education," she says. That led, two years ago, to a wellness initiative that now includes a weight loss challenge, a "get moving" program, a smoking cessation program, a health fair and a 5K run.

"We can't have our own fitness club, but we are trying to get local clubs to give discounted rates," she says. "We're trying to be as creative as possible with limited resources."

And, "we're trying to incorporate the family this year," she adds, because dependents account for much of the company's health care costs. "We're having the health fair on a Saturday so families can participate."

Another survey respondent, the Dallas Area Rapid Transit DART, began its wellness program last year and has stepped up its efforts this year with "more intense, comprehensive" efforts, according to Teana Bush, human resource project manager.

Almost 10 percent of the 3,200 employees take part in various health, wellness and financial education programs. More would participate, Bush says, if the budget were bigger.

The DART incentive program allows employees to earn points for activities such as working out, attending lectures and getting an annual physical. Every point equals one dollar, which can be turned in for gifts from the wellness store and, at the end of the year, for a cash payout.

"We try to encourage them to eat healthy, drink water, exercise," says Bush. "Behavior change is what we're after. That takes a little while ... Wellness starts slow, but gets big. It can make a giant impact."

Another survey respondent, ODS Companies, also is in the second year of its program. ODS, a Portland, Ore., medical and dental insurance provider, kicked off the initiative with a talk by Robert Sweetgall, president and founder of Creative Walking, Inc.

"We did it on company time to show that it's important enough that we're willing to pay for it," says Dr. Mera, vice president and medical director. A senior vice president also spoke at the opening event, to reinforce upper management's support.

The company chose a walking program because it can include both active and sedentary members of its 800-member workforce, Dr. Mera says. "We're not just handing out pedom-

eters. We have a kit with a log book" that allows walkers to take cross country "virtual journeys." Some walkers have already logged enough miles to reach Iowa City, Iowa, on their "journey" to Portland, Maine.

For every 100 miles, walkers get a choice of gifts such as socks, ear muffs or fanny packs.

And to help employees "understand their own medical conditions rather than blindly going to doctors," ODS offers Healthwise Knowledgebase. The online resource offers easy-to-understand information about common health problems and guides people through the decision-making process, according Dr. Mera. "Physicians know if the patient is involved, the outcome is likely to be better."

ODS also focuses on nutrition through a Weight Watchers program. That program, which began before the wellness initiative officially started, has had 130 participants who have lost "over 3,000 pounds aggregate."

Dr. Mera himself has learned a few lessons about wellness programs along the way. "Upper management has to be the driver. It has to be on company time. It has to be simple and inclusive, and there has to be some kind of incentive to get people to participate."

ODS, DART and Lake County all offer health screenings. Robert Szarzynski, an employee relations specialist for the county, notes that it is taking advantage of a local hospital mobile health unit that visits libraries, schools and businesses to offer basic screening.

Lake County also included health risk assessments at its first health fair. "It was voluntary. If employees wanted more testing, they could pay the difference," Johnson says. A summary of the health fair results has allowed her "to see where we have to focus our wellness efforts. It's really helped us accumulate information for what we're going to do for this coming year."

Taking the pulse

Calculating a wellness program's true return on investment may be difficult, but Dart, Lake County and ODS are making the attempt.

ODS conducted a baseline measurement before the program started and expects to be able to measure some results by the end of 2006, Dr. Mera says. "We going to look at planned personal leave and unplanned leave, to see if there's any change. We're going to get feedback from employees to see how satisfied they are with various components of the program."

Teana Bush hopes that DART's screenings eventually will help identify the problems that are contributing to "a lot of death claims from heart disease and cancer in individuals who are young in age."

Bush sees the wellness program as a retention tool, because in the transportation industry health problems such as high blood pressure can cost an employee his/her commercial driver's license.

That's why DART is considering launching a disease management initiative to address the problem of high blood pressure. The goal would be to add a new disease management initiative each year for problems such as high cholesterol or diabetes.

Johnson and Szarzynski hope to have hard numbers by the end of next year, but in the meantime they're seeing anecdotal evidence that the Lake County wellness program is beginning to work. In the company cafeteria, "the line for the salad bar is now longer, and they're requesting low-fat food," Johnson says.

"We see people asking for programs, participating in them and self reporting on successes," Szarzynski adds. "The first step is getting the mindset changed."

The health risk assessments will allow Lake County to track claims for conditions that are preventable, Johnson says, and to focus more attention on those areas.

Still, she notes, while high-risk employees are always welcome to participate in the program, "it's going to take a lot; I'm not going to see a quick turn around" with people in that group.

"Now I'm trying to target where I'll get the most bang for the buck. Our focus is on those who are healthy and those who are borderline. Those will keep my cost down, so we want to make sure they stay healthy long-term. I can stabilize costs if I don't see any more shifting" into the high-risk category.