Employers promoting fitness: To battle steep insurance costs, businesses help employees get healthier

July 11, 2005

Wearing a pedometer, Kelly Dircksen treads 2,000 or so steps a day at the office, racking up her highest counts in her treks to the photocopier. Her 2-1/2-mile daily goal entails after-work walks, as well.

The 34-year-old quoting specialist said her company pays 50 percent of any fitness-related costs for her and her family, including a Weight Watchers program, running shoes for her kids, and the entry fee for her son's marathon.

"I'm definitely healthier," said Dircksen, who celebrates incremental fitness victories with her co-workers at CLS Benefit Solutions Inc. in Indianapolis. Employees, not the company, set their fitness goals to qualify for the perk.

With the average company experiencing double-digit increases in annual health insurance premiums over the last six years, many are increasing their efforts to promote employee fitness.

The National Business Group on Health, a not-for-profit representing 200 of the nation's largest employers, said 93 percent of U.S. companies report using some type of health promotion.

Employers are moving toward more tightly defined fitness measures: Twentyeight percent offer health-risk assessments with independent medical providers and 42 percent award financial incentives to employees who succeed, NBGH said.

The Indianapolis-based National Institute for Fitness and Sport reports increased requests for health-promotion assistance, especially from small companies, and it has been tailoring programs to meet different-size budgets, according to Bill Burgman, director of corporate fitness management.

One quarterly "modest program" it offers provides health screenings and presentations on topics like ergonomics, stress, nutrition and exercise.

IBJ, with help from the Health Foundation of Greater Indianapolis, tracked down a number of local employers who are trying to get workers more interested in fitness and health. Many are taking creative approaches and achieving positive results, they say.

Encouraging prevention

Human resources staff at MacAllister Machinery Co. last year invited their inventory control manager, Sheldon Oakes, to join a focus group created to reduce rising health care costs. He wound up putting his advice to the test.

"We suggested taking preventative measures [because] by doing early testing, they might save pennies on the dollar later," Oakes, 54, said.

So, the company added colonoscopies to its health care plan and began screenings for blood pressure, cholesterol, weight, flexibility and smoking.

Health tests alone can't lead to fitness, so MacAllister hired behavioral clinicians and health coaches to assist their employees. It offered cash to employees who met certain fitness goals.

The coaches make all the difference, said Oakes, who benefited from their individualized attention.

"I lowered my blood pressure. I lost about 25 pounds," he said.

He also gained $300 for his success in lowering just one disease risk factor-his blood pressure.

"My weight loss wasn't enough to qualify me for the body mass index [cash] incentive, and I'm working on that incentive for next year," Oakes said.

In all, MacAllister awarded 220 employees cash incentives, totaling $81,300 for improved self-care.

"Rather than take a punitive approach for an unhealthy lifestyle, they had incentives," Oakes said.

Keeping fit at work

How to best help employees help themselves is a question many companies ask. Named one of the top 100 companies to work for by Fortune magazine this year, Roche Diagnostics Corp. made fitness easier at the workplace.

The company hired the Nashville, Tenn.-based on-site health care provider CHD Meridian Healthcare to open a wellness center for 3,500 employees on the Roche campus. Following federal privacy laws, Roche has no access to employees' medical files but does get key figures to analyze its investment.

"We expect the nurse practitioner to write 1,000 prescriptions each year, and if that happens, that will achieve about $500,000 in savings," said Roche's Chris Young, director of human resource solutions.

The most commonly treated ailments have been high blood pressure and ear, nose and throat problems.

Roche reduces high-priced doctor visits and gains on productivity when employees take 15 minutes to visit the on-site nurse practitioner rather than two hours to visit the doctor, Young said.

Its employees also get comprehensive health screenings, health coaches and wellness spending accounts used as incentives.

CHD Meridian handles the incentives, so Roche remains away from its employees' personal health issues. Besides the monetary benefit, the company feels the program boosts morale.

"As an employer of choice, we want people to say, 'I'm healthier because I work at Roche, and that's where I want to be,'" Young said.

Promoting better choices

Our lifestyles are the culprits in rising health insurance costs, said Mike Campbell, president and owner of CLS Benefit Solutions. The answer, he said, is to change the work culture, incubate wellness and promote it in every communication.

"The choices people make-they are [usually] bad choices," Campbell said.

Corporate leaders can take the opportunity to create work environments that become "conduits" for wellness, he said. Addressing stress is particularly important to cutting illness and disease rates.

IUPUI has experimented with stressreducing wellness breaks at noon. The university's introductory yoga course is provided at no charge.

"I thought of yoga as this new-age, soft, bogus-type of thing," said Rebecca Shear, program coordinator at the Center of Philanthropy at IUPUI and program participant. "I never would have tried this if it wasn't offered in an easy way. I ended up liking it. Never underestimate deep breathing at lunchtime. It helps to relieve stress."

Attorney and yoga devotee Maltie S. Maraj, associate director of the awards section of research and sponsored programs at IUPUI, comes back to the office with so much energy, the afternoon "just flies by," she said. Better still, she doesn't have to trade off her personal fitness for responsibilities after work as a mother of a toddler.

IUPUI's lunchtime benefits are created by a human resources employee whose title reflects the programs she promotes.

Maggie Stemming, work-life consultant at IUPUI, handles flex-time and noontime benefits programs. Attuned to lifestyle trends, she exemplifies a changing trend among human resources personnel, who are moving beyond policies, hiring and workplace regulations to consider employees in broader contexts.

"For women and employees under age 35, work-life balance is especially important to them," Stemming said. In addition to yoga, she cultivates the spirit of wellness with walking challenges, water aerobics, intramural sports and sessions on women's health issues.

All for one?

While wellness programs in general are being embraced by many companies, some are confused about how to go about it. Should they use a democratic approach or target employees at high risk for diseases?

"General health promotion you put out to all employees because it's something being given and aims at the population in an indiscriminate way," said Larry Hicks, Midwest Benefits Practice Leader with the human resources consulting firm Hay Group in Chicago.

In addition, Hicks advocates the use of disease management companies to screen and manage the chronic conditions of about 40 percent of the work force with health problems, such as high blood pressure, heart disease, diabetes, back and neck conditions, and excessive weight.

Dr. Julie Meek, founder and CEO of the Haelan Group in Indianapolis, said exclusive use of "disease management" misses the point. Her business, which serves about 25 companies, is a "population health management company," using the democratic approach to improve health.

Health promotion needs to identify people ahead of the predicted medical costs and ahead of their suffering, Meek said.

"Everyone gets a health-improvement plan for that year. We are reaching 96 percent of the employees and their families and developing goals," Meek said.

The National Association of Mutual Insurance Companies is one such group experiencing success with a broader model. In partnership with Lumbermens Mutual Insurance Co., they hold Weight Watchers sessions at work.

When customer service representative Maria Santiago came up with the idea, NAMIC ran with it. Employees pay $120 to join the onsite Weight Watchers program. If they meet certain weight-loss goals, their employers reimburse them.

Santiago, 27, and a new mother, lost 8-1/2 pounds in three weeks. She said she has had a few jobs since leaving college, but none that provided such support.

"I've never had a better employer," she said. "If you want long-term employees, you want healthier employees."
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