Start a free wellness program or run a successful health management program in the office for little or no cost to your company. the advantages of corporate 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, primarily from wellness providers but also from corporations trying to start their own wellness workplace programs. There are a number of things to do to implement a successful health management program at work.

Suggestions for Beginning a Free or Affordable Wellness Program

Before beginning a inexpensive or free wellness program for your corporation, learn more about what workers want. Survey workers to learn more about their wellness concerns.

Keep the survey confidential to protect employees’ identities. Usually the most popular corporate wellness topics are smoking cessation, weight loss concerns and heart and cholesterol health.

Look for Corporate Wellness Freebies

Find out who’ll come in for free to speak to staff members and explore partnerships with outside agents related to corporate wellness.

For  instance, contact a local branch of a well-known weight loss business and ask if someone can come in and speak to workers. Look for agencies that are willing to come in and talk about topics related to wellness at no cost to workers, in exchange for something from you.

Find Corporate Wellness Partnerships

Working with a weight loss business to set up a speaking engagement for workers is the perfect opportunity to explore a potential wellness partnership.

The weight loss corporation may say that if 10 employees join the program, they will hold weekly meetings at corporation headquarters for the individuals  who joined. the weight loss group also may offer corporation employees a discount if a few individuals  join the program.

Nonprofits an Untapped Health Management Resource

There are also plenty of nonprofit agencies who would be thrilled to visit a corporation 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 business could offer to organize an MS walk (in keeping with business health management objectives, right?), or an auction with staff member and company-donated items where the proceeds go to MS.

The individuals  at the nonprofit agencies would be happy to open a dialog with your business and to talk about what they’d want in return for a speaking engagement. In many cases, they won’t need anything at all for a first meeting.

Collecting Data and Reviewing Wellness Program Results

Accumulating data and evaluating  results of a wellness program could be tricky because of HIPPA laws. Notwithstanding, when at least 10 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-level management.

And, business successes will potentially give management more incentive to provide money for more health management and wellness programs in the future.

The beauty of it is that you are simply assisting employees to make smart choices so the costs of implementing a wellness program are minimal compared to the benefits.

Worker health is a major concern for small business owners. In a small shop, even several sick workers can disrupt the flow of the workplace and bring the operation to a standstill.

Instead of sitting back and hoping for the best, some owners are taking the matter of employee health into their own hands by starting employee wellness programs. Here’s how they work . . .

Overview of worker wellness programs

Staff Member wellness programs are programs initiated by the business to improve the overall health of their labor force and to help individual staff members overcome specific health-related hurdles.

These programs may be offered in a selection of formats -  In mandatory staff training sessions, as voluntary seminars, or through a third-party provider offering a wide-range of staff member assistance programs.

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

Why offer worker wellness programs?

Apart from the obvious concern for the health of your employees, there are several other reasons why staff member wellness programs make sense for small businesses. Right off the bat, your corporation will benefit from the reduced level of absenteeism that goes hand in hand with a healthful workforce.

Wellness 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 can have a big impact on a small business, a more reliable workforce will inevitably translate into a smoother work cycle and a more robust bottom line.

Wellness Program Features

Wellness programs can cover a wide range of health-related topics. Based on your employees’ needs, it’s entirely up to you to determine the type of programming you want to offer.

However, most employee wellness programs offer some at least some programs in the following areas -

• Nutrition. Diet can significantly impact an employee’s ability to do their job effectively. Nutritional programs educate workers about food options and equip them to make healthy dietary options.

• Physical Fitness. In addition to diet, exercise is an important factor in a healthy lifestyle. Wellness programs frequently provide employees with opportunities to incorporate exercise into their daily lives.

• Use of tobacco Cessation. Statistics prove that smokers tend to fall ill more frequently than their non-tobacco use colleagues. Since sick employees disrupt the workplace, tobacco use cessation programs are a no-brainer for both businesss and employees.

• Physiological Testing. Many companys offer physiological as a regular part of their wellness programs. Cholesterol tests, blood pressure screenings, and other simple exams can provide early warning signs for additional serious problems.

• Stress Management. Stress itself takes a toll on staff members. Nonetheless, stress is also linked to other health problems such as depression, cardiovascular illness, diabetes, and obesity. Wellness programs that help staff members deal with stress improve not only the psychological health of your staff members, but their physical health as well.

The benefits to starting a wellness program are many.

A few corporate wellness tips to get workers began on the path to a healthier lifestyle -

1. Look around, and determine if workers lead a healthful lifestyle before starting an worker wellness program.

• How many workers dash outside at lunchtime for a smoke break?
• Would a smoking cessation program help?
• How often do the junk food-laden vending machines have to be replenished?
• is anybody exercising or taking advantage of local walking trails as part of their healthful living goals?

The answers to these questions will give companies a better idea of the worker wellness program that’s right for them.

2. Survey staff members to determine their healthful 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 wellness program benefits most businesses because workers do not have the time or energy to stay on top of wellness concerns at work or when they leave the office to go home.

3. Provide wellness programs a large kick-off with a healthy living “fair.” Offer staff members free flu shots, blood pressure (BP) checks, cholesterol screenings, body/fat ratio assessments, smoking cessation programs and free mammograms- and contact the local hospital, because there’s plenty more where this came from.

Companies keep their employees hopping during the week. Give employees a chance to amp up their healthy lifestyle on the corporation dime. A wellness program is an added benefit that employees get for working for the company!

4. Incent to live- offer money for employees to lose weight, commit to a tobacco use cessation program and normally enjoy a healthier lifestyle.

Make certain to encourage humankind’s innate competitive nature by offering prizes for wellness staff member “winners.” And, encourage a healthier lifestyle by sponsoring staff members who want to enter a local 5K for charity race, run a marathon or play a sport.

The last ten years has brought major changes in business attitudes toward wellness programs. Interest in self-help and self-care programs has increased as growth in health care costs have encroached substantially into profits.

Changes in the organizational structures of health care facilities, namely the growth of the for-profit health care sector, and the need to contain costs are changing the ways in which purchasers of health care plans are viewing their own efforts toward provision of worksite health care programs and facilities.

Projections for the next decade indicate that worksite health programs will continue to become important factors in the provision of healthcare, including avoidance activities, for both government and private industry.

In companies with existing wellness programs, administrative rationale for sponsoring these activities ranged from bettering employee health (28%) to bettering employee morale (9.7%).

Programs include interventions associated with safety, health risk (assessment|appraisal}, tobacco use cessation, blood pressure control, nutrition programs and stress management. Benefits cited range from improved health and productivity to lowering healthcare costs.

Demographics of the USA  Workforce

• 110 million Americans were in the civilian labor force in 1981; by the year 2000 the civilian labor force is expected to be almost 140 million.

• 44% of the 1984 labor force was female; 10% was Black.

• the median age of the workforce is 32 years and is expected to increase to 32 years by 2030.

• 57.9% of all staff members work in businesses with between 2 and 500 employees; 45% work in businesses with fewer than 100 staff members. an additional 7.5 million American Citizens are self-employed and 3 million are farmers.

• 18 percent of all wage and salaried workers in 1985 were union members.            

• 45 percent of all employees are employed in offices.            

Prevalence of Corporate Wellness Activities            

Based on a 1985 survey, almost 66 percent of worksites with 50 or more employees had corporate wellness activities in 1985.  The frequency of worksite-based activities by selected categories in 1985 was -             

Wellness Program Activities            

Tobacco use Control          35.60%   

Health Risk (Assessment|Appraisal}    29.50%         

Back Care             28.60%

Stress Management       26.60%      

Exercise             22.10%

Off the Job Accidents    19.80%         

Nutrition             16.80%

Blood Pressure Control    16.50%         

Weight Control          14.70%   

Worksite size is the strongest indicator of program prevalence.            

Most staff members believe the benefits of their corporate wellness activities outweigh the costs, even though few formal investigations exist.            

The most frequently cited reason for starting programs and perceived benefit from programs is improved employee health.

At most worksites with activities (85.4%), all employees are eligible to participate. 30% of worksites with activities offer them to corporation dependents, and an equal% offer them to retirees.

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

Use of tobacco Cessation Programs

Tobacco use related health problems cost U.S.  companies $26 billion per year in lost productivity and $7 to $8 billion in tobacco use-related medical costs.

Workers who smoke are 50 percent more likely to be hospitalized than nonsmokers, have 2 times as many job-related accidents as nonsmokers and have absenteeism rates approximately 50 percent higher than nonsmokers.

People  who smoked an typical of one or more packs of cigarettes per day had 118 percent higher medical expenses than nonsmokers.

76 percent of current smokers and 80 percent of former smokers and nonsmokers feel that companies should restrict use of tobacco to certain areas.

In 1985, 65% of smokers, 85% of nonsmokers and 78% of former smokers, felt that smokers should refrain from use of tobacco in the presence of nonsmokers.

In 1986, 17 states had laws regulating tobacco use in offices or workplaces either in government-controlled offices or offices of private workers.

Examples of smoking cessation intervention program used by companies include -

• offering nonsmokers a discount of health and life insurance;

• paying full or partial fees for use of tobacco cessation programs;

• providing cessation programs on corporation or shared time;

• offering cash payments to quitters after 6 of 12 smoke-free months;

• participating in national quit tobacco use days; and

• adopting a smoke free corporation policy and setting deadlines for implementing the policy.

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 yield a two- to three-fold difference in cardiovascular deaths between active employees and their more sedentary counterparts.

In addition to bettering strength, balance, and flexibility, fitness plans may reduce  the probability of back injuries among certain occupational groups.

93 million workdays in the USA are lost each year as the result of back problems.

Research findings support the notion that worksite exercise plans improve fitness and help reduce other health risks, although results related to improved productivity are weak due to lack of methods for accurately measuring productivity.

A very small proportion of worksites have on-site physical fitness facilities.

The majority of employees sponsored physical fitness programs involve skills training such as aerobic dance, low impact aerobics, resistance training, preand post-natal exercise classes, and walking/jogging groups.

Some businesses subsidize employee participation in community “Ys,” health clubs or other community programs if no on-site facilities are available.

Worksite physical fitness programs could reduce costs to employers by decling staff member healthcare claims and expenditures.

Individuals  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 ascended at least 15 flights of stairs or walked 1 1/2 miles weekly.

Health care costs for obese individuals  are roughly 11 percent higher than those for thin individuals .

Nutrition and Weight Control

One-third of the U.S.  population is obese to the extent of decreasing their life expectancy.

Improvements in eating habits could reduce  the risk of serious health problems like high blood pressure (BP) and cholesterol levels and is instrumental in the control of non-insulin-dependent diabetes.

The workplace offers a few advantages for nutrition education; support and influence of peers and management, availability of a daily eating situation, and opportunities for follow-up and monitoring.

Worksite nutrition programs may be grouped in 6 wide categories -

• cafeteria programs;

• multi-component programs;

• weight control programs;

• cholesterol reduction programs;

• programs for pregnant and lactating women; and

• other nutrition education topics.

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

Stress Management

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

Corporation pays many of the costs related to worker stress, both directly in the form of healthcare costs and in lower productivity.

Job factors which are associated with stress include -

• not authorizing employees to participate in decisions about the work process;

• positions which require more or less skill than the worker has;

• changes in work demands;

• lack of clarity about expectations and standards; and

• conflict with coworkers or supervisors.

Most worksite stress management programs are implemented thus of requests from employees.

Stress management programs focus on three kinds of skills -  relaxation skills, coping skills, and interpersonal skills.

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

• seminars conducted by trained experts;

• 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 individuals  to reduce the negative physical effects of stress; and

• teaching individuals  to recognize and control sources of stress at work and in personal life.

Seat Belt Usage

Motor automobile accidents are the biggest single cause of lost work time and on-the-job fatalities of USA  company.

Motor automobile accidents account for 27 percent of all work-related deaths and 45 million days of lost work each year.

More than 36% of the 11,300 accidental work deaths in 1983 involved automobiles.

Workers who routinely fail to use seat belts may spend up to 54 percent more days in the hospital.

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

Motor automobile crashes cost $15.2 billion in lost productivity, 88 percent of which is attributed to losses from workforce activities and future earnings.

In corporate settings where safety belt policies, requiring use of belts by anybody riding in a company automobile or using a private automobile on company company, have been enforced, 60 percent to 90 percent use has been reported.

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 worksite safety belt programs include -

• active commitment on the part of management;

• clearly defined and well enforced policy of required belt use on the job;

• positive incentives; and

• ongoing education and training programs.

Case Studies of Wellness Programs

Based on an extensive examination of its extensive staff member wellness program, LIVE FOR LIFE, Johnson and Johnson announced the break-even point for the program occurs in year 3 and by year 5 they have a net advantage of $316 per staff member. Their year 9 projected benefit is $677 per staff member.

Employees at four Johnson and Johnson corporations who were exposed to the wellness program increased their daily energy expenditure in vigorous activity by 104% compared to an increase of 33% among workers at corporations that were offered only an annual health screen.

Participants in the United Methodist Publishing House’s 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 lower than projected use in healthcare costs for 1985 ($902,116 projected with actual costs $142,884) to the wellness program even though the results aren’t conclusive.

In 1985, the Adolph Coors Business conducted a telephone interview of a random sample of its 10,000 employees to determine changes in health practices since the introduction of an employee wellness program 4 years earlier.

The sample of 495 workers was stratified to match the corporation profile as for age, sex and job description.

The survey stated that 65% of respondents began exercising in the last 4 years, 37% had improved their diets, 20% were regular users of the wellness center, 9% had stopped use of tobacco as the result of the corporation’s use of tobacco cessation program and regular participants of the wellness center miss an average of 1.96 workdays yearly because of illness or injury compared to 3.08 days for non-participating employees.

The Coors Business also achieved a cost savings from a cardiac rehabilitation program that was implemented 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 typical 1.9 months saving $152,000 in lost work time and in 1985 cardiac patients missed an typical of 2.6 months, saving $125,000 that year.

Instituting a wellness program improves the health of employees, decreases staff member absenteeism and saves the business money, too. Learn more about beginning an staff member wellness program in the office.

Advantages of Wellness Programs

• A corporation investment of $100-$150 per worker annually to participate in an worker wellness program can save companies $300 to $450 for each worker every year, according to Ron Goetzel, Director, Cornell Univ. Institute for Health and Productivity Studies.

The savings can take several years to actualize, says Goetzel, and are seen in lowered health expenditures.

• the Wellness Councils of America reported a $24 return for every $1 spent on a company wellness program for small corporations.

• As reported by a 2005 survey by the Art of Wellness, corporations who instituted employee wellness programs realized a 30% reduction in medical and absenteeism costs in less than four years.

A successful wellness program begins with company leaders. Company owners ought to lead by example, taking part in their corporation’s corporate fitness program and working closely with a wellness coach.

Business leaders should be certain staff members are well aware of their wellness efforts, posting weight loss results or tobacco use cessation results on business intranet or bulletin boards for everyone to see.

Staff Member Wellness Programs that Really Work

• Be certain to encourage staff members to kick begin their own wellness programs by visiting their doctor. A complete physical should include information about blood sugar, cholesterol levels and general health.

• Target specific health-related concerns in a corporate fitness program. Information about how to fight obesity, use of tobacco, alcoholism and drug abuse ought to be at the forefront of an staff member wellness program, along with related conditions.

• Hire a wellness coach to instruct employees on how to lead a healthful lifestyle.

• Reward staff members for participating in company wellness programs. Let staff members accrue wellness points that they can redeem for prizes.

Make the prizes healthful, too- a free massage, private training session with the corporation’s wellness coach or health food gift certificate encourages even healthier lifestyle options.

• Acknowledge worker wellness leaders in company newsletters, in posted bulletins and on the company intranet.

Corporation Wellness Programs Yield Big Results

For company owners who want to raise employee participation in a company wellness program, consider Johnson and Johnson’s approach.

Faced with only 26% of workers participating in their staff member wellness program, Johnson and Johnson offered workers a $500 discount on health insurance costs if they completed a health risk profile.

The number of workers participating in the Johnson and Johnson corporate fitness program jumped after they offered the incentive — to more than 93 percent.

Ron Goetzel encourages those looking to pitch a corporate fitness program to business leaders to use basic facts about the benefits of worker wellness programs as part of their argument.

Keep it simple, and share results from other corporation’s employee wellness program success stories.

1   The United States spends more dollars on health care than any other nation yet we aren’t the world’s healthiest

• Largely sedentary   

• Smoking is still popular   

• Stress is at epidemic levels (WHO)   

• Alcohol continues to take its toll on Americans   

2   Much of the illness in the USA is preventable

• Tobacco and alcohol are leading causes of death   

• as much as 70% of the cost of health care is driven by preventable illness   

3   Healthcare costs continue to rise

• Healthcare premiums continue to rise and to be passed on to the employee   

• Healthcare cost are typically 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 business   

• Businesss have a vested interest in health related issues.   

5   Research validates that wellness programs can improve health, save money, and even produce a ROI.

• Aldana,S.G. (1998). Financial impact of corporate wellness and methodological quality of the evidence. the Art of Wellness. Vol 2, Number 1.   

• Wilson, M.G. (1996). A comprehensive review of the effects of corporate wellness on health related outcomes -  an update. the American Journal of wellness. Vol 10, Number 6.   

• Wilson, M.G. (1996). A robust review of the effects of corporate wellness on health related outcomes -  an update. the American Journal of wellness. Vol 11, Number 2.   

• Chapman, L.S. Proof Positive -  an analysis of the cost-effectiveness of corporate wellness. 3rd ed. Seattle -  Summex Company, 1996.   

• Pelletier, K.R. A review of the health and cost-effective outcomes studies of robust wellness and disease avoidance programs at the worksite -  1993-1995 Update. the American Journal of Health and Promotion. Vol. 10, Number 5.   

Key Components of a Wellness Program   

Physical Wellness - Focuses on the development, maintenance, or betterment of one’s physical fitness   

Sample Physical Wellness Programs / Workshops

• Annual health testing

• Regular physical activity

• Good safety habits

Emotional Wellness - Focuses on all aspects of mental fitness

Sample Emotional Wellness Programs / Seminars

• Stress management workshops

• Dealing with aging

• Addictive behaviors

• Parenting

Financial Wellness - Focuses on improving the quality of life of employees by assisting families and person in becoming financially stable

Sample Financial Wellness Programs / Seminars

• Financial management

• Savings and Investing

• Credit and Purchasing

• Insurance and Estate Planning

Spiritual Wellness - Focuses on promoting a healthy inner self

Sample Spiritual Wellness Programs / Seminars

• Make certain to encourage daily devotional readings

• Provide regular service opportunities

• Provide a daily/weekly/monthly chapel (meditation) time during work hours

Nutritional Wellness - Will meet the needs of the workers through group and individual nutritional services

Sample Nutritional Wellness Programs / Workshops

• Individual nutritional Assessment

• Individual and group counseling

• Educational classes

• Weight loss programs

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

The well-liked media have done much to promote the theory of corporate wellness. Last year, In Business -  Madison1 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 Corporation, as reported

Would these ROIs stand up to rigorous empirical analysis of the data? What factors produce such disparate returns among these programs? and does the published literature, subject to colleague review of scientific methods, support the ROIs stated here?

Health and Productivity Management

Illness and injury associated with an unhealthful lifestyle or modifiable risk factors is stated to account for at least 25% of worker healthcare expenditures.

The most significant of these risk factors are stress, tobacco use, overweight or obesity, lack of exercise, excessive alcohol use, and poor nutritional habits.

Over the past two decades, a variety of groups at the local, state, and national levels have promoted the concept that health risk reduction and care management programs can improve worker health, and that worksite health education, health risk management, and benefit counseling should complement standard medical insurance benefits.

The intensity of wellness programs range from bulletin board,  brochure or newsletter information to on-site fitness facilities, health risk reduction classes, and personal lifestyle change coaching.

Wellness programs today often include a health risk (assessment|appraisal}  to evaluate each employee’s modifiable risk factors of disease. Program coordinators then target interventions to those that are at increased risk through personal communications and individual follow-up.

Robust wellness programs may include classes on health risk reduction and job safety, fitness and exercise activities, gym memberships, and reductions in co-payments or premiums for staff members who adhere to advised medical testing guidelines.

Along with this, some businesss are restructuring health benefits and encouraging employees’ cost-sensitivity when accessing healthcare.5 These changes are intended to reduce employees’ need for and utilization of healthcare, yielding reduced group health care costs.

Demonstrated reductions in health care expenditures should then provide employers with a powerful bargaining chip in negotiating lower medical insurance premiums during future terms.

Evidence basis -  A range of ROI estimates

The empirical research has produced results as varied as the popular media on ROI. However, evidence continues to grow that well-designed and well-resourced wellness and illness prevention programs provide multi-faceted payback on investment.

Colleague-reviewed examinations and meta analyses show that ROI is achieved through improved staff member health, decreased benefit expense, and enhanced productivity.

• Goetzel and coworkers, in their meta-analysis of two dozen articles summarizing economic examinations of health and productivity management programs, found an average return of $3.14 per $1 invested in traditional wellness programs. the ROI estimates for the individual programs ranged from $1.49 to $13.7,

• Aldana reviewed 72 articles and concluded that wellness programs achieve an average ROI of $3.48 when considering health care costs 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 found improvements in the risk profiles of participants, with the high-risk group improving more than the “usual care” group1 as a result of more intensive programming.

• Chapman’s 2004 meta-evaluation of 42 studies, ranking overall validity of the studies, reports cost-benefit ratios from $2.05-$4.64.

In addition to immediately quantifiable cost reductions, scientists have announced a selection of spin-off benefits -  greater productivity, intellectual capacity, and reductions in disability12 and absenteeism.9,13,14,15

Such programs might also have positive effects on employee perceptions of the company and employee morale, even among nonparticipants.  These outcomes go beyond savings in direct healthcare costs to provide non-health related ROI.

Tailoring program to maximize ROI Wellness programs aim to reduce the health risks of staff members at high risk while maintaining the health status of those at low risk.

A variety of disease management (DM) interventions are available to fit the specific risk profiles of various worksites. Insurers and corporations now seek to calibrate their interventions to achieve optimal risk reduction and costeffectiveness.

In 2001, Univ. of Michigan researchers announced on stable trends in healthcare costs for over 2 million current and former employees 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 workers moved from low risk to high risk were much greater than the reduces in costs when groups moved from high risk to low risk. Their conclusion -  Programs designed to keep healthy individuals  healthy will likely provide the greatest return on investment.

On the contrary, Pelletier’s meta-analysis and other program evaluations18 suggest that individualized risks reduction for high-risk staff members within the context of robust programming is the vital element in achieving positive clinical and cost outcomes in worksite interventions.

Dose-Response?

A few factors may affect the impact of various programs and the ultimate ROI, including cultural and environmental factors, workforce demographics, level of participation and longevity of the program.

Most cost-benefit studies have been conducted in big corporations with more than fifty workers. But researchers have shown that similar results can be acquired by small corporations with as few as five workers actively involved in a well-managed program.

Various studies also suggest that even relatively modest levels of participation can achieve substantial program impact. Contrary to reports by the well-liked media that such programs require more than 70 percent participation, published reports of at least one case showed positive ROI with 51 percent participation.

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

Future developments

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

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

Meanwhile, the preponderance of data and the strength of the published research stand for a positive ROI for wellness programs.

Indeed, the business case for such programs is now well enough defined that some insurance agents offer discounted rates to companies that institute or subscribe to wellness programs.

Future questions will focus on how to best to combine robust and focused interventions, the intensity of elements, and how to calibrate the dose-response model to achieve a target ROI.

Here, employers, workers, and researchers will need to collaborate to define mutual goals in terms of both clinical and cost outcomes.

Sources -

1. In Business -  Madison. Madison, WI -  September 2004. p. 39.

2. Anderson DR, Whitmer RW, Goetzel RZ, Ozminkowski RJ, Wasserman J, Serxner S. Health Enhancement Research Organization Committee. American Journal of Wellness 2000; 15(1) -  45-52.

3. Manning J. Wellness movement gains ground among businesses, health insurers. Milwaukee Journal Sentinel. August 19, 2004.

4. Chapman LS. Professional opinions on “best practices” in corporate wellness (WHP). the Art of Wellness Newsletter, July/August 2004 - 1-6.

5. Fronstin, P, and Werntz, R. EBRI Issue Brief No. 267, March 2004. Washington, DC -  Worker Benefits Research Institute (EBRI).

6. Powell C. Professionals urge companies to promote employee wellness strategies. Akron Beacon Journal. October 25, 2004.

7. Goetzel RZ, Juday TR, Ozminkowski RJ. AWHP’s Worksite Health, Summer, 1999.

8. Goetzel, RZ. Absolute Advantage. Washington DC -  Wellness Councils of America. Vol 1(8); 2002.

9. Aldana SG. American Journal of Wellness 2001; 15(5) -  296-320.

10. Ozminkowski RJ, Dunn RL, Goetzel RZ, Cantor RI, Murnane J, Harrison M. American Journal of Wellness 1999; 14(1) -  31-43.

11. Ozminkowski RJ, Goetzel RZ, Smith MW, Cantor RI, Shaughnessy A, Harrison M. the impact of the Citibank, N.A. J Occup Environ Med. 2000; 42(5) -  502-511.

12. Serxner S, Gold D, Anderson D, Williams D. J Occup Environ Med. 2001; 43(1) -  25-29.

13. Riedel JE, Lynch W, Baase C, Hymel P, Peterson KW. American Journal of Wellness 2001; 15(3) -  167-191.

14. Edington MD, Karjalainen T, Hirschland D, Edington DW. AAOHN J. 2002 Jan; 50(1) -  26-31.

15. Aldana SG, Pronk NP. J Occup Environ Med. 2001 Jan; 43(1) -  36-46.

16. Pelletier KR. American Journal of Wellness. 2001; 16(2) -  107-16.

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The emerging corporate culture in the United States  is one which has an employee population centered in health, safety and wellness.

Developing a corporate strategy for wellness and disability management makes good corporation 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 Program Champion

This person should be a leader in your organization and a strong advocate of health. Typically this is a personal who actively pursues his or her own personal quest for optimal health.

The program champion must’ve the resources and authority to drive the program forward. the program champion’s key role is to ensure the strategic plan for health is aligned with the corporation’s business objectives, strategic focus and organizational values.

For  instance if the organization promotes that “our strength is our individuals ” the wellness program must demonstrate how programs will nurture and protect that valuable resource.

2. Form Your Wellness Strategy Team

The Wellness Strategy Team should include decision makers and stakeholders from areas of the business that can influence health and the corporation’s bottom line.

These areas may include; finance, HR, 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 advised.

The role of the Strategy Team is to develop and implement the strategic plan, look for opportunities to promote health, ensure the program is integrated into key areas of the organization, streamline efforts, maximize company resources and program evaluation.

3. Complete an Organizational Health Audit

The purpose of an Organizational Health Audit is to evaluate your existing programs and services, physical environment and policies and procedures that support health.

It’s also important to look at your organizational culture or “how things are done” around the company.

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

4. Analyze Your Corporation’s Cost Pressures

Cost pressures are identified by reviewing  a number of areas including; benefit costs, Workplace Safety Insurance Board (WSIB) claims, drug usage, type of paramedic claims, absenteeism data and employee assistance program (EAP) utilization.

This process helps to target areas that can be positively impacted by a wellness program and to provide a baseline for investigating  change.

5. Conduct a Health Risk (Assessment|Appraisal} or Employee Needs and Interest Survey

The next step is to determine your employee’s health risks, interests and readiness to change. A confidential health risk (assessment|appraisal} can accomplish many objectives.

It provides a baseline from which to measure personal lifestyle changes, provides staff members with relevant medical information, motivates staff members to take charge of their health and assists in program planning.

Most health risk (assessment|appraisal}s provide individual reports and a corporate report identifying high-risk areas in the business.

A lot of organizations prefer to administer customized needs and interest survey to evaluate worker needs. the benefit of this approach is that the company can gather information on the employees’ perceived wellness needs and program interests.

This information can be incorporated into the strategic plan. Administering a recent survey also has the added advantage of fostering a sense of employee ownership to the program.

6. Develop Your Strategic Plan for Wellness

The strategic plan should incorporate information gathered from the Organizational Health Audit, your corporation’s cost pressures, and health risk (assessment|appraisal} data or staff member survey results.

The strategic plan should include your program mission, three or four goals and a few programs under each objective. the strategic plan provides a framework to encourage, support and evaluate “best health practices.”

It is also important that the plan align itself with the vision, objectives and objectives of the organization.

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

Levi Strauss and Co.’s aspirations include the following statement -  Above all, we want satisfaction from accomplishments and friendships, balanced personal and expert lives, and to have fun in our endeavors.

The wellness program plan included a number of components to ensure that it embraced this statement including the following -

1. A vision statement, which tied in with the corporation’s aspirations.

2. an incentive system to encourage and reward the accomplishment of healthful milestones.

3. A recognition system to applaud success.

4. Friendly competitions between Levi Strauss and Co. locations to ensure a fun environment.

5. Opportunities to participate in small group educational programs to foster team support.

6. Initiation of support groups for staff members completing wellness programs (i.e. smoking control support group).

7. Programs dealing with work and family balance.

Other information that was analyzed and used to develop the plan included -

1. Business demographics

2. Focus groups

3. Cultural audit

4. Top drug report

5. employee assistance program utilization

6. Staff Member benefit services report

7. Health and dental claims

8. Operational performance summaries

9. Health risk (assessment|appraisal}s

7. Prepare a Business Case to Support Your Plan

Your company case for wellness provides the necessary details for approval at the  senior management level. the company case includes -

1. the Strategic Plan for Health

2. A proposed program budget

3. Advertising strategies

4. Program leadership options

5. an implementation plan

6. Evaluation methodology.

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

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

Advertising and Marketing strategies should address how the program will be promoted and rolled out to various groups within the organization i.e. decentralized locations, high risk staff members, older staff members.

Program leadership should 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 should incorporate the following types of programs that help create awareness of positive health practices, assist workers in making lifestyle changes and initiatives, which support long-term change.

Awareness programs create an awareness of the importance of healthful lifestyle practices and motivate workers to take the next step. Examples of awareness programs include posting educational posters, newsletter articles and lunch and learn seminars.

Lifestyle change programs are more extensive and longer in duration. They’re 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 and procedures, the physical environment and creating a corporate culture that supports good health practices. Follow-up sessions and support groups for employees who have completed 6-10 week wellness programs also provide a supportive environment for long-term change.

Analyzing the effectiveness of wellness is ongoing. A formal investigation should be conducted each year and may include; re-administering steps three to five, program participation statistics and a year end survey to revisit “soft” issues such as morale, program satisfaction and future program direction.

8. Solicit Input and Communicate Your Plan

Employee input is crucial to the long-term success of your program. an Employee Advisory Committee must be formed to roll out the plan. Another key responsibility of this team is to solicit feedback from all levels of the organization to ensure buy-in.

Front line Manager’s Information Sessions and focus groups are also important. This group needs to buy-in to the notion that they play a key role in supporting positive health practices.

Regular meetings are recommended with front line managers to receive ongoing input, address issues and orient new managers.

Conclusions

The World Health Corporation’s definition of health is “a state of complete physical, mental and social well-being and not merely the absence of illness and infirmity.”

In order for us to develop healthful workplaces, wellness programs must’ve a program champion, have staff member ownership, be management supported, results driven and strategically aligned with the overall business goals of the organization.

Wellness program that embrace these qualities will have a positive impact on an corporation’s bottom line. Canadian research points to many case studies where onsite programs have resulted in reduced absenteeism, lower claims and increased productivity.

Organizations who have embraced wellness as part of “how they do business” have one thing in common. They demonstrate a commitment to their most valuable resource - their people .

They understand the increased pressures associated with downsized organizations, a quickly changing workplace, an aging work force and the challenge of balancing work and family obligations. and they share a common belief that healthful staff members are happier, absent less and more productive.

References -

Design of Wellness Programs by Michael P. O’Donnell. 1995. Published by the American Journal of Wellness.

Pro Fit-ability by Veronica Marsden. Group Healthcare Management. May 1997.

Meeting Expectations by Laura Mensch. Staff Member Health and Productivity. August 1999

7 Steps to Wellness by Daphne Woolf and Veronica Marsden. Group Health Care Management. February 1996.

Published in the Journal of Wellness for Northern Ireland, Issue 9, March 2000

The list below provides “best practices’ that can help meet any wellness program budget! the Wellness Program ideas are divided into topic areas.

General Wellness Progam Ideas

• Policy - Conduct an Worker Needs and Interest Survey

• Policy - Create a management/employee Wellness Committee

• Policy - Select health plans that cover costs for weight management and smoking cessation

• Policy - Waive co-payment or reimburse for preventive healthcare visits

• Program - Display  pamphlets on a selection of wellness topics for workers to take

• Program - Establish a wellness resource center or library with videos, books, magazines, DVD’s on a variety of topics of interest to employees

• Program - Identify staff members who are mentors or champions for healthy activities and ask them to present or to list as a contact for other employees

• Program - Plan and promote periodic or regular educational sessions.

• Program - Plan monthly educational sessions on the national health observance topic

• Program - Post a Wellness Bulletin Board and update it monthly

• Program - Promote messages from national health observances during the month

• Program - Publish and/or post healthful tips in newsletters, paycheck stuffers, bulletin boards, etc.

• Program - Sponsor a benefits fair

• Program - Sponsor company fitness and healthy eating challenges

• Program - Sponsor corporation health fairs or other on-site events

Nutrition Programs

• Policy - Offer free, healthful snacks for staff members (fruit, nuts, popcorn)

• Policy - Provide healthful meal choices in cafeterias and at business events

• Policy - Give information to employees about the nutritional content of food served in the cafeteria

• Policy - Start a fresh fruit “snack basket” in the breakroom or cafeteria

• Policy - Stock vending machines with healthier options

• Policy - Subsidize healthful foods in the cafeteria or vending machines (10¡ apples could  be more appealing than $1.00 candy bars)

• Program - Coordinate a weekly or monthly healthy lunch club

• Program - Have  handouts available on a variety of healthful eating topics

• Program - Include nutrition articles in corporation newsletters

• Program - Schedule a healthful food tasting contest Free

• Program - Schedule educational sessions at lunch-time on a variety of nutrition topics of interest

• Program - Sponsor an worker healthy food cookbook. Either sell the cookbook and use profits for programs, or buy a cookbook for all employees

Weight Loss Programs / Weight Management Programs

• Policy - Consider flexible work schedules so that workers can participate in weight-loss programs

• Policy - Subsidize registration costs for weight-management programs

• Program - Form a support group to help workers who are trying to lose weight

• Program - Locate registered dieticians near your worksite as a resource for workers who want information on healthful eating, meal planning or weight control

• Program - Offer individual counseling for staff members attempting to lose weight

• Program - Offer on-site fitness and weight-management programs through your local hospital, Weight Watchers, TOPS or local, registered dietician

• Program - Schedule an educational session on diet myths and healthy eating

Exercise Programs

• Policy - Allow flexible work schedules to encourage exercise

• Policy - Develop a fitness space with aerobic equipment, and weights

• Policy - Develop accessible walking paths, trails, and/or bike routes

• Policy - Make sure to encourage staff members to walk more by parking farther away from the entrance

• Policy - Establish a fitness center with aerobic equipment, weights, aerobics classes, fitness specialists

• Policy - Hold walking meetings

• Policy - Make the stairwells more appealing (carpet, fresh paint, artwork, posters)

• Policy - Offer reduced fitness club membership fees to all employees

• Policy - Give facilities for staff members to secure bicycles

• Policy - Schedule 5 - 10 minute stretch breaks during the day

• Policy - Subsidize health club membership for staff members who participate a minimal number of days per week (ex., 3 days per week)

• Policy - Support lunchtime walking/running clubs or company sports team

• Program - Be sure to encourage stairwell use and incentives

• Program - Install a basketball hoop outside

• Program - Promote and support community walks or fitness events

• Program - Promote walking during breaks and other off-time periods

• Program - Give periodic fitness incentive programs to encourage exercise

• Program - Schedule educational sessions on fitness activities

Tobacco use Cessation Programs / Smoking Cessation Programs

• Policy - Create a smoke-free grounds

• Policy - Develop a tobacco-free workplace

• Policy - Make sure to encourage the use of 1-800-QUIT-NOW, North Carolina’s free Tobacco Use Quitline. Or check www.QuitlineNC.com

• Policy - Reimburse for tobacco replacement products

• Policy - Subsidize the cost of smoking cessation workshops

• Program - Provide  flyers and information on health effects from smoking and tobacco cessation

• Program - Schedule awareness sessions to motivate workers to try to quit tobacco use

• Program - Schedule on-site tobacco use cessation workshops

Staff Member Health Testing

• Policy - Discount health insurance premiums or reduce co-payments for employees who participate in screenings and who participate in managing their risk factors

• Policy - Install blood pressure monitoring equipment

• Program - Offer flu shots for workers and family members

• Program - Offer Health Risk (Assessment|Appraisal}s to all workers, including counseling and follow-up

• Program - Offer periodic blood pressure (BP) screenings and follow-up

• Program - Offer periodic screenings for cholesterol, blood sugar, body composition, etc.

Stress Management Programs / Be sure to work Life Balance Programs

• Program - Allow flexible schedules for family/work life balance

• Program - Offer and promote an staff member assistance program

• Program - Give information on substance abuse prevention

• Program - Provide  flyers and information on stress management and mental health

• Program - Give  handouts and information on work life balance, like financial planning, childcare, parenting, elder care, etc.

• Program - Provide supervisor and manager training on communication, relationship building, organizational stressors, etc.

• Program - Review corporation policies and work schedules to identify organizational stressors

• Program - Review the worker assistance program to ensure it is meeting the needs of the staff members and company

• Program - Schedule educational sessions on stress management and work life balance

• Program - Schedule seminars on relaxation, stress management, and work life balance topics

Working with local hospitals and other organizations, you can obtain information on providing screening and intervention programs that could improve your employees’ health and save your corporation money in absenteeism, treatment for disease complications, and lowered productivity.

Below are some ideas to help get you started.

Based on your Employee Needs and 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 workers with pre-hypertension or hypertension (high 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, like Body Mass Index (BMI)  or body fat measures

• Bone density for potential risk of osteoporosis,

• Cancer screenings such as, skin analysiss, mammograms, or PSA screenings,

• Vision checks for glaucoma, or visual acuity

• Other screenings depending on your staff member population and needs

Your local hospital, corporation physician practice, or health department my provide assistance. Nevertheless, when you’ve a young workforce you could 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 could  be healthy lifestyle practices to reduce risk and prevent illness.

In addition to the health screenings, consider offering a Health Risk (Assessment|Appraisal} to all workers. the Health Risk (Assessment|Appraisal} will help to identify factors that may lead to additional risks, like use of tobacco history, stress levels, perception of health, family history, job satisfaction, support systems, and mental health.

Often the screening results are included on the Health Risk (Assessment|Appraisal}, which provides a more robust snap shot of health risks. the summary results provide the important information to plan appropriate interventions.

Wellness Program Interventions

The key to the success of screenings and Health Risk (Assessment|Appraisal}s / Health Risk (Assessment|Appraisal}s is the interventions or follow-up programs. the information from the screenings increases awareness and often motivates workers to consider making healthier changes.

It’s the follow up interventions that provide the essential support and assistance needed for workers to actually make and maintain those changes.

The interventions can include individual follow-up and ongoing counseling, individual or group medical coaching on the risk factors, behavior change programs, and/or organizational support. Examples include -

• Strategies to lower blood pressure

• Managing diabetes

• Taking care of your heart

• Healthful eating

• Weight loss strategies

• Increasing exercise

• Tobacco use Cessation

Of course, 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 Wellness Committee objectives you can plan the best strategies for your business and workers. Consider the community resources available to provide services, such as health associations, hospitals, health care providers, and/or public health agencies.

The Quick Wellness Program Ideas provides Quick program idea tips for your consideration. Also refer to Prevention Strategies to determine the best approach for your corporation based on the wellness budget in order to reach the desired outcomes and goals established.