Employers’ challenge: Causing lifestyle changes
One of the biggest challenges facing employers is that employees believe they are already engaging in healthy behaviors and may not see the need for change, according to the Hewitt Associates 2008 annual health care survey.
While 88 percent of employees say they are engaged in healthy behaviors, they don’t necessarily take specific actions toward living a healthy lifestyle. Less than one-half of employees say they eat right or are exercising three or more times a week. Six out of 10 employees say they do a good job at getting preventive screenings, but only four out of 10 say they do a good job at tracking their essential health numbers and asking for advice on how to stay healthy.
To make matters worse, what employees say they do, doesn’t match national data or their employer’s claims and experience. So, they may have good intentions but their actions are waning.
The survey also found that employees support linking incentives to promote healthier lifestyle decisions.
Seven out of 10 employees support lower premiums for practicing healthy behaviors such as exercising regularly, and 76 percent of employees agree with the idea of having higher health care premiums for smokers.
Wellness programs are becoming a popular way for companies to cope with the increasing price of health care.
“Employers have done just about all they can do in terms of changing plan designs and changing insurance companies and all of the traditional kinds of things that they tried back in the managed care era,” said Jack Bastable, national practice leader of health and productivity management at CBIZ Employee Services.
About five years ago, he said, businesses started realizing that 70 percent of costs associated with health care are due to preventable conditions, such as smoking, obesity and type II diabetes. In fact, it is estimated that preventable behaviors cause illnesses that cost the U.S. health care system an estimated $100 billion each year. Now, about 85 percent of U.S. businesses have wellness programs.
“It’s a paramount necessity that employees start taking better care of themselves,” Bastable said. “At the same time, employers must set the stage by getting involved and promoting healthy lifestyles among employees by implementing effective wellness programs.”
He said both large and small companies are now fine-tuning their programs so they are more effective. For example, instead of just offering a discount on a gym membership, they also are offering coaches and programs to help employees stop smoking. They also might offer incentives to get a health evaluation. That evaluation might detect a health problem in the early stages when costs are lower than at the full-blown stages.
“Good wellness programs will save an employer money,” Bastable said.
Employers would like to see the savings on their premiums, but the savings often come in areas such as better productivity, less absenteeism and less workers’ compensation.
“If you have two equal people, the person who is healthier will outperform the person who is not,” Bastable said. “Healthier people always outperform those who are not.”
State’s plan earns honors
The Kansas Health Policy Authority recently received an award from the Institute for Health and Productivity Management for innovative strategies in its state employee health plan. The plan is designed to control costs by promoting healthy lifestyles and personal responsibility.
The plan includes:
• Incentives for tobacco users to stop smoking and for nonsmokers to remain smoke-free.
• A wellness plan called HealthQuest, which offers a financial incentive for taking a personal health assessment and 24-hour health coaching.
• Information about cost-effective prescription drug use.
• Outreach for those who suffer from chronic health conditions.
“They were recognized because of the design of their plans and the programs that they offer to really support the health and well-being of the state’s employee health plan members,” said Bastable, who also is director of education for value-based health for the Institute for Health and Productivity Management.
Mike Michael, deputy director of the state employee health plan, said the plan is available to about 76,000 individuals, which includes employees, spouses and dependents under age 18. He said the state has had a wellness program for years, but in 2008 expanded the offerings to include health coaching, health screenings and lowered co-payments on diabetic and asthma drugs.
“The hope would be that the individuals would have easier access from an economical standpoint to staying on the medications that they needed to,” Michael said. “So, hopefully, they didn’t end up with an asthmatic event or something where the person ends up in the ER.”
He said the state offered a $50 gift card incentive to participate in a health screening and 15,774 people took them up on the offer. The health screenings tested things such as blood pressure, cholesterol, weight and glucose level. Once done, employees could enter those results into an online health assessment tool where they would get a report on their health status and suggestions on what to do.
“Our hope was that some folks then in turn, maybe, take that information and contact the health coach and have some support behind them,” Michael said.
Now, the state’s biggest challenge is spreading the word about their health care initiatives. They have employees in 105 counties and retired members who live across the United States.
“We cross a lot of areas, and there are a lot of services available to the employees, and of course, we are going to work more on engagement strategies to make sure that folks know about the program,” Michael said.
Wellness works locally
On a smaller scale, Lawrence Paper Co. has 280 employees and a wellness program that includes an onsite clinic that opened in April 2007. The clinic is available two days a week and can provide items such as prescriptions, lab work, shots and wellness checks.
“To implement and gear them toward wellness and lifestyle changes, they must visit the nurse practitioner twice a year and they also must participate in our annual health fair,” said Liz Stark, assistant personnel director.
Such requirements don’t bother longtime employee Milly Fergus. She described the health fair as wonderful and said she takes the results to her doctor. The health fair and clinic, she said, saves her time and money.
“When you stop and think about how much money that saves from going to the doctor, it’s great,” Fergus said. “It’s just real convenient and very good.”
Stark said the health initiatives have lowered the company’s health care costs, but expects more savings over time. That’s because the clinic is relatively new. The company’s plan also provides disease management and chronic care services for free. Shots and lab work are provided at lower costs.
She described the wellness program and clinic as a win-win situation for the employer and employees.
“The only way that there’s not cost savings to the employee is if they do not participate in the actual wellness program that we offer, but we have very high participation.”