Companies take health education to the workplace.

Corporate wellness programs in the '90s involve more than workplace gyms. In Los Angeles and across the nation, companies are taking a cerebral as well as a physical approach to employee health.

Although many companies have gyms or racquetball courts, most are concentrating on educating their employees about staying healthy and providing on-site screenings, such as cholesterol tests.

Eighty-nine percent of U.S. companies have some type of wellness program, according to a survey by Lincolnshire, Ill.-based Hewitt Associates, an international management consulting firm. Increasingly, these initiatives include health screenings and counseling programs on disease prevention.

"Employers continue to move toward highly targeted health management initiatives that identify individuals at risk for developing health problems and provide education, counseling or treatment assistance early on," said Camille Haltom, who manages health promotion for Hewitt.

Education is a popular solution for improving employee health. Seventy-eight percent of the employers use some type of educational health program - evolving beyond brown-bag lunch workshops to individual counseling on treatment and lifestyle habits.

Many big companies are outsourcing their employee wellness programs rather than performing them in-house - either by hiring private health training firms, or relying more on HMOs that contract with the company.

Atlantic Richfield Co., for example, began contracting out its employee wellness program two years ago to Lifeline International, headed by former Arco employee Kailash Narayan. Much of the work Narayan formerly did at Arco continues through Lifeline.

"Most companies outsource to a different degree," Narayan said. "It's a matter of saving money, flexibility, and that companies don't want to be in a business that is not part of their core business. Having a full medical department is not the best use of time and talent."

In the early 1990s, Southern California Edison offered many on-site wellness programs, but now, according to Suzanne Mercure, the company's manager of health programs, Edison is more of a conduit and advocate for health care information.

"We try to get our health plans to provide better information for the consumer population about what is available," she said.

Edison used to offer an array of educational sessions at lunchtime, but "we don't do as many now and attendance tends to be low. That's probably a reflection of how busy people are. People are in information overload," she said.

Concern about privacy is another reason workshops may not be the place employees want to receive sensitive health information. They may not want other employees to know about their interest in depression or AIDS, for example, Mercure said.

Edison now looks to its six HMOs and point of service plans to provide up-to-date wellness programs, especially disease management programs.

"We've moved wellness and managed care closer to the physician. We weren't doing the right kind of services for dependents and retirees, and people respond better to physicians," Mercure said.

Even measuring the success of wellness programs is better done by the managed care organizations, Mercure said. Companies generally don't have a proper base for measurement while at the health plan or medical group level adjustments can be made for population changes.

Edison employees can still go to the gym with help from the company's preventative care account. Each employee receives $150 a year toward approved services such as nutritional counseling, physical exams, smoking-cessation programs, weight-reduction plans, and even gym memberships.

For companies like Lifeline that specialize in employee wellness programs, education is also a top priority. The group teaches stress management, relaxation techniques, massage therapy and "mind-body health."

Narayan sees a resurgent interest in wellness, "a lot of it driven by recognition that companies have gone too far in downsizing and service has been affected. Employees are so stressed out; we go in and help them deal with the situation. The problem is less the aging work force, but today's downsized work force. The people left behind are not getting the right treatment."

Narayan and Mercure see Internet and intranet access as an efficient way to reach employees and retirees.

"Consumers want information, they want 'dipsticks' or simplified health measures, and they want 'maps,' "to show them how to stay healthy, Mercure said. All those things can be provided via the Internet.

She wants physicians and health plans to be online too, as part of an integrated model that handles complaints and provides information.

"It hits me all the time that we reach only small fraction of the work force," especially in downsized companies with more work and fewer resources, Mercure said. "But it's only a matter of time before all communication is going to be done on the Internet or intranet. We can have information available all the time."