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Fiscal fitness: how wellness programs can boost the bottom line.

Imagine getting a $120 discount on your health insurance for agreeing to take the stairs instead of the elevator. How about getting a $50 gift certificate to your favorite store for agreeing to wear a seat belt or to work out regularly? These are just a couple incentives some companies give employees who participate in a company-sponsored wellness program.

With the help of hospitals and fitness providers, Indiana companies are providing their employees with a variety of wellness programs designed not only to improve workers' health but also to hold down healthcare costs, reduce absenteeism and help in the recruitment of quality employees.

"We know that promoting health at the workplace will eventually affect the bottom line in a positive way," says Chris Arvin, wellness service coordinator for Columbus Regional Hospital. "But it's not a quick fix."

Although wellness professionals acknowledge that some wellness benefits - such as improved morale - are intangible, studies show wellness programs can have an impact on a company's medical costs. For example, a study by consumer-products maker Johnson & Johnson estimated that helping an employee quit smoking can save $1,100 a year, while the same study estimated that an employee who starts an exercise program can save the company an estimated $260 a year. According to Compensation and Benefits Management magazine, for every $1 that Blue Cross of Indiana spent on its employee-wellness program, the company received $2.51 back.

"Well-designed, well-implemented wellness programs can be very effective," says Darrell Mendenhall, coordinator of the internal wellness program for Clarian Health, an Indianapolis-based health-care provider whose holdings include Methodist, Riley and Indiana University hospitals. "If we can get 20 people into a smoking-cessation program and five of them quit smoking for life, then we've paid for that program for years."

Wellness programs, which grew out of both the fitness craze of the 1980s and in response to skyrocketing health-care costs, can take a variety of forms, including monthly newsletters filled with health tips, seminars, discounts at fitness clubs or full health screenings and follow-ups.

"It's sort of like a grocery store where there's a shelf full of services, from employee screenings to seminars." explains Jeff Hutson of Hancock Memorial Hospital and Health Services in Greenfield. "We take these services to businesses and ask them what they want off the shelf."

Carol Walker, director of the education department of Porter Memorial Hospital in Valparaiso, says the hospital works with corporate clients to fashion wellness programs. "Many times they will come to us with a topic and ask us what we can do for them."

Walker says Porter Memorial Hospital is big on educational programs and working with other community groups to provide comprehensive wellness programs. For example, the hospital puts on an annual health fair at Bethlehem Steel with the help of many other organizations.

Methodist Hospitals in Gary and Merrillville offers a catalog of wellness services allowing a company to pick and choose from variety of programs in a range of prices. The cost of the programs - from smoking-cessation classes to personal wellness profiles - depends on the number of employees and whether the company is a member of the hospital's WorkingWell Network.

But Mark Savage, the manager of Methodists Hospitals' wellness program, says randomly choosing wellness programs without a clear goal is wrong-headed.

"Some companies say they want us to just come out and do a blood-pressure class, and in the back of my mind I'm thinking 'Why are they doing the blood-pressure class?'" Savage says. "It really pays to find out about the population you're dealing with so that you're not spending a lot of money on programs that aren't going to help."

Terri Cueller, team leader of Hancock Hospital's occupational-health program, agrees, adding that a company can determine its wellness needs in a number of ways. One way is a survey questioning employees about their lifestyles and their desires in a wellness program. A company also can review health-care claims to find out what portion of those claims are in disease categories that can be affected by a change in behavior. For example, if a company has a rash of back injuries, a class on how to avoid those types of injuries would be well-advised, Cueller says.

Health risk screenings of employees are another way to establish what types of wellness programs are most needed. These health-risk assessments, which hospitals provide as part of their wellness services, look at a person's age, weight, body fat and blood cholesterol level as well as analyze an employee's nutrition and lifestyle choices and how they affect a person's risk for disease.

But if a company doesn't have the money to conduct an extensive survey or provide health screenings, wellness professionals point out there are some pretty safe bets on where to start. "Only about 22 percent of the population exercises regularly and most carry a little extra weight," explains Arvin of Columbus Regional Hospital. "You can almost always assume that weight loss is a need, especially in Indiana and perhaps even more so in southern Indiana."

The National Institute for Fitness & Sport, a not-for-profit organization committed to improved fitness, offers seminars and other wellness programs in addition to managing 15 work-site fitness facilities for Indiana companies. Corporate clients include the Subaru-Isuzu plant in Lafayette, which has a 40,000-square-foot workout facility on site, as well as Eli Lilly & Co. and National Wine & Spirits.

Chris Costlow, director of marketing for NIFS, says these types of facilities are a real draw for potential employees. But Costlow adds that there is more to wellness programs than just providing aerobics.

Costlow says there are four basic levels in wellness programs: communication, which entails newsletters or bulletin boards with helpful information; assessment, such as screenings used to determine an employee's health; education, which includes classes and seminars on such topics as lowering cholesterol or avoiding lower back injury; and a supportive environment, which entails not only a well-run wellness program but such details as having healthy foods and drinks in the company's vending machines and serving low-fat food in the cafeteria.

Costlow says a company that incorporates all these levels will have a more productive wellness program. But he adds the real key to success is that management really believes in the program. "If you don't have someone in upper management that supports it, the program will die," Costlow says.

"The attitude at the top is crucial," agrees Savage at Methodist Hospitals. "These programs need both philosophical and budgetary support to succeed."

Another key to a successful program is participation by employees. "This is not the old 'Field of Dreams' adage, hold it and they will come. They won't," Savage says. "You have to provide some type of incentive."

Arvin says motivating employees to participate is one of the biggest challenges. "The real question companies have to deal with is how do companies motivate their employees. Some will offer our services for free on work time, like a cholesterol screening. Others will tie it to their benefits package."

Incentives offered can vary from company to company, ranging from T-shirts or coffee cups to monetary rewards to rebates on health insurance. But many occupational-health professionals say incentives are most effective if they are tied to benefits.

In addition to what type of incentives to provide, companies need to consider how to award them. Savage says you can link incentives to participation, which is simpler and cheaper to implement, or rewarding results, such as if an employee loses 10 pounds or reduces his or her cholesterol level. But Savage cautions companies with result-oriented wellness programs to have some way to deal with employees who try but have a difficult time achieving their fitness goals.

Whatever the form, wellness professionals say incentives are critical for reaching high-risk employees. "There's always the concern that only healthy people will participate, and then you're just wasting your money," Savage explains.

Costlow of NIFS says, "Our goal is always to get the people who are at the highest risk." As incentives, NIFS awards seminar door prizes, such as tickets to sporting events or dinner-for-two gift certificates.

Cueller of Hancock Memorial Hospital says persistence is also a key to participation. "One thing you need to do is just keep after it. You get people who say, 'You just want to see how bad of health I'm in, so you can cancel my insurance,'" Cueller says. "You have to allay those fears and give them a reason to participate."

For example, Cueller says her hospital's wellness program gives employees a $10 a month reduction in health insurance premiums if they agree to seven of 15 healthy lifestyle activities.

Another way to increase and improve participation in wellness programs is to take a holistic approach, says Mendenhall, the wellness coordinator of Clarian Health's employee program.

"If someone is overweight, we can prescribe a fitness and diet program, but say it becomes obvious that the person has an eating disorder or is eating because he's lonely or depressed," Mendenhall says. "Then we have to deal with the spiritual and emotional aspects."

Dianne Wiemers Wyman, manager of the Women's Wellness alliance, a collaboration with the Indiana University School of Medicine and NIFS, says a comprehensive plan with education helps because people understand why they need to make a lifestyle change.

"People are much more likely to comply if they understand the why," says Wiemers Wyman. "For example, weight-bearing exercise stimulates growth in bones, which in turn helps prevent osteoporosis."

Costlow says with education employees realize they can make a difference in their health. For example, Costlow says, the risk factors for cardiovascular disease - smoking, high blood pressure, lack of exercise, high cholesterol and diabetes - can be affected by a lifestyle change.

"The five things that lead to cardiovascular disease are all modifiable," Costlow says. "That's what we teach is that you are in control of your health. You're going to look better and you're going to feel better, but you have to take ownership of your health."

And with employees trying to improve their health, a company can reap rewards as well.

"From the employer perspective, you're going to see less sick time, a drop in injuries and worker compensation claims," says Walker of Porter Memorial Hospital. "Not only that, but employers will see improved attitudes and employees who are able to cope with stress better."
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Publication:Indiana Business Magazine
Date:Jul 1, 1998
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