Ten Steps Toward Strategic Corporate Health Promotion Programs

The Corporate Health Promotion Plan management world is evolving rapidly. Each month, there are new research findings that support the premise that Corporate Health Promotion Programs and disease management have a long-term impact on health care costs. Many large corporations that started Corporate Health Promotion Programs three to five years ago are showing savings in health, disability, and workers compensation costs. Small to mid-size corporations are watching all this and wondering where to start with wellness.

Getting upper management support and budget approval is one of the challenges at the beginning of a Corporate Health Promotion Program. This is the case because Corporate Health Promotion Programs can be expensive, averaging $150-300 per worker per year in large corporations. The majority of of the savings are not realized for a number of years. This long-term investing is hard for corporations on the move.

The key to success for Corporate Health Promotion Programs is to take a strategic approach. Here are ten steps to consider when starting a Corporate Health Promotion Program.

1. Start with upper management. Without upper management support, a health promotion strategy can fall flat. Start with the health of your executive team and discover your wellness champions at the top of the organization.
2. Analyze the problem. Look at your health care claims and analyze the trends. Which conditions are driving your medical, disability, and workers’ compensation claims and which are modifiable? What’s worked and what hasn’t thus far? What is the long-term impact of doing nothing?
3. Hold an initial wellness meeting. Invite your primary stakeholders both outside and inside the organization. Ask your broker to facilitate the meeting and invite primary health vendors including health, disability, Employee Assistance Program (EAP), fitness, and occupational nursing. Review claims and utilization information and identify primary areas of concern. Look at current offerings and see how they can be tailored to the needs of the population.
4. Look at both healthy and unhealthy workers. Since 85% of claims are usually attributed to 15% of claimants, it is critical to reach those with the most costly conditions while also reaching employees who are at risk for developing preventable diseases in the future. Voluntary Corporate Health Promotion Programs such as lunchtime wellness seminars miss many of the employees who need them most. Look at initiatives that are population-wide or target intact workgroups. Wellness incentives help but do not motivate everyone.
5. Establish short-term goals for the Corporate Health Promotion Programs. Establish some realistic short-term goals based on your primary areas of concern. Are there any plan design changes that could have an immediate impact on spending? Are there some programmatic actions that could have immediate results?
6. Find out what workers are thinking. Hold some focus groups to determine where employees are with wellness. What’s working? What isn’t? How much interest do employees have in the Corporate Health Promotion Programs? What obstacles and barriers are workers experiencing when they try to change behavior?
7. Make sure you have a high-impact Employee Assistance Program (EAP). Your first wellness dollars should go into upgrading your Employee Assistance Program (EAP). A highly utilized Employee Assistance Program (EAP) can provide a foundation for all of your future wellness programs. A good Employee Assistance Program (EAP) is a trusted link to the hearts and minds of workers. At no additional cost, the Employee Assistance Program (EAP) can provide needed follow-up coaching and personal attention for workers who are working on modifiable health behaviors or involved in disease management initiatives. Nutritionists, fitness, pregnancy, and stress management specialists are all part of a high-value Employee Assistance Program (EAP).
8. Establish three to five year goals for health care savings and measure them. Get help from your broker and insurance carrier help you on long-term goals for your health, disability, and workers compensation plans. Establish program metrics that will help you to measure return on investment (ROI). Go beyond participation rates, completion rates and program satisfaction. Measure changes in readiness, changes in behavior, and changes in risk factors. Establish rigorous methods to measure health care savings over the long term.
9. Establish goals for organizational health. Look at the more intangible benefits of a Corporate Health Promotion Program and quantify them whenever possible. Include worker turnover rates, cost of new hires, worker morale, benefit satisfaction information, and employer of choice issues in setting goals. Establish ways to measure success in these areas.
10. Add specifics to your short and long-term plan. Include a Corporate Health Promotion Plan strategy, a communication strategy, and a Corporate Health Promotion Plan incentive strategy that will fit with your corporate culture. Focus on integration of related components along a health continuum with communications that are focused, simple, and human. Establish a budget that includes primary components such as consumer education, health promotion, Health Risk Assessments / Health Risk Appraisals, and regular biometric screens.

Corporate Health Promotion Programs are crucial to improving the health of our nations. The majority of adults spend more of their waking hours at work than anywhere else, making it a excellent venue for promoting healthful habits. The worksite organizational culture and environment are powerful influences on behavior and this needs to be put to use as a method of assisting workers to adopt a healthier lifestyle. Advantages to Corporate Health Promotion Programs include:
• Weight reduction
• Enhanced physical fitness
• Increased stamina
• Lower levels of stress
• Increased well-being, self-image and self-esteem

Employers can also benefit from Corporate Health Promotion Programs. According to recently published research, employers’ benefits are:

• Enhanced recruitment and retention of healthy workers
• Reduced health care costs
• Decreased rates of illness and injuries
• Reduced worker rates of absence
• Enhanced worker relations and morale
• Increased productivity

A U.S. Department of Health and Human Services report revealed that at worksites with physical activity initiatives as components of their Corporate Health Promotion Programs have:

• Reduced health care costs by 20 to 55%
• Reduced short-term sick leave by six to 32%
• Increased productivity by two to 52%

Thanks to modern medicine, life expectancy for Americans has continually increased. How much we enjoy these additional years, however, depends greatly on how we have lived our lives. If our quality of life is to remain high so that we can fully enjoy these extra years, we must practice good eating habits, be active and refrain from using tobacco products.

Who needs Corporate Health Promotion Programs? If you work in an office or a worksite or are a member of an organization who spends a considerable amount of time at work, you will benefit from a well-designed worker Corporate Health Promotion Program. Employees spend a minimum of about 200 hours a month at work – a considerable amount of time.

Furthermore, stress, distractions and the pressures of the job can take its toll on the worker, which makes it important that a Corporate Health Promotion Plan is implemented. Today, all across America, Canada, Europe and Asia, top Corporate Health Promotion Programs are being used to help improve worker conditions at work and reduce the cost of worker health care.

Some of the top Corporate Health Promotion Programs currently in use today include:

Health Risk Assessments / Health Risk Appraisals

Health Risk Assessments / Health Risk Appraisals is a top Corporate Health Promotion Plan currently in use globally. Organizations that begin it determine the safety and health concerns of workers by the assessment of appropriateness of the facilities and equipment against the needs of the workers.

It can, by way of example, guide the organization into determining how much air quality within an office room affects the users and then help the assessment team to come up with the measures necessary to correct the problem. Health Risk Assessments / Health Risk Appraisals can also evaluate the level of exposure workers have to certain hazardous or dangerous materials and practices.

Immunizations

This isn’t always practiced in every country since there are regions where government sponsored immunization shots are available. However, it has also become an important component of the top Corporate Health Promotion Programs in many corporations in North America.

Immunization, flu shots, such as those used to combat flu, by way of example, are offered to workers for free.

Employee Assistance Programs (EAPs)

Employee Assistance Programs (EAPs) consist of a wide variety of services. It can range from providing educational resources to workers regarding health issues to sponsoring health services and medical care. In many corporations, medical and insurance have also become a staple part of their benefits system.

Weight Management Programs

This is another Corporate Health Promotion Plan that corporations use, particularly those that offer in-house commissary or cafeteria services. Instead of serving richer, high-calorie fare, cafeterias offer options for a healthier diet, usually in the form of low-calorie foods and sugar substitutes.

Employee Wellness Newsletters – Health Education Programs

One of the top Corporate Health Promotion Programs that corporations can begin is a self-powered tool using a newsletter to promote wellness, coupled with a visible campaign. The campaign may be done periodically and focus on a specific topic, such as tobacco use hazards, cancer, stress, carpal tunnel syndrome, safety in the worksite, etc.

The newsletter in itself can be an effective method to deliver information to workers or members of an organization but it is far from perfect. Some workers, by way of example, may not read the newsletter in its entirety or even pay attention to it. If the issues outlined in the newsletter are promoted through an active and highly visible campaign, it will be easier to maximize positive results.

Physical Fitness and Exercise Programs

Another top health promotion program for corporations is one that involves physical activities. Companies frequently sponsor physical fitness-related events such as marathons and organization sports initiatives to encourage workers to remain fit or lose excess weight. In mid- to large-sized corporations, corporations may even pay for gym memberships or in-house physical fitness facilities.

Corporate Health Promotion Plan Incentives

Some of the top Corporate Health Promotion Programs implemented by corporations involve incentive rewards. This involves organization-sponsored initiatives that reward workers for achieving specific wellness goals. Participation in health campaigns and signing up for Corporate Health Promotion Programs are two of the most commonly rewarded schemes. Rewards can range from special recognitions to points (for bigger rewards) to specific gifts. In a few cases, cash may also be used.

However, incentive systems have had mixed reactions and levels of success. But it continues to be one of the top choices among corporations who are willing to modify it in order to fit their unique needs.

Group Activities

In many corporations, corporations take advantage of peer pressure in order to encourage workers to take part in Corporate Health Promotion Programs. This is currently one of the favorite worker Corporate Health Promotion Programs currently in use today and growing in popularity. Peer pressure is frequently leveraged to help promote competitions and to persuade workers to be active in organization-sponsored health fairs.

Corporate Health Promotion Programs at the corporate level are beneficial, right? Wellness statistics clearly show that such Corporate Health Promotion Programs are not only cost-effective for the organization but can assist the worker in developing a healthier lifestyle. With the increasing cost of health care, Corporate Health Promotion Programs simply make sense. So where does the problem come in? Let’s examine the topic from both perspectives.

Corporate Health Promotion Programs: The Good
• A sampling of return on investment (ROI) for Corporate Health Promotion Programs: Bank of America: 600 percent; General Motors:370 percent; Pepsico: 300 percent; Citibank: 465 percent; and the Washoe County School District leading the pack at a whopping 1,560%. (Campbell,J., Wellness Improvement Experts, www.wellnessimprovementexperts.com, Albuquerque, New Mexico.)
• Companies with Corporate Health Promotion Programs have realized a 28% reduction in sick leave, a 26% reduction in adjunctive health care costs and a 30% reduction in disability and workers compensation costs. (Health Affairs, Volume 21, No.2, March, 2002.)
• The Washoe county School District in Northern Nevada realized a $15.60 return on investment (ROI) for every dollar spent due to a 20% reduction in rates of absence. (Hardy,A. (2005). At the Top Of The Class. WELCOA’s Absolute Advantage Magazine, 5(1), 14-20.)
• Corporate Health Promotion Programs provide the structure, encouragement, incentives and ongoing support that many individuals need in order to make lifestyle changes.
• Employees also realize returns on their efforts. FiServ, a financial services technology organization, gave workers who filled out a health risk assessment a significant discount on their health insurance premium. (Holland, Kelley, The New York Times, July 22, 2007.)

Corporate Health Promotion Programs: The Bad
The flip side of the argument centers on basic human rights. Do we want/need our employer to tell us to eat our veggies or lose 30 pounds? Some corporations are doing just that and at least one lawsuit has resulted because of it.
• Three hundred corporations have requested assistance from a national employment and labor law firm to institute more aggressive Corporate Health Promotion Programs.(Cornwell, Lisa, Associated Press, Albuquerque Journal, September 10,2007.)
• Clarian Health, based in Indianapolis, Will start decreasing worker paychecks by $10.00 for every worker who has a Body Mass Index (BMI) of greater than 29.9 because not enough workers were utilizing their wellness services.(Cornwell, Lisa, Associated Press, Albuquerque Journal, September 10,2007.)
• Scott Rodrigues filed a suit against his prospective employer, Scotts Miracle-Gro, because he believed the organization’s antitobacco use policy violated his civil rights. The organization has a policy against hiring workers who smoke and Mr. Rodrigues’drug screen was positive for nicotine.(Holland, Kelley, The New York Times,July 22,2007.)
• worker advocates are concerned that health discrimination may not be covered under the Americans with Disabilities Act.(Cornwell, Lisa, Associated Press, Albuquerque Journal, September 10,2007.)

Penalizing workers by hitting them where it hurts the most,their pocketbook, does not appear to be a favorable approach to molding human behavior.
Such tactics may result in raised resentments and retaliation, primarily in the form of rates of absence and presenteeism (decreased productivity on the job.) Voluntary, incentive-based initiatives, such as the one in the Washoe County School District, can and do produce results. A positive attitude on the part of management along with an opportunity for workers to have a stake in the decision-making may yield the greatest dividends to both employer and worker.The motivation and resolve needed to change unhealthy lifestyle habits can best be derived from the basic tenets of encouragement, respect and support.

Preventing injuries is a high priority for corporations, especially in factory settings such as Honda. That’s why the organization offers several initiatives—including line-site process evaluations —to identify potential hazards and help reduce the chance of injury. As part of an early intervention program, Honda workers who are feeling pain can receive a massage of the affected area during work time.

Stretching initiatives are another effective tool in injury prevention. According to the Best Practices in Manufacturing Web site, Dayton Parts, Inc. (DPI) in Harrisburg, Pa., conducted research that revealed approximately 80% of all manufacturing injuries occurred within the first two hours of each shift. After starting a program that mandated production workers to stretch for 10 to 15 minutes at the beginning of their shifts, they saw a dramatic reduction in injuries.

While the DPI Corporate Health Promotion Plan costs about $75,000 a year to operate, in conjunction with other organization initiatives, it has helped bring the annual cost of workers’ compensation from $700,000 to $200,000 per year.6

To help prevent lengthy absences and reduce workers’ compensation claims, Honda instituted a work recovery program. Through the program, workers who have had an injury can work in a modified job—getting better. Employees in the program spend their work days receiving physical conditioning to increase overall fitness, physical therapy to restore functionality, health education and nutrition counseling. The program is based on information that shows fewer work days are lost when an worker stays connected to the work environment.

The Ohio Bureau of Workers’ Compensation, www.ohiobwc.com, provides a “10-Step Business Plan” as a guide for corporations in providing Corporate Health Promotion Programs that aim to reduce injuries. The plan includes information on safety and health initiatives to prevent occurrences of on-the-job accidents, including:

worker involvement – To ensure the success of any Corporate Health Promotion Program, workers must take part in the safety and health-management process. This can be done through safety and health audits, accident investigations, or by forming safety and health involvement teams, focus groups or committees.

Orientation and training plan – Conduct orientation and training sessions to educate workers on the organization’s safety policies. These sessions should include procedures for the safe use of machinery and tools, chemical hazards and how to prevent contact or exposure, specific job/task safe practices, and hazard recognition and prevention.

Communication – Open communication keeps workers informed and provides suggestions and feedback on the effectiveness of the Corporate Health Promotion Program. Through memos, bulletin boards and staff meetings, important health and safety information can be conveyed throughout the corporate, keeping all management staff and workers knowledgeable about the organization’s safe practices.

The organization plan also outlines incentives for post-injury procedures, including:

Medical treatment and return-to-work practices – arly return-to-work strategies help injured or ill workers return to work in a timely manner. Companies should begin a disability management policy to help injured or ill workers obtain quality medical treatment, making their transition back to work quick and effortless.

Timely notification of claims – Employers should document worksite injuries immediately after they occur and promptly send that documentation to a claims handler. Quickly providing claim information demonstrates care and concern for the injured worker, prevents delays and confusion with the claim process, and reduces the potential for abuse or needless litigation.

Record keeping – Internal documents should be kept to record work-time injuries and to assess the success of the organization’s safety efforts. Organization audits, surveys and injury or illness reports can all be used to analyze which safety practices and policies have proven successful, and what areas of health and wellness need improvement.

Dr. Moore of Nationwide maintains that immunization is the most cost-effective treatment in medicine. For example, vaccinating children against the influenza virus averages a savings (including health care costs, parents’ missed work, etc.) of up to $35 per vaccine recipient. And experts predict that estimate is low, because it doesn’t take into account the rapid spread of the flu.

The American Association of Family Physicians’ Web site, www.aafp.org, offers a recommended adult immunization schedule created by the Advisory Committee on Immunization Practices. This schedule, tiered by age and chances of exposure, recommends diphtheria, tetanus, influenza, pneumonococcal, hepatitis B, hepatitis C, measles, mumps and rubella, varicella and meningococcal vaccinations.

Ideas to incorporate prevention and early detection:

• Hold a wellness fair and invite companies that provide testing services for such conditions as blood pressure, blood iron, cholesterol, body mass index (BMI) and diabetes.
• Provide educational materials about well-baby care and vaccinations.
• Choose health care coverage plans that include wellness check-ups and vaccinations.
• Provide worplace mammograms for workers.
• Sponsor worplace flu shots to coincide with flu season.

Advantages of Stress Reduction Programs

While stress cannot be eliminated from life, or even from the worksite, coping skills can be developed with relative ease. Stress management skills lead to decreased rates of absence and more effective, more productive workers. Because stress has been shown to contribute to such physical conditions as ulcers, high blood pressure and stroke, stress reduction has a direct impact on improving physical health.

Studies have shown that heart patients who attend stress management initiatives have 42% lower health care costs. Other studies have documented a 50% reduction in medical services use when stress management initiatives are employed. Further, Employee Assistance Program (EAP) experts estimate that 20% of any workforce is affected by personal problems that can influence work performance.

Stress reduction tactics to consider:

• Provide worplace yoga or meditation classes.
• Organize support groups among workers.
• Sponsor stress management classes during the workday.
• Provide an employee assistance program that includes both counseling and referral.
• Provide worplace counseling for workers in the case of a work-related trauma, such as the death of a co-worker.

Advantages of Prenatal Care and Breastfeeding

The old adage “an ounce of prevention is worth a pound of cure” is particularly relevant to when applied to preventive measures taken during pregnancy, when a few extra ounces of birth weight can save a child’s life. During pregnancy, simple precautions can help avoid catastrophic results; giving up tobacco use, for instance, drastically reduces the risk of miscarriage and pre-term labor.

The March of Dimes reports that if all women took adequate folic acid before conception and during pregnancy, the number of babies born with a neural tube defect could drop by as much as 70%. The physical and emotional benefits of proper prenatal care to a mother and child are underscored by a strong organization case for offering prenatal wellness benefits. Nationwide’s Chief Medical Director, Dr. Michael Moore, estimates costs to care for one baby delivered prematurely could approach $500,000.

First steps in fostering a prenatal program:
• Invite the March of Dimes to present information about prenatal health at an worker brownbag lunch or breakfast meeting.
• Hold prenatal care information classes for interested workers at lunchtime.
• Provide educational materials about the effects of alcohol, drugs and tobacco use on an unborn child.
• Provide incentives for adopting healthy lifestyles during pregnancy.
• Provide prenatal initiatives and education as part of the organization health care package.

Advantages of tobacco use Cessation Programs

Instances of respiratory diseases, cancer and other illnesses can be decreased through tobacco use cessation efforts. tobacco use cessation initiatives can provide huge opportunities for enhanced health.

The American Cancer Society reports that tobacco use workers cost corporations an average of $1,429 per smoker per year in raised health care costs over non-tobacco use workers. Implementing a tobacco use cessation program costs an average of $45 per worker per year, saving corporations an average of $1,383 per year for each worker who quits tobacco use. Additionally, the American Cancer Society reports that smokers are absent from work 50% more frequently than nonsmokers. They are also 50% more likely to be hospitalized and have 15% higher disability rates. tobacco use decreases onthe- job productivity as well. Employees who take four 10- minute tobacco use breaks a day work more than a month less per year than workers who don’t take smoke breaks.

Places to start with tobacco use cessation initiatives:

1. Establish a organization policy prohibiting tobacco use anywhere on the property.
2. Provide prompts/posters to support no tobacco use policy.
3. Policy supporting participation in tobacco use cessation activities during duty time (flex-time).
4. Provide counseling through an individual, group, or telephone counseling program onsite.
5. Provide counseling through a medical plan sponsored individual, group, or telephone counseling program.
6. Provide cessation medications through health insurance.

Advantages of Nutrition Programs

Nutrition directly impacts nearly every aspect of physical and mental health. A healthy diet can help protect against such conditions as heart disease, diabetes, arthritis, stroke, certain cancers and depression. Obesity, which is among the most common conditions linked to diet, affects a record number of Americans.

The American Journal of Health Promotion estimates the cost of obesity to U.S. organization to exceed $12.5 billion in health care, sick leave, and life and disability insurance. Further, one research study reports that obesity raises health care costs by 36% and medication costs by 77%. To offset the health risks of obesity and poor diet, many corporations have committed to helping workers ensure proper nutrition and undertake weight control initiatives.

Popular nutrition initiatives:

Fruit and Vegetable Consumption
1. Provide healthy eating reminders and prompts to workers via multiple means (i.e. e-mail, posters, payroll stuffers, etc.).
2. Provide appealing, low-cost fruits and vegetables in snack machines and in the cafeteria.
3. Provide cookbooks, food preparation, and cooking classes for workers’ families.
4. Ensure onsite cafeterias follow healthy cooking practices and set nutritional standards for foods served that align with the U.S. Dietary Guidelines for Americans.
5. Provide healthy foods at meetings, conferences, and catered events.
6. Use point-of-decision prompts as a marketing technique to promote healthier choices.
7. Provide healthy cooking demonstrations that teach skills (i.e. fruit and vegetable selection and preparation).
8. Provide taste-testing opportunities at the worksite.
9. Provide worker-led campaigns, demonstrations or programs.
10. Provide local fruits and vegetables at the worksite (i.e. worksite farmer’s market or community-supported agriculture drop-off point).
11. Use competitive pricing (price non-nutritious foods in snack machines and cafeterias at higher prices).
12. Provide protected time and dedicated space away from the work area for breaks and lunch.
13. Make kitchen equipment available to workers.
14. Provide an opportunity for onsite gardening if possible.

Sweetened Beverage Consumption
1. Make water available throughout the day.
2. Provide appealing, low-cost healthful drink options in snack machines and the cafeteria.
3. Modify worksite snack contracts to increase the number of healthy options.

4. Price non-nutritious beverages at a higher cost.
5. Use point-of-decision prompts to promote healthier choices.

Portion Control
1. Label foods to show serving size and/or nutritional content.
2. Provide food models, food scales for weighing and pictures to help workers assess portion size.
3. Provide appropriate portion sizes at meetings, worksite events and in the cafeteria.

Nutrition initiatives in action

While many corporations address weight management through fitness initiatives, corporations are increasingly focusing on nutrition through separate programming. Recognizing the productivity boost and lowered medical expenditures that come with maintaining a healthy weight, many corporations may help pay for obesity treatments for workers. For example, to improve the health of dangerously obese workers, drug maker Wyeth reportedly pays for stomach-shrinking surgeries that carry price tags of up to $40,000.

A 2003 Society of Human Resource Management research study shows that 24% of corporations offer weight loss initiatives. In Ohio, Honda offers an onsite, registered dietitian who provides individual or group consultations on weight management. Body fat analysis and body mass index (BMI) measurements are available to workers at any time.

At Grange Insurance’s Columbus headquarters, the cafeteria chef analyzes meals and provides workers basic nutrition information, including Weight Watchers points. Many corporations partner with the American Cancer Society to offer nutrition information through the ”5-ADay” program, which provides corporations free signage and educational materials about the importance of eating five servings of fruits and vegetables a day. The program also offers a fruit and vegetable ”frequency card” that gives workers a free portion of fruit or vegetables after he or she has purchased a preset number.