Wellness programming means different things to different corporations. Effective wellness initiatives can be as simple as bringing bushel baskets of fresh fruit into break rooms to encourage better eating. They can be as extensive as building fitness facilities onsite or paying for obesity treatments.

A driving factor behind the push toward wellness spans corporations of all types, sizes and cultures: that is, health care expenses are spilling over the corporate belt buckle. The annual cost of medical services in the United States is increasing at seven times the rate of inflation. And the rise in medical costs is one boom pundits expect our economy to sustain.1

This trend makes it increasingly challenging for corporations to maintain current levels of insurance coverage. In 2003, health care inflation forced 65% of corporations to increase workers’ share of health costs.

Seventy-nine% of large firms said they will increase workers’ share of health costs in 2004.2 But with lost benefits and increased financial burdens come lost morale and productivity.

Employers are searching for another way. While corporations cannot control many of the supply-side elements contributing to increasing health care costs—malpractice insurance rates, the nursing shortage—they can help curb demand. That’s why efforts are being redirected from illness to wellness.

The case for Corporate Health Promotion Programs is supported by an ever growing body of evidence demonstrating the high costs associated with controllable health risks:

• One research study reports that obesity raises health care costs by 36% and medication costs by 77%.
• Michigan officials estimate physical inactivity cost the state nearly $8.9 billion in 2002, a cost estimated to be largely borne by corporations through insurance premiums and lost productivity.
• The not-for-profit National Committee for Quality Assurance reports that the estimated average cost for postnatal care for women who did not receive prenatal care was $2,341 more than for women who had. And the indirect costs of unhealthful behavior can be just as high.

Information shows that healthier workers are more productive, spending more time at work and showing increased “presenteeism,” or productivity, while there. Further, healthier workers use fewer medical services. The five leading causes of death in the United States — heart disease, cancer, stroke, chronic obstructive pulmonary disease and diabetes — are directly linked to unhealthy lifestyles. Clearly, encouraging healthful habits presents an opportunity to improve workers’ well being, reduce the need for health care services and help control costs.

Offering worker wellness benefits — large or small — represents an intersection between corporate social responsibility and responsibility to stakeholders. Between worker health and corporate health. It’s frequently the right thing to do for workers and corporations.

Research by Traveler’s Corp. shows a $3.40 return for every dollar invested in Corporate Health Promotion Programs. For many corporations, the choice to offer worker wellness benefits is easy—one where conscience and pragmatism align.

The challenge arises in selecting the initiatives that will deliver the most impact based on trends in your workers’ health risks and medical claims costs. From large corporations to the corner deli, organization owners welcome ways to boost productivity, reduce rates of absence and cut costs. Likewise, Corporate Health Promotion Programs can range from modest to elaborate.

In determining where to focus a organization’s limited resources, looking at benefits, costs and best practices is a good starting point. This section profiles six aspects of wellness and explores their benefits to workers and corporations.

When it comes to working wellness into your workforce, you want someone who knows the ins and outs of health promotion, and who can counsel workers and provide primary care – all within the context of the current regulatory and legal environment.

AAOHN’s survey found that more than half of workers (61%) want to receive health and wellness information from a health care professional, such as a consultant or an worksite occupational health nurse (OHN), compared to pamphlets or brochures (18%) or human resources staff (15%).

OHNs can develop, begin and evaluate components of work site Corporate Health Promotion Programs such as testing initiatives, exercise/fitness courses, Stress management, tobacco use cessation, nutrition and weight control initiatives, and chronic illness management initiatives. Plus, OHNs can help workers navigate through complicated health plans and may even serve as a triage point between workers and their individual health care providers.

Employees might refrain from seeing their health care provider when it means time away from work, inconvenient parking, waiting time in the office and co-pays. In situations where workers are under treatment for chronic diseases like heart disease, worksite nurses can routinely monitor risk factors such as blood pressure or cholesterol on a regular basis.

It’s frequently easier for an worker to ask an worksite nurse for information about symptoms or prescription medication than it is to schedule a follow-up visit to a individual health care provider. Advantages realized by corporations include enhanced worker morale and retention, a recruitment advantage, raised productivity and decreased time away from work.

In corporations with a safety department, the OHN can evaluate and address work-related health issues, including participation in workstation evaluations to correct potential ergonomic problems, and proactively addressing muscle strains by developing stretching initiatives and involving workers in leading stretches.

Good for waistlines & your bottom line

By Sandra Simpson, APRN, BC, COHN-S, manager in Occupational Health Services at a Fortune 500 organization in Memphis, Tenn., and a member of the board of directors of the American Association of Occupational Health Nurses (AAOHN). For a copy of the AAOHN wellness survey, visit www.aaohn.org, or call (800) 241-8014, x0.

In today’s hectic world, the majority of of us are spending more time at work, and have increasingly less time to look after our health. For a long time, corporations have understood the benefits associated with keeping workers well – raised productivity from decreased rates of absence and lowered disability claims. For these reasons, coupled with the fact that many corporations realized double-digit health care costs last year, corporations should consider Corporate Health Promotion Programs as a way to keep workers healthy.

But just how important are these initiatives to workers? How frequently are they willing to take part in initiatives designed to positively impact their health and wellness? Who do workers trust to provide them with important information about their health?

Answers to these questions and more were recently garnered from a research study commissioned by the American Association of Occupational Health Nurses Inc. (AAOHN).

The AAOHN survey questioned 500 workers nationwide about their perceptions of Corporate Health Promotion Programs. More than three-quarters of all members indicated these initiatives are a good way to improve their overall health, and nearly 60% consider these offerings an incentive to remain with their current employer. worker retention and turnover impact the bottom line, so building Corporate Health Promotion Programs into the work site culture is a valuable way to help retain talented workers in addition to enhancing personal health and worksite productivity.

The Health wish list

Employees appear to have their own agenda when it comes to their health. With new national security threats, new economic pressures and work/balance issues, it’s not surprising that 85% of survey respondents cited Stress management as a priority topic for work site wellness.

In addition to stress, other preferred topic areas include testing initiatives (84%), exercise/physical fitness initiatives (84%), health insurance education (81%) and disease management lunch and learns (80%).

In addition to lifestyle and personal health issues, those asked expressed concern about work-related health issues, including strains and injuries resulting from lifting or task-oriented muscle repetition, exposure to harmful substances, personal injury, vision changes due to computer work and worksite violence.

What you should do

With such a broad range of health concerns, a primary goal for corporations is finding a way to proactively address the health and wellness needs of the largest number of workers, and effectively change unhealthy behaviors, promote wellness and ward off disease and illness.

Printed materials such as brochures, posters, fliers or pamphlets present an easy solution. But it’s important to remember that different employees require different formats for learning. A good rule of thumb: provide information in a variety of learning formats such as videos, pamphlets, health-related quizzes, display boards, Lunch-and-learn presentations and reimbursement or incentive programs.

This assumes you’ve overcome the first hurdle – getting employees to sign on to a Corporate Health Promotion Program. While survey respondents indicated health and Corporate Health Promotion Programs are important, just six out of 10 (60%) reported that they participated in the Corporate Health Promotion Programs at their corporations. The other 40% cited lack of interest and lack of time as deterrents.

This points to the need for a broad-based, structured Corporate Health Promotion Plan using a innovative approach, with an incentive for participation and effective program marketing.

By investing in an organized Corporate Health Promotion Plan headed by a qualified health care professional such as an worksite nurse, corporations can give workers the access to the health information they want, and increase participation and generate interest at the same time.

The result: workers become savvier health care consumers who feel more in charge of their individual health. And healthier workers make for a healthier bottom line.

Changing health-related behaviors is a difficult challenge. Incorporate the tools below into your Wellness initiatives to assist members in successfully changing health behaviors.

Tool #1: Establish effective goals
• Focus on areas that can impact the overall goal.
• For example, if the overall goal is to lose weight, the most productive areas to focus on are the activity and dietary changes that will lead to long-term weight loss.
• For example, stress management and improving self-esteem may also impact weight loss; however, improving relationships, while a worthy topic, will not necessarily impact weight loss.
• Make the goals specific, attainable, and forgiving. For example:
• “Exercise more” is too general.
• “Walk five miles everyday” is specific, but may not be attainable.
• “Walk 30 minutes everyday” is specific and more attainable, but is not very flexible.
• “Walk 30 minutes, five days a week” is specific, attainable, and forgiving.
• Use a series of short-term goals to achieve the ultimate goal.
• Short-term goals break big challenges into more easily attained pieces.
• Smaller steps also provide Corporate Health Promotion Plan members with encouragement and success. These small successes are critical for maintaining motivation towards a long-term goal.

Tool #2: Increase self-awareness
• Self-monitoring is useful for tracking behavioral and environmental cues that trigger a particular behavior.
• Keeping track of behavior status is also useful for times when progress towards a goal is difficult to measure, or when an individual is in a maintenance stage.

Tool #3: Provide rewards and motivation
• Encourage members to reward themselves for achieving small successes on the way to their ultimate goal.
• Remember that rewards don’t always have to be “things.” Words of encouragement and praise can provide powerful motivation when spoken by a teacher, instructor, parent, friend, etc.

Tool #4: Respond effectively to set-backs
• behavior change is conceptually a continuum. However, movement along that continuum is not just in one direction. Staff members can move backwards or forwards or sometimes just stay put. Communicate to members that set-backs, lapses and even staying the same (i.e., maintenance) are common for individuals trying to change behavior.
• Stress is frequently a factor in lapses and relapses. Provide a variety of stress management resources to help members better handle the stress which could trigger a set-back.
• Brain storm to create a list of potential (and probable) barriers to member behavior change. Then formulate strategies to meet each of those challenges.
• Enhanced time management and decision-making skills can be effective ways to overcome behavior change relapses.
• Provide members with information regarding the behavior change process so that they will be better prepared for the challenges they will face. A brief overview of the Stages of Change may be helpful.

Health Information Technology can make the entire health care system more effective and efficient by enhancing:
• Documentation (lab and test results, clinic notes, consult recommendations)
• Communication (provider to patient, provider to provider)
• Information input (templates to facilitate data entry)
• Delivery of care (documenting all patient-provider interactions in a single system)
• Chronic disease risk identification (evaluation of risk factors, recommendations for appropriate preventive services and screenings)
• Consistent recording of correct billing codes

But, adapting to Health Information Technology is a challenge.
• Health Information Technology almost always involves a “new system.” Consequently, the entire staff, from health care providers to IM/IT personnel is on a learning curve.
• Existing IT infrastructure may not be adequate, so the Health Information Technology system may be very slow, or may frequently crash.
• The new system may not have all the forms you need already in place. New forms may be needed.

Lessons learned from Health Information Technology implementation

Make use of as many training opportunities as possible.
• Learn as much as you can about the Health Information Technology that you need to use. Become an expert.
• Ask questions if you are unsure how to navigate the system.

Keep the big picture in mind.
• Be aware that those keeping the Health Information Technology system up and running may have a very different set of priorities. The IM/IT staff may not see your request as a priority when it is taking all their manpower to trouble shoot the new system each day.
• Other changes to the Health Information Technology system may be in line in front of yours, so be patient.

Think through changes thoroughly.
• Take time to think through a new form thoroughly. Know exactly what you want before talking to the developer.
• Don’t think in a vacuum. If you build a form, make sure it is one your staff will use and find efficient.
• Create a draft version of the form and use it before requesting that it be put into the new system.
• Be prepared to build a good case for why your form should be created. Build a stronger case if your form should be developed ahead of other requests in the queue.
• Be patient and persistent when working with a programmer/developer on a new form. Meet frequently and set up timelines and deadlines.
• Coordinate with IM/IT and the Health Information Technology contractor to see if they can support a new project in the necessary time frame.

For more information about Health Information Technology implementation, go to the Agency for Healthcare Research and Quality (AHRQ) National Resource Center for Health Information Technology at http://healthit.ahrq.gov.

Organization processes are structured activities that achieve a specific result. For example, scheduling appointments is a organization process that results in an orderly work flow and timely patient care.

Corporate Health Promotion Plan implementation frequently requires changes to established organization processes. These changes may be simple, such as adding prescreening appointments to the scheduling process, or more complicated, like determining how time devoted to a particular Corporate Health Promotion Plan will be coded.

Not all change can be affected painlessly. However, developing a plan for achieving change will overcome barriers like:

“But we’ve always done it that way” or “But we’ve never done it that way.”

Each change situation will be different. The path to achieving change may not always be straightforward.

Lesson learned: Making small, incremental changes will be easier than trying to make one big change. It is also easier to modify a current process than to introduce a brand new one.

Develop a road map for change.

Describe the current organization process.
• For example: what is the current registration process for the weight management program? Include steps for both members and staff.

Identify where the new or modified organization process could fit into the current process.
• For example, prescreening appointments for the weight management program could be scheduled when members sign up OR the prescreening could be done at the first class.

Collaborate.
• Look at the change process to be a team effort. Determine everyone who will be affected by the change and get their input.
o For example, be sure to ask the personnel that set up the prescreening appointments AND the personnel that would do the prescreening for their ideas.
• Recruit one or more champions for the change. It helps if the champion has some clout.
• Get buy-in from as many employees as you can – including those that might be most resistant to the change.

Communicate.
• Don’t keep the change a secret. The more employees know, the more likely they will support a change.
• Anticipate barriers ahead of time. Be ready to articulate concrete benefits that will result from the change – especially advantages such as costs avoided or training time conserved.

According to Gordian Health Solutions, the effectiveness of Corporate Health Promotion Programs in improving health and decreasing health care costs is directly linked to incentives: the more substantial the incentives, the higher the success rate. Incentives can range from tokens of achievement, such as t-shirts, water bottles and sports equipment, to more substantial financial awards, such as cash incentives or copay vouchers for the successful completion of a program.

Nationwide Insurance is seeing results from a small incentive program initiated by one of the organization’s worplace nurses. To encourage lunchtime walking, the worker has informally launched a “shoelace program” modeled after the karate-belt color system. Employees progress through the color scale until they reach “black-lace” status. The reward system has resulted in more workers making commitments to walk during their lunch hour.

At the high end of the reward spectrum, some corporations pay cash to workers who meet wellness goals. LuK, Inc. offers workers $250 for kicking the tobacco habit and remaining smoke free for 12 months. For logging fitness points that add up to 10 miles a month, workers are eligible for health assessments, which can result in reward amounts of up to $225.

The most effective motivator, according to Gordian research, comes through linking participation in Corporate Health Promotion Programs directly to insurance premiums. Doing so clearly demonstrates to workers the positive effects of wellness on their own health care costs. frequently, the first step in linking wellness programming to insurance coverage is lowering deductibles for wellness care or eliminating deductibles altogether. By adding this benefit, corporations can encourage workers to undertake routine screenings and other procedures to respond to health problems before they become chronic. Early detection benefits both patient health and employer health costs.

Incentivizing Corporate Health Promotion Plan participation with health care credits

More frequently, corporations are going beyond increased wellness care coverage and looking to demonstrate the importance of wellness by linking participation to workers’ bottom lines. Worthington Industries has recently rolled out a program that allows workers to eliminate their portion of the insurance premium by enrolling in a Healthy Choices Corporate Health Promotion Program.

During the first year of the Healthy Choices program, workers and their spouses complete Personal Health Assessments and medical screenings to determine their levels of health risks. Nurses, dietitians and physical fitness specialists are available to help moderate- and high-risk members develop individual action plans for enhanced health through the use of educational materials, behavior modification, telephone help from third-party program health coordinators, and formal health management initiatives. By completing the assessments, workers earn their full premium credit. Because some plans at Worthington require no worker contribution, a cash award takes the place of a credit in those cases. During year two of the program, the wellness bar is raised slightly. To continue to receive the wellness credit, members in the moderate- to high-risk category will be necessary to work at setting goals with third-party health coordinators.

Year three raises the bar again, requiring members to show progress in meeting goals and to continue to work with health coordinators to reach goals.

After year three, Worthington Industries workers will be on the wellness track. The organization believes that will mean a healthier workforce and cost savings for workers and the organization. The well being of Worthington workers is the foundation of this program, and both workers and the company are expected to benefit from the long-term advantages of the Healthy Choices Corporate Health Promotion Program.

While Worthington has taken a broad approach to wellness, other corporations have found success in offering incentives in specific areas. Longaberger, for example, offers a discount on health care policies for workers who do not use tobacco. An individual worker who doesn’t use tobacco saves $7 per bi-weekly pay. For tobacco-free workers with family coverage whose families are also tobacco-free, the savings increases to $14 per pay.

The next step: Penalizing harmful behaviors

As it stands, health care is the only type of insurance that doesn’t focus on penalizing for behaviors that put the insured party at risk. With health care costs increasing so dramatically, that could soon change. Just as an accident likely raises auto insurance premiums, increasing premiums for those who engage in unhealthy behaviors is a possible next step in employers’ attempts to manage health care costs.

Reports that workers would support this type of action are stacking up. One Ohio employer conducted an informal survey that indicated workers would consider it a morale boost if health-conscious workers were relieved of some of the burden of subsidizing care for workers who engage in behaviors that adversely affect their health. Whether or not this type of program gains popularity, one thing is sure: the need to control the rise in health care costs is becoming ever more pressing.

The Last Step: Getting Started

Whatever the strategy, from offering workers health resources to providing incentives for healthy behaviors, corporations have a real opportunity to improve morale and productivity, reduce rates of absence and control health care costs through wellness. The first step is committing to taking one, no matter what size effort is appropriate for your corporate.

Small steps lead to big strides.

Advantages of Physical Fitness Initiatives

Exercise reduces weight, lowers risks of heart attack and stroke, helps to control blood pressure and diabetes, and improves mood. Studies increasingly show that physical fitness may also help reduce the occurrence of certain types of cancer. Researchers at the Centers for Disease Control and Prevention (CDC) recently documented another major advantage: physical fitness improves the health of the nation’s medical care expenditures.3 According to the CDC, physically active individuals incur $865 less per year in medical costs than inactive employees.

Dr. Michael Moore, vice president and chief medical director at Nationwide Insurance in Columbus, maintains that physical fitness is the most effective tool in health maintenance. “If you could prescribe exercise in a pill, it would be the number-one prescribed treatment in the world,” he said. In step with Dr. Moore’s prescription, nearly one-third of U.S. corporations help workers pay for gym memberships, according to an Associated Press report. Subsidizing gym memberships is just one way corporations encourage active lifestyles.

Popular Physical Fitness Initiatives:

1. Allow access to on- and off- worksite gyms and recreational activities before, during, and after work hours.
2. Provide and encourage participation in after work recreation or leagues.
3. Provide cash incentives or decreased insurance costs for participation in physical activity and/or weight management or maintenance activities.
4. Provide shower and/or changing facilities onsite.
5. Provide outdoor physical fitness areas such as fields and trails for worker use.
6. Provide bicycle racks in safe, convenient, and accessible locations.
7. Provide onsite fitness opportunities, such as group classes or personal training.
8. Provide an onsite physical fitness facility.
9. Start initiatives that have strong social support systems and incentives, such as:
• Buddy or team physical activity goals
• Initiatives that involve workers and family
• Initiatives to encourage physical activity, such as pedometer walking challenges
• Explore discounted or subsidized memberships at local health clubs, recreation centers, or YMCAs
10. Provide flexible work hours to allow for physical activity during the day.
11. Support physical activity breaks during the workday, such as stretching or walking.
12. Host walk-and-talk meetings.
13. Map out onsite trails or nearby walking routes and destinations.
14. Have workers map out their own biking or walking route to and from work.
15. Post motivational signs at elevators and escalators to encourage stair usage.
16. Provide exercise/physical fitness messages and information to workers.
17. Provide or support recreation leagues and other physical activity events onsite or in the community.
18. Start worker activity clubs such as walking or bicycling clubs.
19. Provide onsite child care facilities to facilitate physical activity.
20. Sponsor a bike to work day and reward workers who participate.
21. Start a box and solicit fitness and health tips.

Health Risk Assessment: Helping Quantify Employee Health help you quantify staff member health

An Health Risk Assessment Health Risk Assessments / Health Risk Appraisals is an important tool to help you isolate the value of strong Corporate Health Promotion Plan Programs.

Health Risk Assessment: What is it?

Does the term “Health Risk Assessment” have you puzzled? If so, then you are not alone. Unfortunately there is no standard definition or format for a Health Risk Assessment. A health risk assessment is both a procedure and a document, too, depending on the context — you must answer questions and ideally undergo some simple Employee Health Screening and Biometric Testing to develop a document that describes what’s good and bad about your current state of health.

To add confusion to the situation, there’s a field called health risk management. Talk to an OSHA inspector about health risk assessment and they will likely assume you’re referring to an analysis of contaminants and industrial chemicals in a factory or manufacturing facility.

Health Risk Assessment: The Typical Health Risk Assessment

A comprehensive health risk assessment is aimed at producing a concrete baseline of a individual’s health, and includes the majority of of these features:

blood pressure check,
cancer testing,
blood sugar test, and
a thorough analysis of the staff member’s health status.

Health Risk Assessments / Health Risk Appraisals would analyze the staff member’s:

lifestyle measures,
health conditions,
prescriptions medications,
functional concerns and abilities,
quality of life,
self-efficacy,
fitness level.

Corporate Health Promotion Programs: The Grand Slam

Corporate Health Promotion Programs are as close to a grand slam proposition as you’ll find, according to the majority of researchers and Corporate Health Promotion Plan experts.

But if you have skeptics in your company who are questioning the time and cost of beginning an Corporate Health Promotion Program, you may be wary too. Aren’t staff member Corporate Health Promotion Programs subject to the adage “There’s no such thing as a free lunch”?

Corporate Health Promotion Programs Don’t Have To Be Expensive

Fortunately, staff member Corporate Health Promotion Programs don’t require a big investment. Like any other corporate project, mismanagement and “death by committee” can inflate the cost of Corporate Health Promotion Programs, but it’s hard to spend too much time and money on them. After all, Corporate Health Promotion Programs are mostly informational in nature. Flyers, e-mails, maps, and Corporate Health Promotion Plan Wellness Fairs can only cost so much. There’s no expensive, specialized Corporate Health Promotion Plan machinery.

Corporate Health Promotion Plan statistics on successful programs are particularly persuasive. Unlike many cost-saving measures, Corporate Health Promotion Programs actually add to staff member satisfaction – but they also reduce Health Insurance premiums and staff member absenteeism.

What are some common Corporate Health Promotion Programs?

Corporate Health Promotion Programs run the gamut, depending on your worksite demographic, from physical activity for health patients to nutritional initiatives that encourage workers to replace unhealthy snack foods with healthy fare like dried fruit and shelled nuts.

Following are some examples of Corporate Health Promotion Programs:

ergonomic safety
cardiovascular disease education and testing
staff member safety
Health Risk Assessments / Health Risk Appraisals
walking Corporate Health Promotion Programs
drug testing