Healthy Choices Equal Lower Health Care Costs

Far-sighted Alabama businesses and associations are instituting and expanding workplace wellness programs. Their leaders realize that well-run programs more than pay for themselves by reducing health care costs, as well as absenteeism. In addition, wellness programs boost morale and assist in employee recruiting and retention.

When staff members know management cares about their health, they feel appreciated and are more prone to make healthier lifestyle choices, says Cathy Ogletree, human relations director for Burr & Forman LLP, a major law firm with offices in Alabama and Florida, including Birmingham, Mobile and Montgomery. “We value our employees, so developing a workplace wellness program only made sense for us, ” Ogletree says. “We’ve been amazed with the results.”

Burr & Forman began its wellness initiative in 2008 with a summer walking contest, then expanded the program with the assistance of a wellness consultant. Offerings now include on-site health screenings, a weight loss and maintenance program, health coach counseling, free on-site flu shots and smoking cessation support.

Individual offices may also participate in additional events, such as fund-raising walks. “We try to offer a variety of programs because we know our employees have different interests and time commitments, ” says Deb Becker, legal administrator and wellness coordinator for Burr & Forman’s Mobile office.

Thanks in part to such efforts, the firm saw slowing insurance rate increases for several years and then a five percent drop this year.

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Burr & Forman paralegals Sharee Thompson (left) and Jessica Lang enjoy exercise in downtown Mobile.

Photo by Ashley Rowe

“Our motivation for creating a wellness program wasn’t to save money, but that’s been an added benefit, ” Ogletree says. “We’ve also been surprised by the positive impact the program has had on our recruiting efforts.”

Between 80 and 90 percent of Burr & Forman’s 520 employees take part in one or more offerings of the company’s award-winning wellness program each year.

Contest prizes, health premium discounts and other financial incentives have helped spur participation. “We continue to get tremendous feedback, and have seen tangible improvements in our employees’ health. Many have lost weight and now regularly exercise, ” Ogletree says.

While various studies have demonstrated a significant return on investment for wellness programs, a commonly cited review published in “Health Affairs” February 2010 notes that medical costs fall by about $3.27 for every dollar spent and that absenteeism costs fall by about $2.73 for every dollar spent. “With a healthy return on investment and all the other positives, why wouldn’t a company want to promote and facilitate wellness among its employees? It’s kind of a no brainer when you think about it, ” says Lauren Whitt, Ph.D., University of Alabama at Birmingham wellness coordinator, who was hired to develop a wellness program for the institution’s 20, 000 employees.

UAB’s comprehensive, award-winning wellness program includes healthy lifestyle perks, such as a farm stand that allows employees to conveniently purchase fruits and vegetables. Green Screens, focusing on blood pressure, were held on-site each week for 14 weeks this year in conjunction with the UAB Employee Wellness Summer 5 in 5 Challenge. The five-week program emphasizing nutrition and physical activity used both weekly weigh-ins and blood pressure screens to monitor results. “We like to keep things fresh by periodically offering new programs, ” Whitt says.

Pushing the wellness envelope, UAB recently announced the institution would begin hiring only nonsmokers. The organization also has upped its commitment and support for smoking cessation among current employees. “It’s a bold step, but we are a health care leader and need to set the example, ” Whitt says.

As part of fulfilling its leadership role, UAB held the inaugural Innovations in Wellness Conference this past November. The well-received wellness program conference, which targeted businesses and other institutions across the state, is to be expanded and marketed more widely in coming years.

Medical costs drop $3.27 for every $1 spent on wellness programs.

One of the issues discussed at the conference was the importance of educating and encouraging employees to follow health provider recommendations for chronic health conditions, including taking medications as prescribed. Dr. Mark Todd, chief pharmacy officer for UAB Hospital, shared a quote from former Surgeon General C. Everett Koop: “Drugs don’t work in patients who don’t take them.”

Whitt recommends employers who want to begin a wellness program first focus on nutrition, exercise, health screenings and tobacco cessation programs. “Financial incentives for employees are also important because they increase participation rates.”

In addition to reducing health care insurance costs, wellness programs also can decrease workers’ compensation claims and costs. North Alabama employers, including Boeing Co.’s Huntsville operations and Huntsville Hospital Health System, have seen significant cost improvements, says Sherree Clark, executive director of Huntsville-based Premier Health Networks of Alabama. “Employees with chronic health conditions tend to have more workers’ compensation claims and require longer periods to heal from their injuries. It’s in an employer’s best interest to encourage and support employee health from prevention to keeping on top of chronic conditions, ” Clark says.

Boeing’s wellness program includes an on-site health clinic, which allows health concerns to be quickly addressed or referred for physicians follow up. The company also encourages its employees to regularly exercise in part by offering on-site group exercise classes. “Those are just two examples. Boeing, in general, goes above and beyond when it comes to its wellness program, and is reaping the benefits, ” says Clark, whose company provides support for several of Boeing’s wellness efforts.

Huntsville Hospital Health System, which Clark also is affiliated with, is another wellness program leader in North Alabama, she says. Clark points to one of their most successful efforts, Health Matters, a diabetes management program. System employees and family members with diabetes who participate in Health Matters commit to attending educational programs, exercising a certain number of times per month, having regular lab work, and following physician orders. In exchange, participants receive free diabetes medication, supplies and lab tests, as well as a complimentary fitness center membership.

As a result, while the average diabetes patient incurs $11, 744 in costs for their disease each year, according to the American Diabetes Association, Huntsville Hospital program participants averaged $7, 050. For 2011, 64 percent of participants showed a decrease in their total paid health insurance claims. The system’s insurance claims decreased by $228, 319, an average of $4, 390 per employee. “The cost of the Health Matters program is a fraction of what’s saved in health care costs, ” Clark says.

Because Alabama consistently ranks among states with the highest incidence of obesity and the chronic illnesses that accompany it — including diabetes and cardiovascular disease —widespread adoption of workplace wellness programs is critical. “It is more important than ever for Alabama providers and employers to partner for wellness solutions, ” Clark says.

“No company has to figure out how to create a wellness program on their own, ” Clark says. “They just need to reach out.”

Blue Cross Blue Shield of Alabama, for example, encourages employers to create wellness programs and helps create or expand such programs. “In addition Blue Cross has on-staff wellness program counselors available to assist employers as they develop or expand their wellness programs, ” says Chelsea Hendrix, manager of wellness and promotion for the health insurance company.

Blue Cross offers a range of wellness program choices for its own 3, 900 employees, including an annual health risk assessment, biometric screening and fitness challenge.  Employees are encouraged to participate in Scale Back Alabama, a statewide weight-loss contest held each January. Gift cards are used as incentives and rewards for wellness program participation and meeting health goals.

Among the company’s honors for wellness was its recent recognition by the American Heart Association for being a Platinum-Level Fit-Friendly Worksite. The association applauded Blue Cross for decreasing health care costs by helping employees live a healthier lifestyle. Blue Cross carefully tracks program participation and cost reductions to help demonstrate the significant value of workplace wellness programs.

For the 84 percent of Blue Cross employees that took part in a wellness activity during 2012, health care cost decreases of between 9.35 and 15 percent, depending upon the parameter, were seen. “We know wellness programs work, and we want to walk the walk, as well as talk the talk, ” Hendrix says.

Kicking off a wellness initiative doesn’t have to be expensive, and it’s not necessary to develop a comprehensive program to start, says Heather Whorton, RN, wellness coordinator for Occupational Health Group in Huntsville, which is affiliated with Huntsville Hospital Health System and other area hospitals. “Those are some misconceptions that keep the average company from getting a program off the ground, ” Whorton says. “Another misconception is expecting to see a payoff from any efforts taken within six months. It takes longer than that.”

Whorton’s group provides wellness program services, including health screenings, health risk assessments, vaccine administration, weight management programs and lunchtime learning sessions, to about 150 North Alabama companies. “We help tailor a wellness program to a company’s specific needs, ” Whorton says.

“Providing annual on-site health screenings and getting employees to complete a health risk assessment is a good place to start because you want to catch health problems early on when they are easier and less expensive to treat.”

The cost for recommended health screenings typically is covered by health insurance plans.

While companies can benefit from receiving aggregate information from health assessments and screenings, it’s important that employees know their individual results will not be shared with their employer. “Employers want to know where they should be focusing their wellness efforts. For example, if there’s a problem in general with high blood pressure among employees, more targeted educational efforts and outreach may be needed, ” Whorton says. “But employee privacy must not be violated.”

Employees should be provided with their screening results and contacted individually by the health screening provider when results show the employee needs preventative health care counseling or physician referral. “Diseases can be caught in earlier stages and lives saved through on-site screenings, ” Whorton says. “The reality is that many employees don’t get an annual checkup or recommended screenings on a regular basis.”

Looking toward the future, employers are likely to see health care insurance premiums tied to whether they have a wellness program and to the incidence of tobacco use and obesity in the workplace, Clark says. Smoke-free workplace policies are growing in popularity among employers nationally. “Tobacco cessation is something that can be controlled and has a tremendous impact on employee health and health care costs, ” Clark says.

Kathy Hagood is a freelance writer for Business Alabama. She lives in Homewood.

Kathy Hagood

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