July 2008 Issue

Workplace Wellness — Companies Make Employee Health Their Business
By Juliann Schaeffer
Today’s Dietitian
Vol. 10 No. 7 P. 34

Recognizing that healthy workers equal better returns, savvy employers are making on-site wellness job one, outfitting cafeterias with organics and even forbidding the hiring of smokers.

Smoking, bad eating habits, and an overall apathetic attitude toward health—people with poor lifestyle habits aren’t the only ones who suffer the costly consequences. Towers Perrin’s annual Health Care Cost Survey indicates that employers will shell out an average of $9,144 per employee this year for health benefit expenditures (an increase of roughly 6% since last year).

Many employers, however, are finding that corporate wellness programs aimed at keeping employees healthy is a win-win for everyone. According to a recent survey by Watson Wyatt and the National Business Group on Health, almost one half (46%) of interviewed employers said they currently offer financial incentives to employees to encourage healthy behaviors.

“Employers are looking at wellness programs not only as a way to help them contain their healthcare costs, but wellness programs are also really important in terms of recruitment and retention of employees, especially in industries where it’s tough to find people,” says Fiona Gathright, president of Wellness Corporate Solutions LLC. Gathright adds that many companies establish wellness programs to stand out from their competition and control healthcare costs. With roughly 70% of healthcare costs directly related to lifestyle choices, she says, “All we can do is try to get people to live healthier lifestyles.”

R. Douglas Metz, DC, executive vice president and chief health services officer at American Specialty Health (ASH) Incorporated, says health improvement has waxed and waned for many decades in the healthcare system, but corporate America is definitely opening its eyes to the possibilities of programs aimed at health improvement and prevention for employees.

“In the last five years or so, there has been a crescendo of interest across the industry to implement health improvement programs as a way to improve the health and productivity of workers while managing costs,” he says. “Healthcare cost management is an important part of the rationale by both improving productivity and reducing the cost of absenteeism, presenteeism, medical loss, [etc]. So right now, there’s great interest by many employers and many health plans to incorporate such programs.”

While the emphasis in healthcare used to be on the treatment of acute illnesses, Metz says that has changed to a focus on prevention due to a wave of largely lifestyle-influenced and preventable chronic illnesses such as type 2 diabetes and heart disease, which affect an increasing number of Americans each day. “In recent years, plan managers have been asking with more regularity, ‘Why don’t we try to keep people healthy?’” he says. Metz cites work from Dee Eddington, PhD, at the University of Michigan, who has done research about the return on investment and the cost value of keeping people healthy. “Research suggests that it is less costly to keep somebody well—to invest programs to help employees stay well—rather than to have them use expensive medical services when they become ill,” Metz says.

While corporate wellness programs are not a new trend by any means, they’re picking up speed as more employers are catching on that prevention may be the key to lowering employee healthcare costs. In addition to decreasing doctors’ visits, hospitalizations, and prescriptions, employers and employees also benefit by reducing absenteeism and presenteeism and by having a more productive workforce overall. With programs entailing everything from health coaches and reduced fitness club rates to walking trails and cafeterias filled with fresh, organic fruits and vegetables, America’s employers are getting creative to convince employees that living healthy is better for all involved.

Following Its Own Example
ASH doesn’t just personify the workplace wellness concept; it helped design it. As a provider of worksite health improvement programs, it provides health coaching, fitness, weight management, and other health improvement programs to both national health insurers and directly to small and large employer groups.

About five years ago, ASH decided to follow its own example, implementing a “Get Healthy” program for its 600-plus employees. For its efforts, ASH received a gold award from the National Business Group on Health in its 2008 “Best Employers for Healthy Lifestyles” awards, was named one of the “Fittest Companies in America 2008” by Men’s Fitness magazine, and was the 2007 recipient of the California Fit Business Silver Award from the California Task Force on Youth and Workplace Wellness.

“We’ve taken the concept of employee wellness from our own services, and we’ve brought that into our company and made it available to our employees, which I think you could expect from an organization that considers wellness and health improvement to be a cornerstone of the product offerings that they have,” says Elizabeth Thompson, MPH, RD, clinical director at ASH.

The first step on the road to its employees’ wellness? Healthy vending machines. Thompson explains: “We had an all-company staff meeting about six to seven times a year where CEO George DeVries would bring us all together [400 to 500 employees]. At one particular meeting, he announced to the staff that we had made a decision as a company to begin our own wellness program and that when we got back to the offices, the vending machines would no longer have chips and soda but … healthier foods such as waters and juices and granola bars and energy bars. So they were still snack items, but they were healthier.”

Thompson says the company put together criteria for items that could be included in the new vending machines: items that were low in added sugar, low in sodium, and were whole grain based. “While there was a little bit of resistance in the beginning, it caught on very quickly,” says Thompson, adding that the nutritious machines are now second nature to employees.

As an additional incentive for employees to get their wellness act together, ASH offers a Get Healthy! annual award to one employee who has attained significant wellness goals during that year, such as losing weight, quitting smoking, or even gaining weight, if necessary. “The employee is rewarded with one week of salary, one week of paid time off, a trophy for their desk, and recognition at our annual all-employee awards banquet,” says Thompson.

To further motivate employees, ASH encourages healthy living through various challenges. The Healthyroads Holiday Challenge encourages employees to maintain their weight within 3 pounds between Thanksgiving and New Year’s; another challenges employees to walk 150,000 steps in one month using a high-tech ActiPed monitor clipped to their shoes; and a veggie challenge encourages employees to increase their daily fruit and vegetable intake. The company offers employees the same Healthyroads Coaching Program that it sells to clients, aiding employees in tobacco cessation, stress and weight management, and chronic disease prevention and management.

On-Site Cancer Detection
From its U.S. headquarters in Wilmington, Del., AstraZeneca is helping its employees lose weight, eat healthier, and exercise while on the job to create a more productive workforce. Healthy incentives aren’t new to this company. “I’ve been here 12 years, and wellness programs were in place long before that,” says Amy Milhorn, RN, senior manager of corporate health services at AstraZeneca, who manages wellness programs at the Wilmington location. “Just being a healthcare company, wellness has always been one of our primary focuses. As we move forward, we certainly have narrowed in on the whole wellness program even further with our PQA.”

PQA, one component of AstraZeneca’s employee healthcare strategy, stands for prevention, quality, and adherence. It is part of a comprehensive plan designed to help employees maintain a healthy lifestyle through support programs, preventive screenings, on-site healthcare services, and benefits designed to optimize preventive care.

While wellness services have been in place for more than a decade, programs are continually enhanced and reviewed for additional benefit. One noteworthy addition is the Get HIP Program, which started last year. “HIP stands for health incentive program. We decided to put a program in place to encourage healthy behaviors and award people points that could be redeemed for gifts and prizes for participating in programs like online modules, health screenings on site, going to the fitness center—anything that we could put in place that we thought would induce a behavior change—and we’ve awarded points for those activities,” says Milhorn. “The program began in 2007, and at the end of last year, we had 37% of our employees enrolled in the program, which we felt was a great achievement in [the] first year of the program.”

AstraZeneca also offers creative programs to get employees exercising, such as a treadmill challenge—a treadmill was placed near the cafeteria and employees signed up for 15-minute increments—and a successful weight loss competition that mirrored NBC’s popular show The Biggest Loser in which AstraZeneca employees lost a total of 534 pounds over eight weeks.

Perhaps the company’s most rewarding initiative is its cancer screening programs. “One of the programs that we are most proud of is our breast cancer screening program,” says Milhorn. “Here at our headquarters location, we have an on-site digital mammography machine, and we contract a technician to come in to administer the mammograms.”

Employees receive a clinical breast exam from certified nurses, “and through that program we have identified about 36 malignancies, so we’re quite proud of that—and most of those have been early stage,” says Milhorn, adding that the switch to the digital machine in September 2007 was a great accomplishment “because we were only one of a few sites in the area where the general public could get a digital mammogram.”

Milhorn estimates the on-site breast cancer screening participation rate to be close to 80% of the eligible population, with the company performing more than 1,000 mammograms each year. The feedback about the programs has been positive, especially from the women who have had breast cancer detected. “I can’t tell you how grateful they are,” says Milhorn. “And three of the malignancies that we had detected actually were detected just upon the clinical breast exam alone.”

AstraZeneca also offers annual, on-site prostate cancer screenings for male employees aged 50 and older, entailing a digital rectal exam and prostate cancer PSA blood work, and skin cancer screenings are offered once every two years. With 100% coverage for preventive screenings under most employee benefit plans, AstraZeneca is paying today for a healthier workforce tomorrow.

A Wave of Incentives
Headquartered in Broomfield, Colo., WhiteWave Foods is a maker of organic and natural products such as Horizon Organic, Silk Soymilk, and Rachel’s yogurt. With roughly 385 employees at its headquarters, WhiteWave has a wealth of initiatives to promote all-around wellness through not only health-based programs but also volunteerism, community involvement, and environmental initiatives.

To motivate employees to get active, WhiteWave offers free on-site yoga classes and reimburses employees for a portion of their athletic center membership fees (such as for a fitness center, yoga studio, or annual ski pass). “We also offer free membership through Colorado Mountain Club, [which] supports employee wellness and just being active in your environment,” says Deanna Bratter, a responsible livelihood manager at WhiteWave, who handles the implementation of employee programs. “Colorado Mountain Club is a resource that offers hiking information and coordinates group hikes for all ages and skill levels. It really provides employees with opportunities to get involved and incorporate that work-life balance.”

In WhiteWave’s Wave Café, the employee cafeteria run by Bon Appetit, fresh, local, and organic foods are used whenever possible and are subsidized by the company to make prices affordable for employees. “[The cafeteria] has a wonderful variety of different organic and local foods and really helps promote not only healthy eating but also an organic diet,” says Elizabeth Tilak, MS, RD, WhiteWave’s nutrition research manager. “And they’ve also got a lot of educational materials that they provide for those who can’t participate in the cafeteria.”

But WhiteWave Foods also believes that environmental responsibility is a key part in overall wellness, so it instituted a zero-waste recycling and composting program in 2006. “We take it another step further here, tying in employee wellness [regarding] health and nutrition to environmental health and wellness of the planet, so this is a zero-waste facility,” explains Bratter. “All of the to-go containers that we provide are compostable and biodegradable.”

According to the company, its recycling and composting efforts in 2007 alone have saved resources equivalent to more than 186,500 gallons of water and 126,500 kilowatts of energy. And going one step further, its headquarters features environmentally friendly office furniture, with chairs that are 41% recycled and 99% recyclable.

WhiteWave also provides its employees with a free Eco-Pass, allowing them to ride all local public transportation for free. Bratter adds, “We also host a variety of alternative transportation events throughout the year” that educate employees about being more responsible for the environment and their health.

Walking for Wellness
Employee wellness programs have been around at the Cleveland Clinic for roughly two years, but they’ve really started to gain momentum in the last year, according to Kristin Kirkpatrick, MS, RD, the clinic’s wellness manager. Many of its programs focus on weight management, physical activity, and stress management, and it’s found that walking is a great tool for all of the above.

“One of the important wellness programs that we’ve implemented is our employee walks program,” says Kirkpatrick. “We always want to be able to give employees the tools they’ll need to make their lives a little bit healthier, so we really started all our initiatives with walking.

“We have a huge campus right outside of downtown Cleveland,” she adds. “We have 37,000 employees as a whole, and that’s mainly based in northeast Ohio. So we have a lot of space.” To get employees moving, the Cleveland Clinic mapped indoor and outdoor routes (1.2-mile and 2-mile routes) for its employees to walk on their lunch break. Another walking program has groups of people meet at a location and walk every day.

The Cleveland Clinic also created the Strut Your Mutt walk (in its first year) to get employees moving. The Cleveland Animal Protective League recently brought all of its adoptable dogs to this event, and employees brought their own dogs to walk. The event allowed all involved to get a breath of fresh air and physical activity and gave the shelter’s dogs a chance at a new home.

“It’s like a first step for someone who’s sedentary a lot of times to get healthier,” says Kirkpatrick. “It’s mainly for employees, but we also invite the community to it. We donate all of our proceeds to a local shelter, and it’s really just an event to get the public out walking their dogs, walking themselves, and getting their families out. We do focus on employees, but we also know the importance of extending wellness into family life.”

As people also have the chance to adopt the animals at the event, Kirkpatrick says, “We hope to change some lives that day—maybe have someone adopt an animal, start their own walking program, or just [get] some family members out there to really just walk a mile. To us, that may sound insignificant, but for some people that’s not easy to do. But you do it that first time and you have a good time, and you start doing it every day of the week.”

Another equally appealing initiative is the farmers’ market that the Cleveland Clinic is working to establish on its campus. “This is something that is very important to us because we do want to support local business,” says Kirkpatrick. “We’re going to have a farmers’ market on campus with products from our local farmers. It’s a guarantee buy for our farmers because anything that’s not purchased by the community or our employees will be purchased by our cafeteria, and it will be served at a discounted rate with meals.

“So from a dietetic perspective, that’s really important that we provide our employees with the healthiest food that we can to set a good example. If we give them healthy food, hopefully they’ll go home, serve their families healthy food, and hopefully that’ll be the goal that we will reach,” she says, adding that it also gives the foodservice staff fresh food to prepare.

The Cleveland Clinic is also getting serious with smokers; it recently implemented a program whereby it would no longer hire people who smoked. “This is a strong move on our part,” says Kirkpatrick, “but we really want to be the leaders with wellness. We don’t see that we can be the leaders unless we enforce something like this. It’s also really important to us that our employees that are currently here that smoke get into a tobacco treatment program so we can help them to quit smoking, and it’s important to us that we begin to eliminate the smokers on our employee roster as well. We’ve gotten some pretty good feedback, so it’s turned out to be a great program.”

Kirkpatrick says she doesn’t want employees to look at these programs as if they’re the wellness police. “The whole thing is just to improve the health and well-being of our employees, and we want to take an approach that takes away the barriers,” she says. “A lot of times, people don’t do a certain action in health and wellness because of a barrier. There’s always some excuse, and we want to take away those excuses, be it financial or geographical. We want to make it easy for our employees to eat healthy, get enough exercise, and work with stress management,” hopefully leading to a healthier employee base for the future.

— Juliann Schaeffer is an editorial assistant at Today’s Dietitian.