1. Creating a Healthy Workplace
Planning a Staff Wellness Program

2. Objectives
To provide information on how to initiate a staff wellness program that fits the mission, vision, and values of an organization.
To review ways to determine the wellness needs of an organization’s staff and identify their greatest health risk factors.
3.To provide a framework describing steps on how to plan, develop, implement and evaluate a wellness program.

3. What is Wellness (Health Promotion)?
Perspectives on Wellness:
Physical – fitness, nutrition, medical self-care
Emotional – stress management, depression, crisis care
Social – community, family, friends, co-workers
Intellectual – educational, career development, achievement
Spiritual – love, hope, charity
Occupational – safe, nurturing worksite environment
You define wellness for your organization!
Source: Am.J of Health Promotion & National Wellness Institute

4. What is Wellness?
Wellness: “An intentional choice of a lifestyle characterized by personal responsibility, moderation, and maximum personal enhancement of physical, mental, emotional and spiritual health.”
Worksite Wellness Program: “An organized program in the worksite that is intended to assist employees and their family members (and/or retirees) in making voluntary behavior changes which reduce their health and injury risks, improve their health consumer skills, and enhance their individual productivity and well-being”.
The purpose of worksite wellness programs is to
improve the health and productivity of the staff
and reduce health-related costs by helping to
change towards a healthy lifestyle.
Source: Larry Chapman, WebMD Health Services

5. Health risks increase health costs
The relationship between modifiable health risks and health care expenditures:
Staff who are/have:
Depressed have 70% higher annual health plan costs.
Stressed have 46% higher annual health plan costs.
Elevated blood sugar have 35% higher annual health plan costs.
Obesity have 21% higher annual health plan costs.
Smokers have 20% higher annual health plan costs.
High Blood pressure have 12% higher annual health plan costs.
Not exercising have 10% higher annual health plan costs.
Source: Goetzel RZ, et.al (1998, October). The relationship between modifiable health risks and health care expenditures: An analysis of the multi-employer HERO health risk and cost database JOEM, 40(10):

6. Health Risks Increase Sick Leave Use
Sick Leave Absenteeism – impact of behavioral health risks (n=34,451)
Mental health related sick leave results in a 150% higher absenteeism
Back Pain – 140% higher
Stress – 131% higher
No exercise – 118% higher
Obesity – 116% higher
Source: Serxner, S., et al., (2001). The impact of behavioral health risks on worker absenteeism. JOEM, 43(4),

7. Health risks increase workers comp cost
Workers Comp (WC) Costs are higher for increased health risks (n= 3,338)
Low Overall Wellness Score – 1989% higher annual WC costs
Smoking – 1243% higher
Poor health – 836% higher
No exercise – 556% higher
Low life satisfaction – 255% higher
Multiple health risks multiply WC cost
Low health risks = $106 average annual WC cost
High (multiple) health risks = $1241 average annual WC cost
Source: Musich, S., et al (2001, June) The Association of Health Risks with Workers’ Compensation Costs, JOEM, p

8. Health Risk are Common in our workplace!
Percent of Working Adults with Major (Preventable) Risk Factors
Poor Nutrition – 71%
Little or no Exercise – 63%
Stressed – 61%
Cholesterol – 54%
Back Care – 44%
Driving related (seat belt use, speeding, DUI, texting/cell phone)– 32%
Smoking – 22%
High Blood Pressure – 21%
Alcohol Use – 16%
What is your organization’s “fingerprint” of health risks?

9. Employee Health is a significant cost to organizations
Estimated 2004 Median Health Cost per Employee - $18,538
N=46,000 + x 3 years
Health Claims - $7,465
Turnover - $5,908
Absenteeism - $1,296
Disability - $820
WC - $496
Presenteeism - $2,554
Source: Goetzel RZ, et.al (1998, October). The relationship between modifiable health risks and health care expenditures: An analysis of the multi-employer HERO health risk and cost database JOEM, 40(10):

10. A Good Place to Start for Your Organization’s Wellness Program
Plan on Addressing
Physical activity
Tobacco use
Stress
Weight Management
Blood pressure
Cholesterol
Nutrition
Medical self-care
Back care
Injury prevention

11. Gaining Senior Management Support
Challenges
To make a case for a wellness program – a clear economic rationale
To demonstrate importance in reducing health costs
To propose a model program and evaluation plan that best fits your organization
To propose a reasonable budget that will achieve your program goals.
To identify a senior level wellness champion
To show that prevention can result in a return on
investment within as little as one year
Implement an annual evaluation and regularly
report progress and results.
It is also the right thing to do for your employees!

12. Assessing Your Employee Wellness Needs
For Planning a Wellness Program, look at:
Historical data (if any)
Demographic data
Employee Wellness Interest Survey
Focus groups
Design team
Medical claims data
For Evaluation of your program, look at:
Medical claims
Prescriptions claims
Workers Comp
Sick leave
Disability
Presenteeism

13. Wellness program models Quality of Worklife
Quality of Worklife Model
The fun approach, morale-building
A good fit with smaller work-sites (< 1,000 employees)
ROI is a low priority
New to wellness
Limited follow-through capability
This model may have:
Group activities
Fun and social events
Awareness-oriented
Light focus
Limited biometric testing
No spouses served

14. Quality of Work Life Model
Primary Wellness Targets: fun events, stress relief, nutrition, community service, general wellness and health information
Typical Activities: health fairs, lunch and learn, wellness event, free fruit, chair massages, nutritious pot lucks, movie events, company games
Participation: 15% to 35% of staff
Approximate cost / EE / Yr: < $45
Likely ROI: < 1:1.0

15. Wellness program models Traditional Approach
Traditional Approach Model
A good fit for medium sized or larger worksites (>1,000 and > 10,000)
ROI is a moderate priority
2-10 years of wellness
Some follow-through capability
Follows corporate direction
This model may have:
Both group and individual activities
More health emphasis
Education-oriented
Mixed focus
Moderate biometric testing
Knowledge building
Spouses served

16. Traditional Approach Model
Primary Wellness Targets: In addition to the Quality of Work Life Model, plus the overall wellness score, cholesterol, BP, tobacco use, obesity, medical self-care, physical activity
Typical Activities in addition to QWL: Health risk assessment (HRA), biometric testing option, fitness club memberships/facility, weight management program, smoking cessation, web-based health info, healthy cafeteria/vending options, preventive medical benefit coverage, wellness newsletter, short-term incentive program
Participation: 28% to 58% of staff
Approximate cost / EE / Yr: $46 - $150
Likely ROI: 1:1.5 to 1:3.0

17. Wellness program models Population Health Management
Population Health Management model
A good fit with larger work forces (> 10,000)
ROI a very high priority
Very mature wellness
Prepared to educate staff
Strong follow-through capability
Strong virtual corporate and site-driven
This model is:
Mostly individual based
More risk emphasis
Behavior-oriented
Serious focus
Heavy biometric testing
Skill building
Most spouses served

18. Population Health Management
Primary Wellness Targets: In addition to the Traditional Model, plus productivity, injuries, HC utilization, presenteeism, health consumerism,
Typical Activities in addition to Traditional: HRA (incented and used for targeting with 80% minimum), risk stratification and incented interventions, telephonic coaching, medical self-care and consumer workshops, injury prevention, benefit linked incentive, wellness achievement incentives, resiliency initiative for productivity, spouses also served
Participation: 65% to 95% of staff
Approximate cost / EE / Yr: $250 - $450
(this cost does not include staffing and incentive costs)
Likely ROI: 1:2.5 to 1:6.5

19. Wellness Program Infrastructure
Virtual –based program infrastructure:
On-line Health risk assessment (HRA)
Incentives for Wellness (track on-line)
Wellness newsletter
and messaging
Health guides
Welcome kit
Telephone/on-line coaching
Site-based program infrastructure:
On-site programs, facilities such as yoga class, gyms, tobacco cessation classes, massage therapy, challenges, etc.
A good wellness program will have an infrastructure that includes both virtual and site-based!

20. Administrative Infrastructure
Brand your program!
Program Name
Logo
Tag line
Art style
Internal program staff
Vendor staff (HRA, lifestyle management, coaching, incentive program)
Form a Wellness Team with good employee representation
Program proposal and work plan
Program goals/objectives
Program budget
Program evaluation plan
Develop a strong communication plan!!

21. A supportive environment for wellness
Onsite fitness facilities and training facilities.
Shower facilities
Bike racks
Walking trails
Healthy food options
No tobacco vending – tobacco-free campus!
Computer access to E-health resources
Quiet space
Wellness as a formal organizational value
Employee orientation
Flex time for exercise
Incentive rewards for wellness
HR policies
Wellness recognition
Medical benefit coverage for prevention
Performance appraisals
Financial incentives
Environmental change
Employee involvement
Reminders
Consistent focus
Policies
Benefits
Communications
Supervisor support
Leadership support

22. Staff Health Risk Assessment and Addressing Health Risk Factors
HRAs function to:
Help the individual view his or her health risk factors;
Provide a personalized plan that serves as a catalyst for health behavior change;
Allows the individual to monitor their health over time;
Determines readiness for change; and
Evaluates any changes in personal health.
Employers gain valuable group data to identify greatest health risk factors, attitudes, readiness and perceptions of their staff over time.
Select an HRA (HRA vendor) that will meet your wellness program goals!

23. HRA Completion Maximize completion by:
Addressing employee concerns (confidentiality)
Make it a part of your annual open enrollment
Connect to flex plan choices
Provide a premium reduction for completing
Require for HSAs
Provide cash for completion (size of reward will increase participation; 80% or greater completion if reward is at least $200).

24. Getting the most out of your HRA!
Select a good HRA
Incent it strongly
Use the data for planning
Plan and implement virtual interventions
Use cohort data for evaluation and future planning

25. Group Activities Most popular: Walking events and clubs
Weight loss groups
Women’s and Men’s health issues
Smoking cessation
Fitness center membership
Sports leagues
Support groups
Stress management

26. Site-based programs Employee health services
Fitness camps and exercise classes
Smoking cessation classes
Nutrition classes
Massage therapy
Individual and group challenges with incentives
Health fairs
Sports challenges and teams
Weight loss challenges and groups
Walking /cycling challenges and groups
Blood pressure screenings
Flu shots

27. Communication is Key! Websites Email Supervisors Flyers Table tents
News ads

28. Program Evaluation Did the program meet its objectives?
How many people participated in the program (or in each component of the program?) – include HRA completion.
How did the users like the program (individual program evaluations)
What improvements in individual health or risk factors occurred? – include comparison to previous years HRA
What positive effects did the program have on our organization? – health claims, sick leave, WC, etc.
How much did the program cost?
What was the net economic effect (C/B or ROI?)
How should the program be changed for this next year?

29. Thank You! Lisa Reeve Director of Wellness and Health Human Resources
Scott & White Healthcare