3 Ways to Boost Employee Health with On-Site Wellness Program Support
Original post benefitspro.com
When employers launch a robust employee health program, too often corporate wellness becomes another job for someone who already has a full range of responsibilities.
That’s why it’s crucial to have someone “on the ground” who owns health and wellness and can in turn play an active role in building a successful health management program.
We see the benefits of providing an on-site wellness presence. Our client sites that have a dedicated on-site program manager enjoy a 33 percent higher participation rate compared to similar programs that don’t include an on-site manager.
The benefits of having an on-site wellness program manager include the following:
- Screening participation: 58 percent increase
- Health advising participation: 43 percent increase
- Coaching enrollment participation: 21 percent increase
In addition to on-site program managers, here are three ways our clients inspire employee wellness with on-site solutions—and how this option might make sense for your organization.
1. Drive engagement with health advocates
To meet the needs of more than 12,000 employees in 18 locations at a leading automotive parts manufacturer, my employer HealthFitness provides six on-site health promotion coordinators and eight full-time benefits advocates to help employees and their families navigate the health care system.
On-site advocates serve as corporate wellness navigators and answer questions employees may have related to their benefits—from how the medical plan works to how to earn incentives.
Advocates work as a touch point for employees—whether they meet before, after or during shift breaks.
Results:
Support from on-site benefit advocates has paid off in providing real results for both employees and the company.
- 48,000 benefit advocacy contacts driving referrals to benefit providers
- 6.2 percent year-over-year reduction in health risks
- 93 percent completion rate of health assessments and screening for employees and spouses
2. Activate boots on the ground
To build rapport with the manufacturing population at a leading producer of agricultural products, our on-site staff regularly meets employees where they are—donning steel-toe boots and protective gear to join them in the field, safety meetings, or break rooms.
Our on-site presence lets them know we are here for them and are committed to their health.
For example, to make it easier for employees to participate in wellness activities such as screenings, on-site staff are scheduled to work early hours (from 4 a.m. to 12 p.m.), giving workers the opportunity to participate in blood pressure screenings without leaving the worksite.
The mindset of ‘we bring the program to you’ is essential to program participation success.
Results:
- 11.3 percent decrease in average number of high health risks from 22.47 to 2.19 among 2,400 participants.
- 97 percent of participants were “satisfied” or “very satisfied” with their on-site biometric screening event.
- 63 percent of employees participated in one or more lifestyle management programs in 2013.
3. Build a network of on-site wellness champions
Our on-site program manager leverages a wellness champion network of more than 30 employees to meet the needs of 12,000 employees at an agricultural and construction equipment leader.
Wellness champions build employee awareness and increase engagement in corporate wellness programs.
Employees at 20 sites throughout the country turn to the wellness champions as a resource, to share ideas and ask questions. Wellness champions also represent employees during ongoing conference calls and help ensure health and wellness continues to be part of their daily routines.
Results:
- 85.3 percent of the employee population has participated in at least one health management activity.
- 43.1 percent participation in a walking program that challenges employees to walk 10,000 steps a day.
- 21.1 percent participation in health coaching so employees can develop an individual, confidential plan to help them reach their health goals.
Wellness program wins in federal courtroom
Employers use wellness programd to encourage employees to be aware and in control of their health.
The implementation of wellness programs have come under fire from the Equal Employment Opportunity Comission in the last several months. Lawsuits filed by the EEOC claim wellness programs that require health risk assessments violate the Americans with Disabilities Act.
One of the claims raised involved Wisconsin based Flambeau, Inc., and the decision in the case stands in favor of the wellness program.
As laid out by the National Law Review, the manufacturing company mandates employees to complte a health risk assessment and biometric screening to be eligible for its health plan. If an employee does not complete the requirement, then the employee becomes responsible for the full premium in order to stay covered.
The EEOC alleged in the lawsuit that when an employee did not complete the assessment and biometric testing, Flambeau cancelled his medical insurance and shifted the responsibility of the entire premium cost to him.
The EEOC argued that the biometric testing and health risk assesment constituted "disability-related inquiries and medical examinations" that were not job-related and consistent with business necessity as defined te the ADA. The EEOC also argued the plan was not a "voluntary" plan and that Flambeau did not qualify for the "safe harbor" protections set forth by the ADA.
In her ruling, U.S. District Judge Barbara Crabb ruled Flambeau was not in the wrong in implementation if its voluntary company subsidized health insurance plan. The judge ruled Flambeau fell under the law's "safe harbor" provisions because the mandatory health assessment and biometric testing were conditions for employees to voluntarily receive the insurance offered by the company.
This decision applies to wellness programs that are part of the employer's benefit plan. How it applies to stand-alone or other wellness programs is not seen at this time.
The EEOC may seek out an appeal in the case.
Over-screening could be killing your wellness program
Wellness programs are seen as a way to hold down healthcare costs for companies. The idea is you give employees a helping hand to better their health and eventually their need for doctor visits and medications lessen.
But is it working?
Al Lewis, CEO of Quizzify and author of Surviving Workplace Wellness, believes the U.S. is "drowning" in over-diagnosis and over-treatment and wellness programs are partly to blame, according to EBA's article, 'Wellness programs ‘massively over-screening’ people'.
“This country is drowning in over-diagnosis and over-treatment, raising health care costs,” Lewis said.
Lewis believes the over-testing done on employees as a requirement in a company's wellness program could lead to false positives, unneeded medications or higher expenses for employers and employees.
Ron Goetzel, senior scientist at Johns Hopkins Bloomberg School of Public Health, agrees there are a lot of lousy wellness programs out there, but there are some good programs too.
“What we’re trying to do is figure out what works,” Goetzel said. “The most effective way is creating cultures of health where people go to work every day and come out healthier because of the culture, through leadership support and commitment, and a culture of doing everything to promote health.”
Lewis and Goetzel comments come from debate during the Population Health Alliance Conference in Washington, D.C. on Nov. 2, 2015.
One compelling reason to participate in a wellness plan
Originally posted by Dan Cook on July 16, 2015 on benefitspro.com.
In the midst of questions about the effectiveness of wellness programs, one advocate for such programs says the results of a recent survey show that wellness initiatives greatly reduce the risk that a person's chronic condition will go undiagnosed.
The group, HealthMine, a consumer health engagement company, polled 750 people enrolled in wellness programs and found that 28 percent of participants had been diagnosed with a chronic condition in the past two years. Almost half of those (46 percent) had received their diagnosis through the wellness program, suggesting that they may have gone much longer without treatment had the program not been available.
HealthMine described the findings as particularly salient with regards to some of the most pressing American health concerns, noting that a third of those who suffer from diabetes are unaware of it. The solution, suggests HealthMine, is to expand the availability of wellness programs as well as to increase the number of health tests that allow people to better understand their health vulnerabilities.
A separate poll that HealthMine conducted of 1,200 consumers found 74 percent support the use of genetic tests in wellness programs to help consumers identify health risks.
Moreover, most of the survey respondents signaled they would take part in various health screenings if they were offered by their employer.
The survey nevertheless showed far greater resistance to certain health screenings than to others. Nearly three-quarters said they would be up to do a screening for vision or blood pressure, and 69 percent said they would do a cholesterol screening. But only 58 percent said they would do a cancer screening, 54 percent said they would do a BMI screening and only 41 percent said they were up for a skin analyzer.
HealthMine CEO Bryce Williams said these surveys suggest that only when consumers are aware of their own health conditions will wellness programs meet their full potential.
"To succeed, wellness programs must enable people to learn their key health facts, and connect individuals to their personal clinical data anytime, anywhere,” he said. “When consumers and plans are empowered with knowledge, wellness programs can make recommendations meaningful to individuals, and help to prevent and manage chronic disease."
A past study suggested that while companies do typically hope that wellness programs can help them keep down health care costs, their top motivation for doing the programs is to improve the health of their employees.
7 sins of wellness programs
Gold standards are starting to emerge for corporate wellness programs. Virgin Pulse, which has been monitoring wellness program adoption and design, says there are basically two categories extant in the corporate world today: wellness 1.0 and wellness 2.0.
The overarching difference lies in engagement levels. But engagement has been a tricky quality to define, and even harder to achieve. Virgin's idea with 1.0/2.0 is to simplify the process, identify the major components that can lead to engagement, and offer easy-to-adopt methods to begin to grow engagement.
“While wellness 1.0 is a great start to showing your employees you care, it’s limited from the very beginning — many of these programs can be inapplicable and unappealing to a vast majority of people,” Virgin says in “Moving Beyond Wellness 1.0. “They may not offer enough variety or flexibility for people at different stages of their journey to better health. For some, there may be too many barriers to participation for them to overcome.”
Wellness 2.0 programs tend to include options that address three key health areas:
- Exercise options, which make “people more energetic, focused, and productive”;
- Healthy food options and health eating support, which offset “poor nutrition stemming from eating too much sugar, carbs, or fat can actually [which] cause cognitive impairment”; and
- Sleep assistance options, because people who are well rested perform much better on the job than do those who don't get enough sleep.
But beyond those elements, the 2.0 programs don't have the characteristics that Virgin found in programs that are bedeviled by lack of engagement.
Virgin starts by examining the 1.0 level of wellness programs, and offering a list of defects that these low-engagement programs typically display. The Seven Deadly Sins of wellness 1.0 programs are:
- They only target the sick
Positive: Good for those with health issues who want to change.
Negative: Limits the number of employees who will be interested in the program or who can take advantage of what is offered. - They don’t encourage lasting behavior change
Positive: Elements of the program can lead to quick benefits.
Negative: Healthy behaviors aren't reinforced so health gains are often lost later on. - They don’t engage your potential wellness champions
Positive: For those they target, these plans can work well in the short term.
Negative: If the program is all about helping people with health problems get somewhat healthier, the program leaves out the healthy workers who want to further enhance their health. These people can be champions of the wellness plan, Virgin says. But too often they are not considered in plan design, so they don't participate.
- hey lack daily engagement
Positive: There isn't one for this category.
Negative: Poor communications with employees about their wellness options can doom even a robust wellness program. As Virgin notes, “Once the kickoff meeting is over, an employee’s health risk assessment is complete, and they have their login for the wellness site, most don’t engage with the program again until they’re nudged — or as far out as the next wellness kickoff meeting.” Engagement needs to be daily, Virgin argues, to drive engagement. - They focus on HRAs and biometrics alone
Positive: Both are great tools for evaluating the physical well-being of your workforce.
Negative: Too often, the information from HRAs and biometrics screenings isn’t used to create an actionable wellness plan that helps address the health concerns these assessments uncover.
- They only offer rewards upfront
Positive: The upfront “bonus” attracts people to the program initially.
Negative: That bonus is often the only tangible reward employees ever see for participation. “The unfortunate result is that many of the people you’d like to see in your program may very likely disengage after the big initial reward is gone,” Virgin says. - They’re an administrative burden
Positive: Keeps employment strong in the HR department.
Negative: Costly! “The last thing you need is a system that’s tough for you to manage and tough for your people to use. Unfortunately, that’s often what happens with wellness 1.0 programs. The harder it is to administer, the further down the list of priorities it falls.”
5 Ways to Drive Healthy Behavior Change Virtually
Originally posted on https://ebn.benefitnews.com
Employees have access to thousands of apps covering health and wellness on their mobile device. Employers and wellness vendors can offer workers hi-tech ways to track their physical activity, promote healthy eating and inspire wellness at work. Here are five mobile apps and outreach ideas to get employees moving and engaged in your wellness program.
For office employees sitting at their desk all day, sedentary work can cramp muscles and staring at a computer screen too long can cause eye strain. Employers can remind employees to take stretch breaks by building reminders into the network, such as having a reminder pop-up on their computer.
On the app side, HotSeat challenges people to get out of their seats for small breaks. It includes competitions, feedback on how your small bouts of physical activity add up to meaningful amounts. UtiliFit is another app that is breaking into this space, says LuAnn Heinen, vice president and wellness leader, National Business Group on Health.
Employers can encourage better nutrition and healthy food choices with smart receipts from the company cafeteria, says the National Business Group on Health vice president and wellness leader. When employees purchase food at the company café, the smart receipt shows the calorie and nutritional content of their food choices.
Many employees can’t afford to hire a personal trainer, but technology like Anthem’s and online trainer FitOrbit’s virtual fitness and real-time, Internet-based coaching offers fitness training without breaking the banks. After selecting a trainer based on a short questionnaire, the employee electronically receives a customized fitness and nutrition plan and ongoing coaching – the latter via the modern miracle of unlimited texting, plus a weekly personal exercise plan – to support their goals.
StickK app and website asks individuals to put up their own money for a charity that they hate if they don’t accomplish their wellness or other goal. The StickK website facilitates that transaction so that a gun control advocate, for example, would have to fork over cash to the National Rifle Association for failing to meet their goal. The platform also builds in an array of behavior principles (beyond giving away your money to a cause you oppose), among them social recognition and rewards, and feedback.
IRS Issues Regs on Wellness Program Incentives
Originally posted January 28, 2014 by Jerry Geisel on https://www.tirebusiness.com
Financial incentives that employers provide to employees participating in wellness programs generally could not be included in determining if an employee is exempt from a healthcare reform law requirement to enroll in a plan offering minimum essential coverage under newly proposed regulations.
Healthcare plan premium contribution discounts are an example of such an incentive.
The Internal Revenue Service (IRS) regulations proposed Jan. 23 and published in the Jan. 27 Federal Register involve the relationship between a premium affordability test established by the Patient Protection and Affordability Act and the financial incentives employers provide for employees to participate in wellness programs.
Under the healthcare reform law, employees are required to enroll in a plan offering minimum essential coverage. If they do not, they are liable for a financial penalty. In 2014, the penalty is $95 or 1 percent of income, whichever is greater.
Employees are exempt from the penalty, however, if the premium their employer charges for coverage is “unaffordable,” which the law defines as greater than 8 percent of household income, and they did not enroll in the plan.
Under the proposed regulations, financial incentives, such as premium discounts for wellness program participation, would be excluded in running the 8 percent affordability test.
For example, if an employer charged employees a monthly premium of $100 for single coverage if they participated in a wellness program and $120 if they did not, the $120 premium assessment would be used to determine if the employee had access to affordable coverage.
In the case of premium discounts offered in connection with tobacco-cessation programs, however, the lower premium offered to employees participating in these programs would be used in running the premium affordability test, the IRS said.
“This rule is consistent with other Affordable Care Act provisions, such as one allowing insurers to charge higher premiums based on tobacco use,” the IRS said.
“There is more of a consensus among regulators on the benefits of tobacco-cessation programs compared with other wellness programs,” said Amy Bergner, managing director of human resources solutions at PricewaterhouseCoopers L.L.P. in Washington, referring to the different treatment for tobacco-cessation programs than other wellness programs.
This report appeared in Crain’s Business Insurance magazine, a Chicago-based sister publication of Tire Business.
Making HSAs and wellness work together
Originally posted January 13, 2014 by Rose Rosa on https://ebn.benefitnews.com
Maximizing the positive impact of a wellness program is a goal of many employers. Much of the discussion around wellness focuses on how to increase employee participation. Doing so remains a challenge for many employers, but there are some innovative approaches employers are exploring.
One concept we’re seeing is tying wellness to health savings accounts. With a HSA, employees can use tax-free dollars to pay for qualified out-of-pocket healthcare expenses, typically including items such as eyeglasses or prescription medications. Now, some employers are expanding use of HSAs to drive wellness participation.
Combining wellness and HSAs is a long-term strategy. However, there can be some immediate benefit for the employer, which typically begins by going from a traditional fully insured plan to a high-deductible plan with a HSA, thereby saving the employer some money right out of the gate.
Here’s how tying a HSA to wellness can work: The employer funds or partially funds a HSA, which is the “carrot” to get employees interested in the account. Over time, some employers introduce the so-called “stick” to maximize participation by requiring employees to meet certain health-related criteria.
Here’s one possible approach:
• In the first year, the employer contributes to the employees’ HSA account (typically, a 50% contribution).
• To receive the 50% contribution in year two, employees are required to complete a health risk assessment.
• In year three, the employer will increase the requirements, perhaps including completion of another HRA, plus biometric testing.
By increasing the conditions that must be met, it creates a natural progression that helps employees become more aware of their health and to do something about any issues identified by the screening. It also demonstrates to employees what they need to do to control their personal health care costs; those who make progress get discounts on their plan, so they become more responsible for their own health and ultimately their own savings. As employees control their costs, they help control the employer’s costs as well.
In the end, it’s a win-win scenario; the combination of HSAs and wellness programs can provide value to both employees and employers. It’s also an effective way to guide beneficial behavior since employees who follow the program are more likely to take steps to become (or stay) healthy. Using this type of program can also be a good opportunity to tie in other health initiatives, such as smoking cessation. One approach is to apply a smokers’ surcharge on the employee contributions (the stick) while also offering smoking cessation programs to help the employee quit smoking (the carrot to avoid the stick).
To make this combined strategy work, education is a vital. HSAs are most effective if employees understand how the program works, so it’s the employer’s duty to teach them. With this approach, employees have greater risk and higher deductibles, but they also have greater control and choice, coupled with an incentive to be healthy. Essentially, this spurs the employee to become a more educated consumer of health care services.
But it’s up to the employer to make the first move.
Workplace wellness in the new age of the ACA
Originally posted January 02, 2014 by Alan Pollard on https://ebn.benefitnews.com
With all the implications that the Affordable Care Act has on employer’s health insurance obligations, it’s easy to overlook its effects on workplace wellness programs. Yet these programs are very much affected by Obamacare.
Now that privacy and equality guidelines that previously only applied to insurers and providers are being applied to all sponsors of health promotion and prevention programs, the feedback we’re hearing is that many employers are either unaware or don’t understand what’s expected of them vis a vis their wellness programs in this new legal environment.
Some organizations that led the charge in workplace wellness in the last decade have mature programs targeting specific conditions such as obesity or smoking. These types of programs in particular face new hurdles presented by the final ruling, yet many companies don’t understand exactly what is needed to become compliant.
Further, some companies that have taken steps to modify their programs to be compliant are finding out firsthand just how complex re-engineering can often be — and how vocal some highly informed employees can be against changes.
For example, the protection of privacy of personal health information afforded by the Health Insurance Portability and Accountability Act has been legislated for a long time, but now puts additional restrictions on workplace wellness programs. How does a company that has long collected this type of information as proof of qualification for a reward or a premium subsidy handle this new obligation?
Other scenarios: How does an employer set up simple employee fitness events like a 5k walk or even a step test to obey the requirements for a reasonable alternative standard for those who cannot participate due to a physical disability or a physician’s recommendation? Or, how do you reward your employees for losing weight in a way that doesn’t alienate them by pressuring them to share sensitive information?
Whatever the structure, you must be able to prove your wellness program is, as the new law phrases it: “reasonably designed to promote health or prevent disease; has a reasonable chance of improving the health of, or preventing disease in, participating individuals; is not overly burdensome; is not a subterfuge for discriminating based on a health factor; and is not highly suspect in the method chosen to promote health or prevent disease.”
After spending more than two decades in the wellness industry, I’m very encouraged by the ACA’s strong recognition of the important role well-designed wellness programs play in promoting health, preventing disease and controlling the rising cost of care. However, the new regulations also include many important design requirements and consumer protections that raise the bar for wellness providers to deliver more professional and evidence-based programs, and for employers to be more aware of privacy issues, fairness and quality outcomes.
For CEOs this presents an opportunity to re-examine and elevate the standards for workplace programs, choosing the ones based on science-based evidence of measurable impact. For those in the wellness industry, this lays down both a challenge and opportunity to improve the quality and sustainability of interventions — especially those aimed at reducing obesity, tobacco use, physical inactivity and mental health.
We urge all responsible parties to thoroughly examine their wellness offerings for the ability to deliver all that the new law demands — and promises. And for employers, it’s important to make sure your business partners can ensure the ACA compliance of their programs.
Healthy employees create competitive advantage
Originally posted September 24, 2013 by Emily Holbrook on https://www.lifehealthpro.com
It may come as no surprise to many that healthier employees are more productive employees, creating a competitive advantage for their employer. That's according to a recent study by Integrated Benefits Institute (IBI), a workforce health and productivity research and measurement organization.
The company studied 1,268 employees at 53 organizations and found that employees that work at companies with a strong commitment to a healthy workforce "spend more time working, work more carefully and concentrate better than employees at other organizations," according to the report.
“If a workplace sets a high priority on the health of employees — who, in turn, are healthier and have better job performance — then it can reasonably be said that an employer’s culture gives it a competitive advantage. Workplace culture reflects the priorities of company leadership and is an area where employers have some leverage to improve business performance,” stated IBI research director Kimberly Jinnett, PhD, the main author of the report.
The study also found:
- Not careful at work: Workers in an organization with a weak health culture reported not being careful at work “all” or “most of the time” more than three times more frequently than those who work in organizations with a strong health culture.
- Not working as often: 44 percent more employees who work in an organization with a weak health culture reported not working as often as they should have “all” or “most of the time” as compared with employees in organizations with a strong health culture.
- Not concentrating: 31 percent more employees who work in companies with a weak health culture reported they did not concentrate “all” or “most of the time,” compared with employees in organizations with a strong health culture.
- Getting less work done: There was no difference in the responses from those in a strong versus a weak health culture with regard to getting less work done — but employee health is a differentiating factor. Emotional distress and overall health strongly influence how much an employee accomplishes, and employees in organizations with a weak health culture have worse outcomes on both measures.
IBI President Dr. Thomas Parry said "as more employers recognize that health influences productivity, as well as health care costs, health outcomes such as absence, disability and presenteeism are being brought into the larger discussion of the business cost of poor health."
Of course, this is not the first time that research has shown the connection between poor employer health culture and employee ailments (and therefore, productivity) and it won't be the last. According to IBI, employers that wish to increase their focus on health-related job performance and its impact on the bottom line "should broaden their view from the individual health of employees to additional organizational factors, including health culture and employee well-being."
Companies are, albeit slowly, starting to see the link between employee well-being and productivity.