Paying for good health brings a big payback

Hospitals and employees save money

Survey your employees about their health status, and the results you find may be eye-opening. Sutter Health, a Sacramento, CA-based health system, discovered that 30% of its employees were obese and an equal number were overweight. A sedentary lifestyle was taking its toll with health conditions such as diabetes and high cholesterol.

Sutter Health Partners, a division of Sutter Health, developed the "Live Well for Life" coaching program, and affiliate hospitals provided substantial incentives for employees to participate. The program was tailored to the needs of the employees and emphasized healthy eating, exercise, stress management, and weight management.

The results have been impressive:

  • 25% of participants moved from high-risk blood pressure readings to normal blood pressure readings. Estimated cost savings: $706 per employee.
  • 27% of participants moved from high-risk scores to healthy range scores. Estimated cost savings: $492 per employee.
  • 11% of participants moved from a high-risk range of body mass index to a healthy range. Estimated cost savings: $738 per employee.
  • 16% of participants moved from a high-risk range for sedentary lifestyle to a healthy range. Estimated cost savings: $1,295 per employee.

The cost-savings estimates are based on a study of healthy risk behaviors and their impact on health care costs.1

"We have reports of people who have gotten off their high blood pressure medicine or their cholesterol medicine by changing the way they eat and exercise," says Kristine Baldwin, operations director for Sutter Health Partners. Some people with significant health issues, such as high blood pressure, have been identified so they can get treatment, she says.

Meanwhile, employees have racked up impressive savings, as well. The incentives vary among Sutter-affiliated hospitals, but most offer $100 or $200 for basic participation: completing a health risk appraisal, meeting with a coach, and undergoing a health screening.

"It's just paying people to participate and get engaged in their personal health," says Baldwin. "We do believe that alone is really making a difference in people's outcomes. "

Sutter Health Partners offers a "high-touch" wellness program. Employees set goals and meet face-to-face with their coach for support and advice to meet those goals. The more progress they make, the greater their potential incentive.

At Marin General Hospital in Greenbrae and Novato (CA) Hospital, employees can receive a waiver of their share of health insurance premiums. At other Sutter hospitals, employees may receive a $500 bonus, paid incrementally throughout the year based on the achievement of goals.

"It's a win-win for everybody. They're happier, they're healthier and more productive," Baldwin says. "What we say is eat well, stay active, and enjoy life. Those concepts translate into their personal life and their professional life."

Employees consider the wellness program to be a valuable benefit, she says. In a satisfaction survey, 73% of employees said the wellness program was responsible for helping them make valuable changes in their lifestyle behaviors, she says.

About 85% to 90% of the employees reported reaching their goals through the program, she says. "That has a lot to do with the skill sets of the coach and [setting] realistic goals."

The wellness program itself needs to have well-defined goals, says Baldwin. Creating a successful wellness program requires more than just setting up some lunch-and-learn classes and exercise sessions.

"Don't just say you're going to do a wellness program unless you know what your objectives are," she says. "Make sure you're meeting the objectives of your leadership or else you won't have the support of your leadership."

Consider these questions: How will you collect data? Will you use health risk appraisals or interest surveys? What interventions will you use? Will they be online or personal coaching or on-site educational programs? Will employees be able to participate during work time? How will you define your success and measure outcomes?

Your corporate culture should support your program, Baldwin says. For example, if one of your goals is to help employees with healthy eating and reducing cholesterol, then make sure your cafeteria has healthy food choices and don't serve donuts at the educational program.

Getting support of the administration is vital. It may take three to five years to see the results of your investment, she says. But you'll need to win over employees as well. Incentives are an effective way to boost participation, says Michael Wood, MS, MPH, a senior consultant in health and productivity with the Seattle office of Watson Wyatt, a human resources consulting firm.

"The difference between having an incentive and not having an incentive can be the difference between having 5% and 90% of your people participating," he says.


1. Goetzel RZ, Anderson DR, Whitmer RW, et al. The relationship between modifiable health risks and health care expenditures. An analysis of the multi-employer HERO health risk and cost database. J Occup Environ Med 1998; 40:843-854.