On-site wellness programs are popular with employers

Companies see effort as a value-added service

The first year that Health Alliance Plan (HAP) offered on-site wellness programs for employer groups, the Detroit-based health plan implemented programs at 20 companies.

Four years later, in 2005, the company set up about 400 employee wellness programs at 194 companies.

"Our employers come to us, looking for ways to keep people healthy and reduce health care costs. Employee morale, recruitment, and retention are all factors that companies consider when they launch a wellness program," says Terri Kachadurian, MS, manager of work site health promotion.

HAP expects to host work site health promotion for even more companies in 2006, she adds.

Companies are looking at absenteeism and productivity, as well as presenteeism, which means an employee is at work but not working at full capacity because of an illness or a condition such as a migraine headache, she says.

HAP offers a wide spectrum of wellness activities, in some cases just filling in the gaps in the programs the company already has. For other firms, HAP develops comprehensive wellness programs.

"We try to understand the company and what their resources are so we can get a better handle on their needs," she says.

The programs run the gamut from on-site health screenings to educational lectures on health and wellness topics.

Many of the on-site services are provided by vendors, local hospitals, or visiting nurses which HAP contracts, but in some cases, the insurer’s nurse case managers will talk to the employee groups about managing their conditions.

HAP provides reports to the employers that include aggregate health screening data, such as how many employers were screened for hypertension along with the number with high-, medium-, and low-risk factors. All of the personal information about employees is kept confidential. HAP doesn’t give the company any individual health information, Kachadurian reports.

"When we have enough participation in any given employer group, we can report aggregate data to them. Often we don’t go back to the same group of employees and do the same service, which makes it difficult to provide employers definite outcomes data on the effectiveness of the program," she says.

Often, an on-site health screening will prompt the employer to sign on for more wellness activities, Kachadurian points out.

"If we find a high level of any risk factors, we encourage the employer to provide additional programs," she says.

Some of the companies invite family members to attend the on-site wellness programs.

"Reaching out to all our members is important. An employee has a spouse and children, and we want to reach all of them," she says.

HAP often offers a small incentive to members who participate in wellness programs and encourage employers to offer bigger incentives.

"We find it really boosts participation when we offer an incentive. As an HMO, regulations limit us to providing a token gift. Employers can give rewards with a higher dollar value, which motivates even more people," she says.

In addition to on-site services, HAP encourages its employer groups to promote iStrive for Better Health, a customized on-line health improvement program offered directly to members.

HAP promotes iStrive to the members through its publications, on the web site, and through employer groups. Swin Cash, captain of the Detroit Shock, the Women’s National Basketball Association team, is the plan’s celebrity spokes-woman for the iStrive program.

Participants fill out an on-line health risk assessment and receive immediate feedback on how to adopt healthier habits. They are offered the opportunity to sign up for one of six lifestyle behavioral change programs — weight management, smoking cessation, nutrition improvement, stress management, chronic disease management, and back pain.

When members sign up for a lifestyle program, they fill out a detailed assessment of lifestyle and behavior relating to that particular program. The questions are designed to determine motivation to change, barriers to change, and other factors needed to create a personalized plan of action to address the issue. "No two health improvement plans are alike. The member receives a newsletter tailored to the individual and e-mails to remind them of healthy behavior," she says.

The recommendations reflect potential barriers to achieving health goals, such as motivation to change, lifestyle factors, and emotional obstacles to changing health behavior.

Members receive a $5 gift card to a chain restaurant offering healthful food for completing the online health risk assessment and a $25 gift certificate to sporting goods or grocery stores for completing at least one of the follow-up programs.

"We believe in prevention and think it’s important for our members to get appropriate preventative services and be as healthy as they can be," Kachadurian says.