Employers offer wellness, prevention to improve employee health

Results include better productivity, lower health care costs

As emphasis increases on wellness and prevention, more and more employers are looking for ways to help their employees stay healthy, and health plans are following suit by offering a wide range of health and wellness programs in the workplace.

"Employers are interested in finding ways to control claims expenditures, and one way to do it is to offer wellness programs to their employees to help them make healthy choices and reduce their risk factors. When employees are healthy, productivity goes up and so does morale," says Justin Branco, wellness program consultant for Regence BlueCross BlueShield of Oregon.

Employer-supported wellness programs help decrease the health risks of employees and reduce health care costs, but they do far more than that, adds Sarah Susalla, RN, BS, CCM, manager of health promotion and wellness for Medical Mutual of Ohio.

"There are a lot of promising outcomes from a productivity standpoint in addition to lowering health care costs by improving the health and well-being of employees. Employers invest tremendous resources in re-training when employees are out on medical leave. When people come to work and don't feel good, their productivity lags," she says.

Employers want to curb and control chronic diseases among their employees and at the same time reduce health care costs, says Nicoletta (Nicki) Morin, CEBS, director of onsite health promotion for CIGNA.

"With today's economy, employers want to keep their employees healthy and productive. They recognize that some employees may have health issues and that if they bring health care professionals to the worksite, they can ensure that employees get the care they need and reduce the time the employees are away from work," Morin says.

"We believe that our health promotion programs will help us increase the health of an employer's population while increasing productivity and decreasing absenteeism," Morin says.

Worksite wellness activities give insurers a chance to provide a holistic approach to managing the care of members by identifying early on conditions and lifestyle activities that could put workers at risk for future health care expenditures, adds Sharlene Kahn, director of case/disease management for Medical Mutual of Ohio.

The case managers at Medical Mutual look at members holistically and from a clinical standpoint to help them achieve a goal of better lifestyle choices, especially if they have a chronic disease, Kahn says.

"We work with members to identify their needs and come up with an individual plan and take an integrated approach to care. We often collaborate with the staff in the wellness program and share information that may benefit the member. The case managers can make referrals into the wellness program for members who can benefit from activities like smoking cessation or weight loss programs. Using our information technician system, the case managers can see all the points of care rendered to the members from all of Medical Mutual's programs and use the information as they coordinate care," she adds.

CIGNA uses an integrated model that allows the health promotion staff to collaborate with their counterparts in case management, disease management, behavioral health, or other programs to ensure that the employee gets the care he or she needs, Morin says.

"The staff in the wellness program are very familiar with other programs that CIGNA offers and refer members to the appropriate programs when they believe someone can benefit," she says.

CIGNA has begun offering large employers the opportunity to have a full health care clinic, staffed by CIGNA employees at the worksite. Employers that take advantage of the program typically have 1,000 or more employees at the site, Morin says.

The on-site clinics are staffed with nurse practitioners, primary care physicians, and/or medical assistants, depending on the needs and wishes of the employers.

Depending on how the clinics are staffed, employees can visit them for tests and procedures, screenings, or when they have an acute condition that needs professional care.

"Some employees may visit the on-site clinic to have their blood pressure or blood glucose levels checked, or, if there is a physician on the staff, may use the clinic as their primary care provider," Morin says.

The insurer is offering more and more worksite wellness programs to augment its online and telephonic support to members, she adds.

For smaller employers, CIGNA offers the opportunity to have a health coach or health promotions coordinator full-time at their worksite.

The health coaches provide one-on-one coaching to help employees manage their chronic condition, lose weight, stop smoking, or adopt other healthy behaviors.

The health promotion coordinator educates employees about wellness programs already available at the worksite, sets up lunch-and-learn programs, and coordinates health promotion activities.

Employers who choose to have a dedicated health coach on site typically have 500 or more employees, she says.

The health coaches all have education and training in working with clients on health management programs.

The health coaches can help employees connect to other resources offered by CIGNA, such as disease management, case management, and behavioral health programs, she adds.

CIGNA offers employers help in developing a health promotion strategy that fits with the health of the employees and the company's culture.

"We offer programs at the worksite that range from a flu shot event or biometric screening event to lifestyle management programs at the worksite," she says.

Lifestyle management programs have both a telephonic and online component and include weight management, stress management, and smoking cessation as well as preventive programs such as pre-diabetes and metabolic syndrome. In addition, CIGNA provides lifestyle coaches who go to the worksite and conduct the classes.

Medical Mutual of Ohio offers customers a core set of programs including reimbursements for Weight Watchers membership, fitness program discounts, telephone smoking cessation programs, and one-on-one coaching by a lifestyle coach. The coach may be a dietician, an exercise physiologist, or a health promotion professional, depending on the skill sets the member needs.

"Aside from the lifestyle coach benefit, which employers may choose as part of their health plan package, the other programs are open to all members, even those with individual products," she says.

The company identifies employees who are eligible for its lifestyle coaching program through a health risk assessment administered to all members, through on-site screenings at the workplace, and by mining claims data, Susalla says.

"All members are assessed when they enroll in the program to see where their true health risks lie. We encourage them to fill out the health risk assessment every year. It helps us identify issues that might not show up on claims data," she says.

The wellness department also gets referrals for the lifestyle coaching program through referrals from case management, she adds.

"When the case managers are working with members on chronic or acute health issues and determine that they are smokers or overweight or could benefit from other wellness programs, they give us a referral and we contact the member and offer our services," Susalla says.

A wellness team at Medical Mutual goes out to employee groups and helps customize programs based on the health risk of their employees and the work place design.

Regence offers a wellness package called Vitality to organizations that purchase a medical plan. If a company signs up for Vitality, a Regence wellness consultant partners with the employer to develop a customized wellness strategy.

The Vitality program includes personalized certified health coaches who work with employees over the telephone to set goals to improve their health and to support them in meeting their goals.

"Health coaching helps members who want to exercise more, improve their nutrition, manage stress, or stop using tobacco and need one-on-one support to meet their goals," Branco says.

The company also offers a 24-hour nurse line that enables employees to speak to a registered nurse when they are sick, hurt, or need health care advice. The nurses help the employees decide if they need to see a doctor or if they can self-manage their problem.