Wellness program targets biggest problem: Obesity
Lose 16 tons and what have you got? Health
Like many of the nation's employers, Aurora Health Care in Milwaukee faced a problem that was large in every dimension: Girth, scope, cost, and health implications. Obesity is linked to higher rates of chronic illness than smoking and drinking.1
Health screenings revealed that more than one in three (35.3%) of Aurora employees had a BMI above 30, the definition of obese. While that prevalence was eye-opening, it mirrors the national experience. Some 35.7% of U.S. adults are obese, according to the Centers for Disease Control and Prevention.
Aurora decided to address the problem by boosting its wellness initiative, adding financial incentives, and providing support for weight management. "Our leadership knew we needed to do something when they found these statistics," says Amy Confare, Aurora's integration analytics manager.
The health system, which has more than 30,000 employees in 15 hospitals and more than 172 clinics, already had added healthier options in its cafeterias, smoking cessation benefits and an insurance premium increase for smokers. Its campuses are tobacco-free.
A closer look at employee health costs revealed that the health system was spending almost $250 million a year on medical care and prescriptions. The profile of employees: They had an average age of 44. Seventy-five percent were women, and 63% were overweight.
"We had to do something to help people lower their weight," says Confare. "Aurora looked at what other organizations were doing inside and outside of health care to help their employees maintain a healthy lifestyle."
Many options for weight management
Aurora developed a wellness initiative that began in early 2013. Employees on Aurora's health plan (about two-thirds of employees) can earn a discount of up to $13.33 per biweekly pay period by complying with three criteria: Being tobacco-free, completing a health risk appraisal, and being of a healthy weight or participating in a weight management program.
Weigh-ins began in January. Employees with a BMI of 30 or higher had several options for achieving the premium discount: They could lose 5% of their body weight on their own by August. They could join a Weight Watchers program. They could participate in either a clinic-based or phone-based Health Management Resources (HMR) program, which involves meal replacement and coaching. Or they could obtain coaching from the Employee Assistance Program.
Only the on-your-own alternative required another weigh-in. The others were based on participation in at least 10 of 12 weeks, and Aurora provided a partial reimbursement of costs for the Weight Watchers and HMR programs.
The first weeks involved a flurry of weigh-ins — 17,704 in all — and some pushback from employees.
After all, weight is a sensitive subject, says Confare. "Imagine your company is telling you have to think about losing weight if you have a BMI of 30 or higher," she says.
Breaking old habits
Success stories soon overcame the sensitivities. "We definitely saw that people were thankful," says Confare. A sample employee comment: "You saved my life."
The wellness initiative demonstrated that a phone-based coaching and meal replacement program could be as successful as an in-person clinic, says Doug Black, chief commercial officer for HMR Weight Management Services Corp. in Boston. That's important because phone-based programs are more accessible, less expensive and able to handle more participants, he says.
"The purpose of this is to break old habits and to provide strategies," he says. For example, coaches help participants keep on a healthy eating plan while traveling, celebrating holidays, or juggling a busy family. "You do need a coach to help you pull it all together," he says.
Participants in the HMR clinic program lost an average of 45 pounds, or 17% of their body weight. Those in the phone-based program, called Healthy Solutions at Home, lost an average of 24 pounds or 11% of their body weight. The participants also increased their intake of fruits and vegetables and physical activity.
A study comparing the results of the two methods was presented at the annual conference of The Obesity Society in November.
Aurora is already gearing up for another wellness initiative in 2014. Meanwhile, the positive results provide a base for promoting a wellness program for corporate clients through the health system's accountable care organization, Confare says.
In all, about 3,200 employees lost 16 tons of weight, she says. Healthier employees can provide better care for patients, she says.
And when Aurora partners with other companies, the health system can say: "If Aurora can do this with our own employees, how can we help you with yours?"
- Sturm R and Wells KB. The health risks of obesity: Worse than smoking, drinking and poverty. Rand Corp., 2002. Available at www.rand.org/pubs/research_briefs/RB4549/index1.html.