Wellness program pays for itself with lower claims

Employees earn bonuses by meeting healthy criteria

Exercise. Healthy diet. Relaxation. This is the Rx that doctors and nurses routinely give their patients. But how can you influence them and other hospital employees to follow that advice as well?

Providence Everett Medical Center in Everett, WA, found the answer with a bonus program for employees to meet the "Wellness Challenge." If employees meet eight out of 10 wellness goals, they receive a bonus of $250. That rises to $275 for their second year of meeting the goal and $325 for subsequent years. Even employees who meet just four out of 10 of the goals receive a modest reward of $50.

More than half of Providence Everett’s 1,800 eligible employees participate in the program. That may sound like an expensive proposition, but Ron Burt, MEd, manager of prevention services, notes that the costs of sick days and injuries far exceed the payout.

"Over the past seven years, we’ve seen a three-to-one return on our investment," says Burt. "People aren’t sick as often. They’re not using health care and they’re not as likely to have injuries."

Alliance (OH) Community Hospital adapted the Wellness Challenge program and found a similar benefit. The average health care benefits cost per employee dropped from $2,326 in 1996 before the program began to $1,993 in 1998.

"When you multiply that by 800 employees, that’s a hunk of change you’re saving," says Ann Walker, director of wellness services at Alliance. "We figured in the two years we’ve had the program running, we’ve saved almost $338,000 in [lower] absenteeism, workers’ compensation, and health care dollars." That total is a net savings, after deducting the $132,650 cost of the program, she says.

The Wellness Challenge begins with a health risk assessment. In 1998, Providence Everett offered $25 bonuses to employees just for signing up and completing the health risk assessment. About 75% of the employees responded.

Participants motivated by outreach

But those small incentive bonuses may not even be necessary to spur participation. When Burt’s department surveyed employees, they found that outreach to the workers was a more powerful motivator than the money. "It was more of an incentive that someone came to them and asked them personally to sign up [for the Wellness Challenge]," he says.

This year, the hospital isn’t offering the sign-up bonus. But Burt will still try to encourage nonparticipants to join the program. "We wanted to get not only the healthy, health-conscious people, but also those people who were really in need of some help and tended to be higher users of health care."

Wellness Challenge criteria may change from year to year, depending on employee health patterns or response to the program. For example, Burt found that some employees decided not to participate in the program because they didn’t want a body composition test or they had trouble scheduling the lengthy assessments. Now, the hospital offers quarterly screenings that include body composition, lipid profile, and blood pressure, but the testing is optional. (For a list of criteria, see box at right.)

The definition of wellness is broader than physical functioning or even fitness. Providence Everett encourages employees to get some TLC from massage, hobbies, or other relaxing activities — and gives them credit for it.

"People haven’t taken time for themselves. We felt that it was an important part of stress management and mental health wellness," Burt says.

Each institution adapts the Wellness Challenge to meet that hospital’s needs. Ann Walker at Alliance Community Hospital reviews the criteria annually for possible changes.

"Last year, our infection control committee came to me and said, We’re having a huge increase in needlestick and sharps injuries. Is that something we can add to the Wellness Challenge?’"

Walker added an item that gave employees credit if they had no needlestick or sharps occurrence. Alliance employees must meet nine of 13 possible criteria to receive a $350 bonus.

"From last year to this year, we had a 17% decrease in needlesticks and sharps occurrences. That doesn’t mean the Wellness Challenge can take all the credit for that. But it certainly contributed to that," she says.

This year, Alliance is adding flu shots to the list. "[Wellness] is not just fitness and eating right. There’s so much more involved with wellness and reducing the costs of employee benefits," says Walker.

Employees who don’t attain a bonus receive a certificate for participating. Meanwhile, Walker continually tries to boost enrollment. "People who smoke, who are under a lot of stress, who have health problems, who are overweight, think, I would never be able to do that [meet the criteria],’" she says. "But we’re chipping away at it. Every year, we see a few more people."

The program can have an impact on employees’ lives. At Providence Everett, Burt recalls a nurse who told him that before she began participating in the Wellness Challenge, she never wore a safety belt when she drove. But because safety belt use is one of the program’s wellness criteria, the nurse started wearing her safety belt more often.

Now, she’s glad she made the change, and not just because she wants the bonus. "She was in a head-on collision and would have died if she hadn’t been wearing her seat belt," Burt says.

[Editor’s note: Providence Everett Medical Center licenses the use of the Wellness Challenge program and provides materials, training, and consulting services. For more information, contact Ron Burt at (425) 258-7881.]