Wellness program nets healthy savings

Comprehensive approach proves successful

A combination of traditional wellness activities, demand management, and incentives has yielded estimated savings of more than $1.2 million in employee health care costs at Anderson (SC) Area Medical Center, says Pat Collins, director of health promotion at the 2,600-employee facility.

All employees are offered a variety of activities, programs, and screenings. The employee health service is part of the health promotion department, providing the opportunity for workers to complete health risk appraisals and receive information on healthy lifestyle factors when they report for annual screenings.

Along with immunizations and tuberculosis skin testing, employees are weighed and their cholesterol, blood pressure, and glucose levels checked. Workers are offered health risk appraisals. An annual health fair features additional opportunities to be screened and to learn about physical and emotional wellness.

Throughout the year, employees can participate in prenatal education classes, weight management programs, stop-smoking courses, low-cost massage therapy, in-house aerobics, discounted community fitness club memberships, body fat analysis, stress management seminars, a walking club, cardiovascular fitness and cancer screenings, cholesterol and diabetes education programs, self-defense classes, dancing classes, and outdoor activities such as hiking and white-water rafting. Most activities are available free or for a minimal charge.

Program takes the gold

The wellness program was launched in 1992, and in 1995 won a Gold designation from the Omaha, NE-based Wellness Councils of America — the organization’s highest award — for an effective workplace wellness program.

Healthy Horizons is an incentive-based wellness program offered to employees. Currently, 400 employees are earning "activity points" that can be redeemed for prizes such as water bottles, coolers, t-shirts and sweatshirts, golf caps, and sports bags. Points are awarded for specific health goals, including being within an ideal weight range, cholesterol level below 200, onsmoking, up-to-date cancer checkups, participation in wellness events or outside fitness events, and various forms of exercise.

"We have a new program beginning called the Healthy Horizons Wellness Challenge, which challenges employees to meet eight of 10 set criteria [similar to the above]. If they meet eight criteria, they get a $200 cash bonus. If they meet four, they will get a $100 cash bonus," Collins says.

The health promotion program also utilizes a demand management component to reduce employee health care costs by teaching self-care. (See related story in Hospital Employee Health, February 1997, pp. 13-18.) Employees receive the 330-page HealthWise Handbook (Boise, ID: HealthWise; 1993) at no charge, accompanied by a 30-minute instructional seminar. The book educates consumers about when it is appropriate to seek medical care from physicians and emergency rooms, and when and how certain problems can be handled at home.

"At that time we tell them about the concept of self-care, we give them the book, and we show them how to use it. We also give them pointers on how to become better health care partners with their physicians. The main reason we’re doing it, bottom line, is we’re self-insured, and if we can keep them out of the emergency rooms when they don’t need emergency care and can keep them from going to physicians when they don’t need to, we’re saving money," Collins explains.

She reports a 5% reduction in emergency room visits and fewer nonemergency cases seeking care there since 1995, when the self-care program began. Primary care physician visits decreased from 37% of employees who visited once in a nine-month period in 1995-1996 to 32% in a nine month period in 1996-1997.

Employees were surveyed earlier this year to evaluate the program. They were asked two questions:

• Do you feel the program has helped manage your health problems at home?

• Do you feel the program has improved communication with your health professionals?

Of the 508 respondents, 82% said yes to the first question, and 57% responded affirmatively to the second one.

Collins also measured decreases in employee blood pressure, weight, cholesterol, and smoking from 1992, when the wellness program began, to 1996. Using national estimates of the amount such health risk factors costs employers, she multiplied those figures by the number of employees who reduced or eliminated those health risks to arrive at an estimate of total health care cost savings to the hospital. That figure amounts to more than $1.2 million. (See table and graphs, above and p. 68.) In 1992, for example, 23% of employees had elevated blood pressure, but only 15% did in 1996.

Those savings are due to the comprehensiveness of the wellness program and not to any one factor, Collins notes.

"We’ve tried to do a whole variety of things because we have such a diverse population of employees in the hospital, so we needed to reach them all in different ways. We also built health awareness, making them aware, for example, that their [high] blood pressure is going to kill them if they don’t do something about it," she says. "You have to use a multifaceted approach and relate the message that wellness is achievable in many ways. You don’t have to be a jock jogging down the highway or eat nothing but carrots. That turns people off. You have to show people that even minor changes make a difference. Every little bit helps."

Administrative support is crucial, Collins adds. With a health promotion budget of approximately $100,000, she considers herself fortunate, but says other employee health professionals can provide smaller programs on a shoestring and still make a difference in employee wellness.

"Anything is worthwhile," she says. "Start small. If I were just going to target one activity, I would just get people moving. Get them into aerobics, dance classes, even walking up the stairs. Get them into self-care; that’s where you can show you’re saving money right away."

Healthy, happy employees are a valuable resource, she points out.

"Wellness may not generate monetary revenue, but it generates human resources revenue," Collins adds. "You’re reducing absenteeism and improving employees’ sense of well-being; therefore, they are going to take care of their patients better, which in turn is going to make patients want to come here rather than somewhere else. What better place to invest than in your own people?"