All About Wellness Plans

Preventing injuries is a high priority for employers, especially in factory settings such as Honda. That’s why the employer offers several initiatives—including line-site process evaluations —to identify potential hazards and help reduce the chance of injury. As part of an early intervention program, Honda workers who are feeling pain can receive a massage of the affected area during work time.

Stretching initiatives are another effective tool in injury prevention. According to the Best Practices in Manufacturing Web site, Dayton Parts, Inc. (DPI) in Harrisburg, Pa., conducted research that revealed approximately 80% of all manufacturing injuries occurred within the first two hours of each shift. After implementing a program that required production workers to stretch for 10 to 15 minutes at the beginning of their shifts, they saw a dramatic reduction in injuries.

While the DPI Workplace Wellness Plan costs about $75,000 a year to operate, in conjunction with other employer initiatives, it has helped bring the annual cost of workers’ compensation from $700,000 to $200,000 per year.6

To help prevent lengthy absences and reduce workers’ compensation claims, Honda instituted a work recovery program. Through the program, workers who have had an injury can work in a modified job—getting better. Employees in the program spend their work days receiving physical conditioning to increase overall fitness, physical therapy to restore functionality, health education and nutrition counseling. The program is based on information that shows fewer work days are lost when an worker stays connected to the work environment.

The Ohio Bureau of Workers’ Compensation, www.ohiobwc.com, provides a “10-Step Business Plan” as a guide for employers in providing Employee Wellness Programs that aim to reduce injuries. The plan includes information on safety and health initiatives to prevent occurrences of on-the-job accidents, including:

worker involvement – To ensure the success of any Employee Wellness Program, workers must take part in the safety and health-management process. This can be done through safety and health audits, accident investigations, or by forming safety and health involvement teams, focus groups or committees.

Orientation and training plan – Conduct orientation and training sessions to educate workers on the employer’s safety policies. These sessions should include procedures for the safe use of machinery and tools, chemical hazards and how to prevent contact or exposure, specific job/task safe practices, and hazard recognition and prevention.

Communication – Open communication keeps workers informed and provides suggestions and feedback on the effectiveness of the Employee Wellness Program. Through memos, bulletin boards and staff meetings, important safety and health information can be conveyed throughout the organization, keeping all management staff and workers knowledgeable about the employer’s safe practices.

The employer plan also outlines incentives for post-injury procedures, including:

Medical treatment and return-to-work practices – arly return-to-work strategies help injured or ill workers return to work in a timely manner. Companies should start a disability management policy to help injured or ill workers obtain quality medical treatment, making their transition back to work quick and effortless.

Timely notification of claims – Employers should document worksite injuries immediately after they occur and promptly send that documentation to a claims handler. Quickly providing claim information demonstrates care and concern for the injured worker, prevents delays and confusion with the claim process, and reduces the potential for abuse or needless litigation.

Record keeping – Internal documents should be kept to record work-time injuries and to assess the success of the employer’s safety efforts. Company audits, surveys and injury or illness reports can all be used to analyze which safety practices and policies have proven successful, and what areas of health and wellness need improvement.

Dr. Moore of Nationwide maintains that immunization is the most cost-effective treatment in medicine. By way of example, vaccinating children against the influenza virus averages a savings (including medical costs, parents’ missed work, etc.) of up to $35 per vaccine recipient. And experts predict that estimate is low, because it doesn’t take into account the rapid spread of the flu.

The American Association of Family Physicians’ Web site, www.aafp.org, offers a recommended adult immunization schedule created by the Advisory Committee on Immunization Practices. This schedule, tiered by age and chances of exposure, recommends diphtheria, tetanus, influenza, pneumonococcal, hepatitis B, hepatitis C, measles, mumps and rubella, varicella and meningococcal vaccinations.

Ideas to incorporate prevention and early detection:

• Hold a wellness fair and invite organizations that provide screening services for such conditions as blood pressure, blood iron, cholesterol, body mass index (BMI) and diabetes.
• Provide educational materials about well-baby care and vaccinations.
• Choose medical coverage plans that include wellness check-ups and vaccinations.
• Provide onsite mammograms for workers.
• Sponsor onsite flu vaccinations to coincide with flu season.

Benefits of Stress Reduction Programs

While stress cannot be eliminated from life, or even from the worksite, coping skills can be developed with relative ease. Stress management skills lead to decreased rates of absence and more effective, more productive workers. Because stress has been shown to contribute to such physical conditions as ulcers, high blood pressure and stroke, stress reduction has a direct impact on improving physical health.

Studies have shown that heart patients who attend stress management initiatives have 42% lower medical costs. Other studies have documented a 50% reduction in medical services use when stress management initiatives are employed. Further, Employee Assistance Program (EAP) experts estimate that 20% of any workforce is affected by personal problems that can influence work performance.

Stress reduction tactics to consider:

• Provide onsite yoga or meditation classes.
• Organize support groups among workers.
• Sponsor stress management classes during the workday.
• Provide an employee assistance program that includes both counseling and referral.
• Provide onsite counseling for workers in the case of a work-related trauma, such as the death of a co-worker.

Benefits of Prenatal Care and Breastfeeding

The old adage “an ounce of prevention is worth a pound of cure” is particularly relevant to when applied to preventive measures taken during pregnancy, when a few extra ounces of birth weight can save a child’s life. During pregnancy, simple precautions can help avoid catastrophic results; giving up smoking, for instance, drastically reduces the risk of miscarriage and pre-term labor.

The March of Dimes reports that if all women took adequate folic acid before conception and during pregnancy, the number of babies born with a neural tube defect could drop by as much as 70%. The physical and emotional benefits of proper prenatal care to a mother and child are underscored by a strong employer case for offering prenatal wellness benefits. Nationwide’s Chief Medical Director, Dr. Michael Moore, estimates costs to care for one baby delivered prematurely could approach $500,000.

First steps in fostering a prenatal program:
• Invite the March of Dimes to present information about prenatal health at an worker brownbag lunch or breakfast meeting.
• Hold prenatal care information classes for interested workers at lunchtime.
• Provide educational materials about the effects of alcohol, drugs and smoking on an unborn child.
• Provide incentives for adopting healthy lifestyles during pregnancy.
• Provide prenatal initiatives and education as part of the employer medical package.

Benefits of smoking Cessation Programs

Instances of respiratory diseases, cancer and other illnesses can be decreased through smoking cessation efforts. smoking cessation initiatives can provide huge opportunities for enhanced health.

The American Cancer Society reports that smoking workers cost employers an average of $1,429 per smoker per year in increased medical costs over non-smoking workers. Implementing a smoking cessation program costs an average of $45 per worker per year, saving employers an average of $1,383 per year for each worker who quits smoking. Additionally, the American Cancer Society reports that smokers are absent from work 50% more often than nonsmokers. They are also 50% more likely to be hospitalized and have 15% higher disability rates. smoking decreases onthe- job productivity as well. Employees who take four 10- minute smoking breaks a day work more than a month less per year than workers who don’t take smoke breaks.

Places to start with smoking cessation initiatives:

1.    Create a employer policy prohibiting tobacco use anywhere on the property.
2.    Provide prompts/posters to support no tobacco use policy.
3.    Policy supporting participation in smoking cessation activities during duty time (flex-time).
4.    Provide counseling through an individual, group, or telephone counseling program onsite.
5.    Provide counseling through a healthcare plan sponsored individual, group, or telephone counseling program.
6.    Provide cessation medications through medical insurance.

Benefits of Nutrition Programs

Nutrition directly impacts nearly every aspect of physical and mental health. A healthy diet can help protect against such conditions as heart disease, diabetes, arthritis, stroke, certain cancers and depression. Obesity, which is among the most common conditions linked to diet, affects a record number of Americans.

The American Journal of Health Promotion estimates the cost of obesity to United States employer to exceed $12.5 billion in health care, sick leave, and life and disability insurance. Further, one study reports that obesity raises medical costs by 36% and medication costs by 77%. To offset the health risks of obesity and poor diet, many employers have committed to helping workers ensure proper nutrition and undertake weight control initiatives.

Popular nutrition initiatives:

Fruit and Vegetable Consumption
1.    Provide healthy eating reminders and prompts to workers via multiple means (i.e. e-mail, posters, payroll stuffers, etc.).
2.    Provide appealing, low-cost fruits and vegetables in vending machines and in the cafeteria.
3.    Provide cookbooks, food preparation, and cooking classes for workers’ families.
4.    Ensure onsite cafeterias follow healthy cooking practices and set nutritional standards for foods served that align with the United States Dietary Guidelines for Americans.
5.    Provide healthy foods at meetings, conferences, and catered events.
6.    Use point-of-decision prompts as a marketing technique to promote healthier choices.
7.    Provide healthy cooking demonstrations that teach skills (i.e. fruit and vegetable selection and preparation).
8.    Provide taste-testing opportunities at the worksite.
9.    Provide worker-led campaigns, demonstrations or programs.
10.    Provide local fruits and vegetables at the worksite (i.e. worksite farmer’s market or community-supported agriculture drop-off point).
11.    Use competitive pricing (price non-nutritious foods in vending machines and cafeterias at higher prices).
12.    Provide protected time and dedicated space away from the work area for breaks and lunch.
13.    Make kitchen equipment available to workers.
14.    Provide an opportunity for onsite gardening if possible.

Sweetened Beverage Consumption
1.    Make water available throughout the day.
2.    Provide appealing, low-cost healthful drink options in vending machines and the cafeteria.
3.    Modify worksite vending contracts to increase the number of healthy options.

4.    Price non-nutritious beverages at a higher cost.
5.    Use point-of-decision prompts to promote healthier choices.

Portion Control
1.    Label foods to show serving size and/or nutritional content.
2.    Provide food models, food scales for weighing and pictures to help workers assess portion size.
3.    Provide appropriate portion sizes at meetings, worksite events and in the cafeteria.

Nutrition initiatives in action

While many employers address weight management through fitness initiatives, employers are increasingly focusing on nutrition through separate programming. Recognizing the productivity boost and lowered medical expenditures that come with maintaining a healthy weight, many employers may help pay for obesity treatments for workers. By way of example, to enhance the health of dangerously obese workers, drug maker Wyeth reportedly pays for stomach-shrinking surgeries that carry price tags of up to $40,000.

A 2003 Society of Human Resource Management study shows that 24% of employers offer weight loss initiatives. In Ohio, Honda offers an onsite, registered dietitian who provides individual or group consultations on weight management. Body fat analysis and body mass index (BMI) measurements are available to workers at any time.

At Grange Insurance’s Columbus headquarters, the cafeteria chef analyzes meals and provides workers basic nutrition information, including Weight Watchers points. Many employers partner with the American Cancer Society to offer nutrition information through the ”5-ADay” program, which provides employers free signage and educational materials about the importance of eating five servings of fruits and vegetables a day. The program also offers a fruit and vegetable ”frequency card” that gives workers a free portion of fruit or vegetables after he or she has purchased a preset number.

Benefits of Exercise Initiatives

Exercise reduces weight, lowers risks of heart attack and stroke, helps to control blood pressure and diabetes, and improves mood. Studies increasingly show that exercise may also help reduce the occurrence of certain types of cancer. Researchers at the Centers for Disease Control and Prevention (CDC) recently documented another major advantage: exercise improves the health of the nation’s medical care expenditures.3 According to the CDC, physically active individuals incur $865 less per year in medical costs than inactive employees.

Dr. Michael Moore, vice president and chief medical director at Nationwide Insurance in Columbus, maintains that exercise is the most effective tool in health maintenance. “If you could prescribe exercise in a pill, it would be the number-one prescribed treatment in the world,” he said. In step with Dr. Moore’s prescription, nearly one-third of United States employeres help workers pay for gym memberships, according to an Associated Press report. Subsidizing gym memberships is just one way employers promote active lifestyles.

Popular Exercise Initiatives:

1.    Allow access to on- and off- worksite gyms and recreational activities before, during, and after work hours.
2.    Provide and promote participation in after work recreation or leagues.
3.    Provide cash incentives or decreased insurance costs for participation in physical activity and/or weight management or maintenance activities.
4.    Provide shower and/or changing facilities onsite.
5.    Provide outdoor exercise areas such as fields and trails for worker use.
6.    Provide bicycle racks in safe, convenient, and accessible locations.
7.    Provide onsite fitness opportunities, such as group classes or personal training.
8.    Provide an onsite exercise facility.
9.    Set up initiatives that have strong social support systems and incentives, such as:
• Buddy or team physical activity goals
• Initiatives that involve workers and family
• Initiatives to promote physical activity, such as pedometer walking challenges
• Explore discounted or subsidized memberships at local health clubs, recreation centers, or YMCAs
10.     Provide flexible work hours to allow for physical activity during the day.
11.    Support physical activity breaks during the workday, such as stretching or walking.
12.    Host walk-and-talk meetings.
13. Map out onsite trails or nearby walking routes and destinations.
14. Have workers map out their own biking or walking route to and from work.
15. Post motivational signs at elevators and escalators to promote stair usage.
16. Provide exercise/physical fitness messages and information to workers.
17. Provide or support recreation leagues and other physical activity events onsite or in the community.
18. Start worker activity clubs such as walking or bicycling clubs.
19. Provide onsite child care facilities to facilitate physical activity.
20. Sponsor a bike to work day and reward workers who participate.
21. Set up a box and solicit fitness and health tips.

Wellness programming means different things to different employers. Effective wellness initiatives can be as simple as bringing bushel baskets of fresh fruit into break rooms to encourage better eating. They can be as extensive as building fitness facilities onsite or paying for obesity treatments.

A driving factor behind the push toward wellness spans employers of all types, sizes and cultures: that is, medical expenses are spilling over the business belt buckle. The annual cost of medical services in the U.S. is rising at seven times the rate of inflation. And the rise in medical costs is one boom pundits expect our economy to sustain.1

This trend makes it increasingly challenging for employers to maintain current levels of insurance coverage. In 2003, medical inflation forced 65% of employers to increase workers’ share of health costs.

Seventy-nine% of large firms said they will increase workers’ share of health costs in 2004.2 But with lost benefits and increased financial burdens come lost morale and productivity.

Employers are searching for another way. While employers cannot control many of the supply-side elements contributing to rising medical costs—malpractice insurance rates, the nursing shortage—they can help curb demand. That’s why efforts are being redirected from illness to wellness.

The case for Employee Wellness Programs is supported by an ever growing body of evidence demonstrating the high costs associated with controllable health risks:

• One study reports that obesity raises medical costs by 36% and medication costs by 77%.
• Michigan officials estimate physical inactivity cost the state nearly $8.9 billion in 2002, a cost estimated to be largely borne by employers through insurance premiums and lost productivity.
• The not-for-profit National Committee for Quality Assurance reports that the estimated average cost for postnatal care for women who did not receive prenatal care was $2,341 more than for women who had. And the indirect costs of unhealthful behavior can be just as high.

Information shows that healthier workers are more productive, spending more time at work and showing increased “presenteeism,” or productivity, while there. Further, healthier workers use fewer medical services. The five leading causes of death in the U.S. — heart disease, cancer, stroke, chronic obstructive pulmonary disease and diabetes —  are directly linked to unhealthy lifestyles. Clearly, encouraging healthful habits presents an opportunity to enhance workers’ well being, reduce the need for medical services and help control costs.

Offering worker wellness benefits — large or small — represents an intersection between business social responsibility and responsibility to stakeholders. Between worker health and corporate health. It’s often the right thing to do for workers and employers.

Research by Traveler’s Corp. shows a $3.40 return for every dollar invested in Employee Wellness Programs. For many employers, the choice to offer worker wellness benefits is easy—one where conscience and pragmatism align.

The challenge arises in selecting the initiatives that will deliver the most impact based on trends in your workers’ health risks and medical claims costs. From large employers to the corner deli, employer owners welcome ways to boost productivity, reduce rates of absence and cut costs. Likewise, Employee Wellness Programs can range from modest to elaborate.

In deciding where to focus a employer’s limited resources, looking at costs, benefits and best practices is a good starting point. This section profiles six aspects of wellness and explores their benefits to workers and employers.

When it comes to working wellness into your workforce, you want someone who knows the ins and outs of health promotion, and who can counsel workers and provide primary care – all within the context of the current regulatory and legal environment.

AAOHN’s survey reported that more than half of workers (61%) want to receive health and wellness information from a medical professional, such as a consultant or an on-site occupational health nurse (OHN), compared to pamphlets or brochures (18%) or human resources staff (15%).

OHNs can develop, start and evaluate components of work site Employee Wellness Programs such as screening initiatives, exercise/fitness courses, Stress management, smoking cessation, nutrition and weight control initiatives, and chronic illness management initiatives. Plus, OHNs can help workers navigate through complicated health plans and may even serve as a triage point between workers and their personal medical providers.

Employees might refrain from seeing their medical provider when it means time away from work, inconvenient parking, waiting time in the office and co-pays. In situations where workers are under treatment for chronic diseases like heart disease, on-site nurses can routinely monitor risk factors such as blood pressure or cholesterol on a regular basis.

It’s often easier for an worker to ask an on-site nurse for information about symptoms or prescription medication than it is to schedule a follow-up visit to a personal medical provider. Benefits realized by employers include enhanced worker morale and retention, a recruitment advantage, increased productivity and decreased time away from work.

In employers with a safety department, the OHN can evaluate and address work-related health issues, including participation in workstation evaluations to correct potential ergonomic problems, and proactively addressing muscle strains by developing stretching initiatives and involving workers in leading stretches.

Good for waistlines & your bottom line

By Sandra Simpson, APRN, BC, COHN-S, manager in Occupational Health Services at a Fortune 500 employer in Memphis, Tenn., and a member of the board of directors of the American Association of Occupational Health Nurses (AAOHN). For a copy of the AAOHN wellness survey, visit www.aaohn.org, or call (800) 241-8014, x0.

In today’s hectic world, most of us are spending more time at work, and have increasingly less time to look after our health. For a long time, employers have understood the benefits associated with keeping workers well – increased productivity from decreased rates of absence and lowered disability claims. For these reasons, coupled with the fact that many employers realized double-digit medical costs last year, employers should consider Employee Wellness Programs as a way to keep workers healthy.

But just how important are these initiatives to workers? How often are they willing to take part in initiatives designed to positively impact their health and wellness? Who do workers trust to provide them with important information about their health?

Answers to these questions and more were recently garnered from a study commissioned by the American Association of Occupational Health Nurses Inc. (AAOHN).

The AAOHN survey questioned 500 workers nationwide about their perceptions of Employee Wellness Programs. More than three-quarters of all members indicated these initiatives are a good way to enhance their overall health, and nearly 60% consider these offerings an incentive to remain with their current employer. worker retention and turnover impact the bottom line, so building Employee Wellness Programs into the work site culture is a valuable way to help retain talented workers in addition to enhancing personal health and worksite productivity.

Health wish list

Employees appear to have their own agenda when it comes to their health. With new pressures resulting from an unstable economy, national security threats and work/balance issues, it’s not surprising that 85% of survey respondents cited Stress management as a priority topic for work site wellness.

In addition to stress, other preferred topic areas include screening initiatives (84%), exercise/physical fitness initiatives (84%), medical insurance education (81%) and disease management seminars (80%).

In addition to lifestyle and personal health issues, those asked expressed concern about work-related health issues, including strains and injuries resulting from lifting or task-oriented muscle repetition, exposure to harmful substances, personal injury, vision changes due to computer work and worksite violence.

What you should do

With such a broad range of health concerns, a primary goal for employers is finding a way to proactively address the health needs of the largest number of workers, and effectively change unhealthy behaviors, promote wellness and ward off disease and illness.

Printed materials such as brochures, posters, fliers or pamphlets present an easy solution. But it’s important to remember that different employees require different formats for learning. A good rule of thumb: provide information in a variety of learning formats such as videos, pamphlets, health-related quizzes, display boards, Lunch & Learn presentations and reimbursement or incentive programs.

This assumes you’ve overcome the first hurdle – getting employees to sign on to a Employee Wellness Program. While survey respondents indicated health and Employee Wellness Programs are important, just six out of 10 (60%) reported that they participated in the Employee Wellness Programs at their employers. The other 40% cited lack of interest and lack of time as deterrents.

This points to the need for a comprehensive, structured Workplace Wellness Plan using a innovative approach, with an incentive for participation and effective program marketing.

By investing in an organized Workplace Wellness Plan headed by a qualified medical professional such as an on-site nurse, employers can give workers the access to the health information they want, and increase participation and generate interest at the same time.

The result: workers become savvier medical consumers who feel more in charge of their personal health. And healthier workers make for a healthier bottom line.