Employers making investments in wellness

Experts say return on investment is plentiful but takes time to be seen.

Wellness programs are becoming increasingly popular among employers, but experts say it remains difficult to measure the return on investment for such offerings.

In 2012, half of all employers with at least 50 employees offered a wellness program, and nearly half of employers without a program said they plan to introduce one, according to RAND Health and its 2013 Workplace Wellness Programs Study.

“Everybody is dipping their toes into this,” said Dr. Derek van Amerongen, market medical officer for Humana in Ohio and chief wellness officer for HumanaVitality, a rewards-based wellness program.

The HumanaVitality program, opened to outside employers in 2012, now has 180,000 members in Ohio — and 3.7 million participants across the U.S.

There are two types of wellness programs — lifestyle management and disease management, according to RAND Health, a California-based nonprofit research institution.

Lifestyle management focuses on employees with health risks, such as smoking and poor eating habits. Disease management focuses on those already with chronic conditions and avoiding further complications, according to RAND Health.

“If an employer wants to improve employee health or productivity, an evidence-based lifestyle management program can achieve this goal,” according to RAND Health. “But employers who are seeking a healthy ROI on their programs should target employees who already have chronic diseases.”

The Metalworking Group, a metal manufacturer in Fairfield and Colerain Twp., is completing its third year using the HumanaVitality wellness program, said Doug Watts, the company’s vice president and chief financial officer.

The privately-held company of about 190 employees moved to self-funded insurance a few years ago after the cost of health insurance kept rising every year. After payroll and metal, health care is the company’s third-largest expense at about $800,000 a year.

“We got into that mode of go to the market every year (for insurance), and the prices just go up,” Watts said. “Before, I felt like I had no control. Now, I feel like we’re totally in control.”

Watts said the company has a 90 percent participation rate in the program. He said at least three cases of undiagnosed diabetes have been caught.

“If it goes untreated, (diabetes) becomes very expensive and an enormous health problem,” Watts said.

Watts said in the first two years offering HumanaVitality, there was actually an increase in insurance claims. However, a drop in claims was recorded this year. Still, Watts said it will take at least five years of data to determine if it’s becoming a trend.

“When you do these things you don’t get immediate payback,” Watts said. “You’re trying to steer the ship, and it doesn’t turn on a dime.”

Watts said in order to make wellness a permanent part of the company’s culture, they’ve moved from serving pizza, fried chicken and soda at events to healthier options like salad, shaved beef and bottled water.

The Metalworking Group also installed a juice bar last year and has an active “juice club” that pays $10 every two weeks for a freshly-made juice every morning.

“You want a healthy workforce; you want them to show up and be on time,” Watts said. “The more they’re here, the more they’re productive.”

Jeff Blunt, spokesman for Humana, said participants begin HumanaVitality by completing an online self-assessment and getting a biometric screening to collect weight, blood pressure, cholesterol and other data points.

“It creates a baseline for measurable improvements and a personalized path to health,” Blunt said.

Blunt said as the consumer takes steps toward improving their health, they earn “vitality bucks” that can be used to purchase music, electronics, apparel, travel discounts and exercise equipment, among items. The consumer can also earn points for donating blood, doing community service or taking a CPR class.

In the last three to four years, Humana’s van Amerongen said there’s been a shift in employers’ responses to wellness programs. He said five years ago employers didn’t welcome conversations about wellness, but now the majority of employers offer it in some form.

Insurer Anthem Blue Cross and Blue Shield, based in Mason, offers a plethora of customizable health and wellness resources, including participation- or outcomes-based programs, said Marcus Taylor, Anthem’s regional vice president of sales.

For its own 40,000 associates across America, Anthem offers up to $700 in credits for things like being a non-smoker, getting a flu shot and finding out your cholesterol and blood pressure levels.

Carolyn Jacob, wellness coordinator at Anthem, said she makes site visits to employers to collect and study aggregate data and help them tailor a wellness program to their needs.

Jacob said the top chronic conditions are usually obesity, high blood pressure, coronary artery disease, stress and depression and muscular skeletal issues.

The Lakota Local School District has offered a wellness program to its employees for at least five years, said Chris Burkhardt, wellness coordinator and child nutrition director for the district.

Lakota’s current wellness program, through Anthem, includes outreach to 1,900 employees, its student population and the greater community.

Lakota’s wellness program for employees — with a $25,000 annual budget — includes on-site flu shots; biometric screenings with a customized report on areas of success and improvement; wellness coaches available from Anthem; Biggest Loser contests; and a five-week pedometer challenge culminating with the local Shamrock Shuffle race.

“We’re not taking them from couch to 5K in five weeks … but to build habits that are successful,” Burkhardt said.

The school district during the holiday season, starting after Thanksgiving, also places fruit and vegetable baskets inside all employee break rooms to encourage staff to take the “5 a Day Challenge” rather than reach for cookies and cake.

Robin Rathnow, a cafeteria manager at Ridge Jr. School in Lakota, said she’s lost over 50 pounds since increasing physical activity and eating healthier with the help of the wellness program. She also gets a yearly flu shot and biometric screening.

“It’s a heads up with my numbers before seeing my doctor,” Rathnow said of the biometric screening.

Rathnow is one of three cafeteria managers in the district to have lost a combined 140 pounds. She said group activities, such as the pedometer challenge, help to create a support network.

Burkhardt said Lakota’s aggregate biometric data for the last two years has shown some improvement in employee health.

But Jacob said it can take three to five years before a monetary return on investment is seen. However, less tangible items such as employee productivity and reduced absenteeism are also forms of ROI.

“Most employers have seen a tremendous benefit from their wellness programs,” said Dr. Rick Lofgren, president and CEO of UC Health, at a health care summit last week in Sharonville. “Not because they’ve seen a reduction in their premiums, but what they’ve seen is an increase in productivity, a reduction in lost days. … And I really think that’s the immediate benefit.”

Stuart Slutzky, chief of product innovation for HumanaVitality, said he studies the science of behavioral economics and what motivates humans to make decisions. He said often Americans discount the impact of their choices today on their long-term health, a term called hyperbolic discounting.

“The payoff is down the road and significant, but people don’t understand that,” Slutzky said. “People tend to be overly optimistic … and believe they have enough time to improve.”

Slutzky said it usually takes a major health event, such as a heart attack, in the person’s life or someone close to them for the individual to start making healthy choices.

In the past year, Hamilton-based nonprofit Community First Solutions introduced a new wellness program of its own design called the CORE Plan. There’s about 80 percent participation rate, said Emily Glaser, spokeswoman for Community First.

The CORE Plan includes an initial health screening each year, and requires individuals complete a certain number of activities such as dentist and doctor appointments. The plan also incorporates fitness classes, social opportunities such as a trivia night or sand volleyball team, art events and financial advice classes, Glaser said.

Jim Davis, human resources director for Butler County, said the county is currently transitioning from an activities-based wellness program to an outcomes-based program.

Davis said the county’s current activities-based program includes health fairs, on-site health screenings, educational resources, Biggest Loser contests and on-site fitness classes for a nominal fee.

Starting in January, the new wellness program from vendor StayWell will include a $100 incentive for employees that complete an online health risk assessment and get a health screening, Davis said.

The county is further incentivizing its 1,350 employees by offering a higher employer contribution toward monthly premiums for those participating.

“There are two sides to one coin on this, to improve employee health and lower claims dollars,” Davis said. “It’s somewhat of a leap of faith. The message is you can improve your health and we can help.”