Connecting with Prevention

Not long ago, employers tackled bulging health costs one way—by shifting more costs onto employees.

There is still plenty of cost shifting taking place in employee health insurance, but businesses are turning to health and wellness programs as a way to both reduce healthcare costs and improve employee health. A report released last week is giving employers some pointers as to how to create programs that engage workers. (Hint: there's more to employee engagement than placing health-themed posters on the bulletin board.)

Harvard Medical School's Department of Health Care Policy conducted the review of BlueCross BlueShield Association's Engaging Consumers@Work program, a workplace initiative that includes physical activity, workplace wellness programs, and nutritional behavior. The 10-week pilot split participants into two groups: education and education plus activation. Some of those activation activities included guides and tracking logs, online signup and tracking capability, pedometers, and employer internal worksite competitions.

The report found workplace education and activation programs increased worker participation in wellness programs by at least 21%.

The report's key findings included:

• Education combined with an activation program is more effective than education alone
• Knowledge and awareness of health-related information improved post-intervention
• Employees are more likely to remember in-home communication than worksite materials

What can employers and health plans learn from this report?

• Incorporate activation components into health and wellness programming to drive greater employee engagement. Examples of these kinds of components are healthy eating/weight loss programs, smoking cessation programs, and activity-based stress-reduction programs.
• Expand educational health-related messaging. These kinds of messages can be delivered at a low cost, such as stapling information to employee checks or adding health facts to employee newsletters.
• Internal promotion and communication of worksite programs is critical to increase participation and ensure program success. Employers must continually educate their employees about worksite health programs. This goes beyond placing a poster on the wall. The study found that people remember direct mail messages sent to the home rather than worksite communication.

Helen Darling, president of the National Business Group on Health, a nonprofit organization of employers based in Washington, DC, said employers have moved past strictly looking at cost and benefit design as a way to reduce costs.

"We have seen a sea change about how employers think about health benefits, healthcare, and the health and productivity of their employees and their dependents," said Darling, who spoke at a press conference last week announcing the report.

Employers have a major role in improving employee health. The Henry J. Kaiser Family Foundation Kaiser Health Tracking Poll: Election 2008, released in June, showed that employees view employers as critical components to their healthcare. They expect their employer to be an active participant in looking out for their best health interests. An overwhelming majority of respondents said their employers lessen their burden of finding affordable, high-quality health insurance and help them with administrative duties. Mary Nell Lehnhard, senior vice president in the Office of Policy and Representation at the BlueCross BlueShield Association in Washington, DC, says employers don't have many options when it comes to lowering costs.

"As a big employer, you can change the delivery system, which is impossible, or you can lower the costs of your own employees by keeping them healthy," says Lehnhard. Richard Lueders, director of human resources at DTE Energy, a southeastern-Michigan-based energy provider with 10,000 full-time employees, said at last week's press conference that employers now understand that prevention is the way to go.

"At the end of the day, prevention is far less expensive and far more beneficial to everyone than the cure," said Lueders, adding that keeping employees healthy is a "win-win."

It can be a win-win, but employers must keep a long-range vision. Improving employee health goes beyond an immediate positive return on investment and may take years to see savings. Taking a broader view on healthcare is quite a change for employers, but businesses are finding simply passing more healthcare costs onto employees isn't working. Health management programs could be a solution.