Wellness in the workplace
Companies offer programs and rewards to boost employee health

by Lisa Antonelli Bacon
for Virginia Business
October 2006

At a fictional company in a fictional city, Buff Trim gets a break on health insurance. Fat Slacker, on the other hand, pays more for the same coverage. Sound like discrimination? Companies prefer to look at such price breaks as incentives, and nowadays more employers are rewarding health-conscious employees.

Call it the second wave of the wellness revolution. After years of wrangling with health insurance carriers over rising premiums, employers are shifting their strategy. They’re offering financial incentives to employees in a bid to encourage healthy lifestyles. For instance at BB&T, the nation’s ninth-largest financial holding company, employees can save as much as 20 percent on health insurance costs by meeting certain goals in the company’s wellness program. Meanwhile, Virginia-based Sentara Healthcare employees are eligible for drawings for gift certificates and cash when they participate in an online health risk assessment.

It’s no secret that unhealthy workers drive up health-care costs through absenteeism and frequent use of medical services. And there’s no escaping the fact that, as baby boomers age, the need for services is increasing. So rather than face continuing double-digit increases in health-care costs, experts are pointing to a new solution: employee accountability. “We can hold the line on costs if people do their part to stay healthy,” says Doug Gray, executive director of the Virginia Association of Health Plans, which represents managed-care providers covering nearly 4 million people.

If employee buy-in is the key to keeping down costs, it can’t happen soon enough in Virginia. According to the Centers for Disease Control and Prevention, 58 percent of all Virginians are overweight or obese, 23 percent do not exercise on a regular basis, and an estimated 25 percent smoke or use other tobacco products. Between 1993 and 2003, according to a federal study, Virginians got fatter faster than any other state, as the number of obese residents rose 10 percent.

Traditionally, only a small percentage of people have taken advantage of corporate wellness programs. Yet as employees shoulder more of the financial burden of their health care, they’re more inspired to cut costs. Plus, as wellness programs develop more teeth, the philosophy seems to be: Take responsibility for your health or pay up.

“ Companies don’t have any choice but to do this,” say Dr. Dee Eddington, director of the Health Management Research Center at the University of Michigan. “We have to move people from the concept of entitlement to being real consumers of health.” During a recent presentation to the Virginia Business Coalition on Health, Eddington laid out a strong business case for promoting employee wellness. Namely, a healthy employee is a happy, productive employee. When employees take care of themselves, it can translate into long-term health-care savings for employers.

Corporate wellness programs aren’t new. BB&T jumped on the wellness wagon 20 years ago. What began with two nurses in Wilson, N.C., (the bank’s original hometown) has expanded into a full-fledged, incentive-motivated plan that covers 73 percent of the company’s 26,000 eligible employees. “There are two reasons we have it,” says BB&T spokesperson A.C. McGraw. “To help employees improve their health and to help both parties control health-care costs.”

Employees are not required to get coverage through BB&T, but those who do are required to participate in the company’s LifeForce program. LifeForce provides health-care professionals who work with employees to tailor individual health development and maintenance programs. After a well-rounded screening that includes body fat evaluation, blood tests and cardiovascular assessment, employees who meet certain age/gender health levels are rewarded with reduced health insurance premiums.

Meeting certain requirements shaves 20 percent off a participant’s health insurance costs. Even if an employee fails to advance to the next healthy phase, the discount remains in effect as long as the worker continues to set and work toward goals. “The program is a great incentive to maintain a healthy lifestyle,” says Dan Donlan, associate analyst at BB&T Capital Markets in Richmond. “It lowers my monthly health insurance payments and saves BB&T money as well. Everybody wins.”

Donlan, 25, says he exercises twice a week, eats a healthy diet and gets plenty of rest. After meeting with BB&T’s LifeForce representative twice this year, he has improved his heart rate, blood pressure and cholesterol levels enough to move into phase three of the program.

Administering the program costs BB&T about half of what it once lost in absenteeism and over-the-top health-care costs. “Compared with peers in the industry, our total health-care cost now is 12 to 13 percent lower per employee,” says McGraw.

Other corporations are beginning to fall in line, filling their insurance packages with health information, seminars, on-site clinical screenings and detailed health assessments. Some include group or one-on-one help with smoking cessation, overeating and exercise programs. Others offer rewards such as gift certificates for going to the gym or the doctor. “The message is we want you to participate in your own health,” says Eddington, “and we want you to do it so badly that we’re going to get the right things to you — appraisals, triage to health programs, etc. — and we’re going to lower your premium.”

While most programs are voluntary, this new generation of corporate wellness programs builds in accountability through checks and balances. They ensure that employees continue to hold up their end of the bargain through a series of measures. For example, progress can be measured by checking employees at regular intervals for such things as cholesterol, body mass index, weight loss or smoking cessation.

In Virginia, the state’s CommonHealth program for state workers has been around for 20 years. Yet even with this longstanding wellness effort, about two-thirds of the state’s 100,000 employees last year were obese or overweight. In the past six years, health-care costs for state employees have increased more than 60 percent. In July, Gov. Timothy M. Kaine renewed the state’s effort by kicking off the latest phase of the state’s Healthy Virginians program. It pushes health maintenance and disease prevention with new incentives, such as discounts at fitness clubs. There are even prizes. When employees take assessments for the state’s weight-loss program, their names are entered into drawings for $250 gift cards. If they take both the pre- and post-assessment, the sweetener goes up to drawings for $1,000 gift cards. To keep people inspired during the program, there are weekly drawings for Apple Nano Ipods.

While experts say it’s too early to determine the success of the new wellness programs, there appears to be growing public support for the idea of tying costs to personal responsibility when it comes to health. A Harris Interactive online survey of 2,325 U.S. adults, conducted between July 11-13 2006 for the Wall Street Journal Online’s Health Industry Edition, showed that 53 percent of the adults say it is fair for people with unhealthy lifestyles to pay higher premiums, compared to 37 percent in 2003.