How a holistic approach to health risks plugs leaks in your bottom line

Mention health care costs to many employers and the response is often one of frustration, trepidation, uncertainly or resignation. While the most challenging problem in health care is controlling costs, the factors exacerbating costs seem insurmountable:

Landmark reform amid political uncertainty. While many employers are preparing to implement the Patient Protection and Affordable Care Act, others are keeping an eye on the presidential election in November.
Obesity epidemic. Obese individuals could account for 44% of all American adults by 2030 if obesity rates nationwide continue to grow at their current pace. (Trust for America's Health, "F as in Fat: How Obesity Threatens America's Future 2012")
Aging workforce. The number of workers age 55 and older is expected to pass those who are 25 - 34 by years end (The Atlantic, 2012)
Lower productivity. Employees who exercised only occasionally were 50% more likely to report having lower levels of productivity than employees who were regular exercisers (Health Enhancement Research Organization, 2012)
Continued cost escalation. While this year's annual premium increase of 4% was modest, it still outpaced general inflation (2.3%) and employee's wages (1.7%) and employers expect a 7% increase in plan costs in 2013. Annual premiums for employer-sponsored family health coverage are $15,745 with workers on average paying $4,316 toward the cost of their coverage, according to the not-for profit Kaiser Family Foundation (KFF) and Health Research & Educational Trust (HRET)'s 2012 Employer Health Benefits Survey report.
Lack of control. Escalating prescription drug use, decisions driven by factors other than evidenced-based medicine, federal and state regulations, patients who consider medical care a "freebie" and so on.

To "manage" the costs many employers have simply focused on stopgap cost shifting by increasing employee contributions to premiums and cost sharing with higher deductibles and co-payments. Yet such practices can ultimately have negative implications for attracting and retaining employees and do not address the root causes of the issue. In recent years, wellness programs have been added to corporate health cost containment efforts but many remain medically focused and some have failed to generate a respectable participation rate.

When it is recognized that the same health risks generating high health care costs also impact absenteeism, presenteeism, Workers' Comp and long-term disability, the failure of such a silo approach is obvious. According to the Centers for Disease Control and Prevention, chronic disease treatment costs account for more than 75 percent of national health expenditures. These conditions, such as obesity, heart disease, and diabetes, not only impact employer health care costs but also can lengthen recovery from work-related injury, increase absenteeism and reduce productivity.

To really manage costs, health risks need to be managed in a broad and integrated way, conveying the message that the company is serious about health in every aspect of work, making employees aware of what is available to them, increasing job productivity and long-term health. Successful companies will:

Focus on understanding the workforce to make sure the program is actually going to meet their needs. Health risk assessments and biometric screenings are needed to identify chronic conditions and costly health risk trends among employees. But such assessments should, whenever possible, be combined with an analysis of loss data and costs as well as self-reported behavioral information to better guide programming choices. While this may seem obvious, a surprising number of companies opt for the "hot" targets (such as smoking cessation) or the "coolest" tool without really knowing if it is relevant. The American College of Occupational and Environmental Medicine has launched a campaign to help employers determine the cost of diseases such as diabetes, hypertension and cardiovascular disease. One of those tools is the Blueprint for Health, a free online calculator that estimates health-related expenses.
Identify the barriers to participation. When employees are asked what keeps them from adopting healthy lifestyles, the number one response is a lack of time. Other issues can be lack of perceived benefit, disinterest, boredom, cliques and so on. The program needs to be built to overcome the barriers and stay fresh.
Involve the entire workforce. The over-arching goal of a wellness program should be a tiered approach to the employees, first getting to those with chronic conditions - 'ticking bombs,' so to speak, then those who show signs of developing such conditions and last, those who are healthy. While the dollar amount invested in healthy employees may be significantly less than others, the objective is to keep them healthy and help foster a wellness culture.
Set specific, measurable goals that are realistic and attainable. Motivation is key to continue participation and pie-in-the-sky goals will only discourage employees. There is no one-size-fits-all solution. Incorporating wellness into safety programs can particularly benefit the aging population, who tend to take longer to heal when injured and have comorbid conditions not shared by their younger working peers. A recent survey by Zoe Consulting Inc. found that workers participating in wellness programs reported fewer work-related incidents and the injuries sustained were generally less severe, resulting in less time off and on average, $2,554 less per Workers' Compensation claimant.
Communicate regularly and use a variety of media. Luann Heinen, vice president of the Washington-based National Business Group on Health, notes that some effective approaches to driving participation include subtly incorporating wellness sign-ups into the open-enrollment period or having new hires meet with the group wellness coordinator as part of their orientation. On a more targeted level, employers have begun directing their wellness communications based on the level of interest they see demonstrated among particular segments within their employee population, with the least-motivated or enthusiastic employees receiving the most extensive and focused communications, while the most motivated employees are not targeted quite as aggressively. According to a 2012 Towers Watson/National Business Group on Health survey of employers, successful companies have embraced new technologies, including social media to provide personalized information when needed for primary care visits, send reminders about obtaining preventive procedures and identify potential gaps in care.
Stay focused. Other tools successful companies have use include: actively managing vendor-prepared communication and education, taking a hardline approach to smoking by banning it, supporting flexible scheduling to help alleviate the time pressure many employees experience, using key influencers, employee testimonials and sponsoring workplace activities to motivate employees.

There is a direct connection between safety, wellness and the bottom line. It comes down to believing you can make a difference, a willingness to confront the hard choices and insuring you control your health care reform.