Health Participation incentives are key to a new county wellness initiative
Acros the country , employers are exploring ways to get their workers to take care of their own health as a way of reducing the cost of medical benefits. Now, a relatively new trend of offering employee wellness incentives may be providing a solution.
Research shows that reducing health risks today reduces health care costs in the future. According to the American Journal of Preventive Medicine, employers who invest in worksite health promotion can see a return of $3-$6 for every dollar invested over a 2-5 year period. Some governments are taking an aggressive approach:
In Texas, state government offers its agencies the option of including their employees in Building Healthy Texans, a stateagency employee wellness program that includes wellness liaisons and allows 30 minutes of exercise during work hours three days a week. Employees can also earn eight additional hours of leave time if they complete an annual physical exam and health risk assessment.
Employee incentives are a key feature of a new initiatives for Texas counties that participate in the Texas Association of Counties Health and Employee Benefits Pool. Other features of the new wellness program, called Healthy County, include a 24-hour tollfree nurseline, maternity program, weight management program, worksite walking program and wellness discounts.
County officials and employees from 79 counties attended a February wellness conference in San Antonio sponsored by TAC’s Health and Employee Benefits Pool. To encourage Pool members to participate in Healthy County, the Pool extended an invitation for both a county wellness coordinator and an executive sponsor to attend the conference with all expenses paid by the Pool.
Some Pool-member counties are looking to Healthy County as a resource to take first steps in advocating wellness among employees. But others were already implementing wellness practices among employees and view Healthy County as a method of support to take their wellness initiatives even further.
Ellis County organized a health fair for county employees in September 2008 with the help of Texas A&M’s Texas AgriLife Extension Service. The health fair cost the county $2,500, but now, with the Pool’s new program, the county can earn funds that would directly offset the cost of future health fairs and other wellness spending.
“It’s exciting because there’s another source for income,” said Diana Buckley, Ellis County’s human resources director. The county’s wellness program recently received a $1,000 award from the Society for Human Resource Management. The county also has reduced its workers’ compensation premium since it began focusing on wellness. After seeing the premium double in recent years, Ellis County’s 2009 workers’ compensation rate was 3 percent lower than the 2008 rate.
“Employees who are healthy and thinking about health are employees who are also safe and thinking about safety,” Buckley said. “If employees know that elected officials care and know we’re on the same team, maybe they’ll notify the elected officials of any possible health or safety risks.”
Dr. William B. Baun, the director of the employee wellness program at the University of Texas M.D. Anderson Cancer Center, told the Healthy County training attendees that in order for employers to succeed with their wellness initiatives, they must engage in “wellness partnerships” with their employees. In order for wellness programs to be successful in counties, he said, they must be designed and delivered to sustain behavior change and facilitate employee accountability for wellness practices. He cited studies from organizations that have reduced health care costs up to 29 percent through employee wellness participation.
Members of the TAC Pool receive Healthy County benefits as part of their health benefit package. And while not automatically enrolled in the program, the nine Pool-member groups that selfinsure can choose to purchase Healthy County programs in addition to the training and access benefits already received at no charge. The Pool has three staff members dedicated to wellness research and planning, two of whom travel directly to Pool-member counties to complement counties’ current efforts in wellness education and help promote new efforts. Jennifer Laird and Carrye Hieronymus are the Pool’s wellness coordinators. They’re available to help local wellness coordinators with implementing Healthy County, and to provide assistance with on-site events such as lunch-and-learns. “Our Pool is committed to wellness,” said Julie Sullivan, the Pool’s wellness program supervisor, citing examples. “Medical benefit plan designs currently have wellness components, such as annual physicals being covered, and colonoscopies not being subject to a deductible. The prescription drug program has coverage for tobacco cessation, and this year we launched Medicine Match, which has a 50 percent prescription co-pay reduction for four conditions for members enrolled in the condition management program.” Wellness experts agree that a key ingredient in any worksite wellness program is having top management’s support.
An early example of executive leadership in government wellness program support was Mike Huckabee, former governor of Arkansas and Republican presidential candidate in the 2008 primaries. As governor, he implemented the state’s first employee wellness program The Arkansas state legislature created an incentive by approving leave time for employees who continuously participate in the program. (Huckabee’s interest in wellness began years before when he was diagnosed with Type 2 diabetes. After changing his lifestyle, Huckabee lost more than 100 pounds and reversed the diabetes diagnosis.)
Preventing conditions such as diabetes – which cost Texans $12.5 billion in 2006 – is a top priority of Healthy County. Through the program, Pool members and their employees receive access to a number of resources as well as incentives aimed at not only managing chronic conditions, but preventing them in the future.
The Pool is offering all counties that attended the conference $25 in wellness funds for each employee who completes a health risk assessment by the end of March. Employees are eligible for a $25 gift card for completing the assessment as well.
Members who attended the conference and their employees who complete a 10-week walking and exercise program called PATH (Planned Action Toward Health) can also earn funds. Participating employees will receive a $25 gift card upon completion of the program, and counties will receive a matching $25 wellness credit. Wellness funds can be used for future county wellness initiatives.
Another incentive is focused on employees who have existing conditions that have proven to be costly over time: high blood pressure, high cholesterol, diabetes and asthma. For those employees, the TAC Pool implemented Medicine Match, in which the Pool pays for half of the co-pay for condition-related medications when the patient enrolls in the comprehensive condition management program.
Employees can also receive up to $200 a year in prizes for logging their progress toward nutrition and fitness goals with the assistance of Blue Cross Blue Shield’s Personal Health Manager. “Prevention is the most cost-effective wellness tool we have,” said Jennifer Hall, deputy director of program administration for the Texas Association of Counties. “Once a person is in the high-risk category, it takes a lot of resources to help them reduce those risks. The trend in wellness today is to put the effort into keeping healthy people healthy so they never become high risk. We can do that with fewer resources, and it’s better for the employees too.”
Pool-member counties who attended the wellness conference received a toolkit outlining the specific programs available to employees. “It was very important to us that attendees left the Healthy County training with a resource guide that detailed all components of the wellness program,” said Laird, one of the Pool’s wellness coordinators. “Since most of the wellness initiatives were a fresh topic, creating a reference toolkit for designated wellness coordinators seemed essential.”
The Pool also wanted to ensure that counties had a way to promote wellness programs directly to their employees while expending as few county resources as possible, so county wellness coordinators received a CD full of Healthy County materials. The Pool created a flash presentation with an overview of Healthy County that county wellness coordinators can show to employees. The resource CD also included a press release for local media; printable posters, brochures and fliers; email copy; and program applications.
“We wanted to develop a wellness media library of sorts to assist the wellness coordinators in administering their own Healthy County program,” Laird said. “Offering each wellness coordinator a reference toolkit and a one-stop shop for Healthy County media and printable materials would make the administration of the wellness initiative that much easier.”
Wellness research shows that ongoing communication is a key component for a successful wellness program, so to keep Poolmember employees informed and excited about wellness opportunities, the Pool will begin sending Healthy County quarterly newsletters in March. The Pool is also developing a listserv so county wellness coordinators can brainstorm, share ideas, exchange resources and encourage one another.
For more information about Healthy County and for printable resources, visit www.county. org/cms/health/healthycounty