Converting pounds to dollars: How to prove weight fighting programs save $
Show impact with hard data
[Editor's Note: This is the first of a two-part series on evaluating weight loss programs. This month, we give strategies to demonstrate the impact of your programs. Next month, we'll report on the use of an audit tool to measure the effectiveness of obesity prevention programs.]
Is data on participation, employee satisfaction, health outcomes, and medical expense trends linked to weight management programs at your fingertips?
"Failure to set goals and measure performance will put a program at risk in many corporate settings," warns LuAnn Heinen, vice president of the Washington, DC-based National Business Group on Health.
Here are ways to demonstrate return on investment:
Make the "weight-safety" connection.
It is difficult to document the impact of losing weight on injury rates, because workers' compensation claims do not have a place to collect body mass index (BMI) or weight.
"Also, in the case of disability claims, information about obesity is often described in case notes, and not coded as a primary cause of the disability," says Heinen.
However, Heinen says that her conversations with case managers confirm that obesity appears to be an important cause of injury and disability. "At the very least, it is highly correlated with these events," she says.
Show that participation levels meet company-set targets, for example, a certain percentage of the at-risk group.
Show that a high percentage of those who start the program complete it.
Evaluate results at three and six months.
"Losing even 5 to 10% of excess weight has health benefits across a population, with a positive impact on outcomes and medical trends," says Heinen. The program vendor should collect weight and BMI on participants, though you'll only have access to this data in aggregate.
It is possible to analyze the medical costs of participants versus non-participants matched for age, gender, health status, and BMI. "However, this requires careful research design," says Heinen. "It should be conducted by a third party with appropriate expertise, not connected to the program vendor."
Demonstrate that all or most of the initial weight loss was maintained one year post- program.
Collect data on the percentage of employees, by age category, who are in different weight categories. Determine how this compares to the nation as a whole.
"Track this over time to see if, for example, the 45 to 50 age group is improving as compared to the national average," advises Robert Emery, DrPH, assistant vice president of safety, health, environment and risk management. Emery is also an associate professor of occupational health at The University of Texas School of Public Health. "Also, consider tracking health benefit payouts for obesity-related disorders."
Link employee weight loss to decreased risk of illness.
First, you would have to identify obesity as a risk factor for a select category of diseases heart disease, diabetes, and cancer, for example, says Chris Kalina, MBA, MS, RN, COHN-S/CM, FAAOHN, director of global occupational health programs and services at Wm. Wrigley Jr. Company in Chicago, IL. "Then determine how losing say, 20 pounds, reduces the risk of the disease."
Kalina acknowledges that this kind of data is not readily available. "But the logical approach would be to identify risk, and demonstrate the reduction of risk that weight loss will impact," she says. First, research a category of disease entity, such as cardiovascular disease, to demonstrate that being overweight is a risk factor. Next, connect the reduction of the risk factor to reduction of the disease.
"It takes work, but once the research is completed, it is done as a foundation for the program," says Kalina.
Match Health Risk Assessment (HRA) data to claims data, to understand the cost of low, medium and high risk groups.
"Our HRA vendor provides the HRA file to our data warehouse vendor," says Patti Clavier, BSN, RN, COHN-S, manager of Intel's Global Health for Life Wellness Program.
"We are able to see low, medium, high risk groups in aggregate, de-identified data. The population can be segmented to see average claim costs and medical expenses of these risk groupings."
How Intel assesses 3 weight loss programs
At Intel's U.S. locations, the effectiveness of every weight loss intervention program offered by the company is assessed in a different way, as follows:
On-site coaching.
Intel's vendor assesses effectiveness through the bio-metrics collected, with the aggregate data de-identified for purposes of confidentiality. "We have Year I data that will be compared to our current Year II data. We also have cohort data for those in both Year I and Year II," says Patti Clavier, BSN, RN, COHN-S, manager of Intel's Global Health for Life Wellness Program.
Additional plans include analysis of non-participants to fully understand the impact of the interventional programs.
"Another data set we watch is presenteeism data," says Clavier. "Those with a nutrition risk show productivity losses." Year-to-year average productivity loss related to nutrition is tracked.
Telephonic coaching.
"Our vendor assesses effectiveness through self-reported data," says Clavier. The most recent data indicate that 53% of employees increased their healthy eating choices, and 47% lost weight as a result of being in the program.
On-site weight management.
"We have had this at several locations," says Clavier. "Soon it will be under corporate contract, with the vendor reporting out participation, weight loss and other ROI data. All employee data will be de-identified for confidentiality purposes."
Do programs stop the 1-3 pound annual gain?
It's the goal of many companies today to prevent the one-to-three pound per year adult weight gain that is unfortunately, the norm. "It's always a challenge to measure something that doesn't happen," says LuAnn Heinen, vice president of the Washington, DC-based National Business Group on Health. "Many companies are satisfied if their HRA data show no weight gain year over year."
There's no one program or solution that fits every employeeor every company, for that matter. "The way to success is to build a health and wellness culture that works in your particular work environment, and that fits your employee population," says Heinen.
Ideally, your programs will be mentioned frequently by the "C-Suite," says Heinen, and role modeled by key leaders.
"The worksite is a place where people influence one another, and the "let's be healthy" culture is catching!" she says.
Trust is asset
As an occupational health professional, you have a powerful asset: A stronger trust relationship with employees than other departments, such as human resources.
"As professionals responsible for safety and health, they are appropriate messengers of the healthy weight message," says Heinen. "Remind employees of the available resources at work to support weight management."
There is no "one-stop" shop for weight management, and it takes constant effort to engage employees all year long, says Heinen. With this in mind, your obesity prevention program should have these components:
An Employee Assistance Program to help people with depression, which often leads to weight gain.
A variety of options to support employees who want to stay at a healthy weight or lose some weight, such as telephonic or in-person coaching, online programs, and group support.
Healthy foods available, so employee weight management efforts aren't sabotaged. "This means the employer is actively managing the cafeteria, catering, and vending offerings at work," says Heinen.
Options for increasing physical activity that are visibly promoted, such as pedometer and walking programs, contests or competitions, on-site yoga or other fitness classes.
Sources
For more information on evaluating weight loss programs, contact:
- Patti Clavier, BSN, RN, COHN-S, Manager, Global Health for Life Wellness Program, Intel, Colorado Springs, CO. Phone: (719) 273-1027. E-mail: patti. [email protected]
- Robert Emery, DrPH, Assistant Vice President, Safety, Health, Environment and Risk Management, The University of Texas Health Science Center at Houston. Phone: (713) 500-8100. E-mail: [email protected]
- LuAnn Heinen, Vice President, National Business Group on Health, Washington, DC. Phone: (612) 827-0552. E-mail: [email protected]
- Chris Kalina, MBA, MS, RN, COHN-S/CM, FAAOHN, Director, Global Occupational Health Programs and Services, Wm. Wrigley Jr. Company, Chicago, IL. Phone: (312) 645-3770. E-mail: [email protected].
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