Health system saves $3 for every dollar spent
Wellness program provides return on investment
Combining traditional wellness programs with demand management has saved the Birmingham, AL-based Baptist Health System $3 for every $1 spent on employee health promotion, says John T. Hilyer, administrative director of the Health at Work program.
While officials there focus more on behavioral outcomes than financial assessments, Hilyer says health promotion activities such as physical activity, stop-smoking programs, and classes on nutrition and lowering blood pressure have resulted in lifestyle changes that lead to lower health care costs. Those activities are offered along with written materials on self-care, a component that manages the demand for health care, which, in turn, reduces an employer’s health care costs.
In a 1992-93 pilot program on demand management, 650 Baptist Health System employees both nurses and nonmedical professionals were taught about self-care options and given supporting literature.
"From there, we encouraged them to give follow-up feedback on whether the book was helpful and whether they used it to reduce physician visits," Hilyer explains.
After three months, more than 55% of participants reported that they used the material to handle a health problem. Of those workers, 27% said they avoided at least one physician visit because they used the material, and 18% said they avoided an unnecessary emergency department visit.
"It makes sense to teach self-care because you do not have to wait three to five years to see an outcome [as with a traditional wellness program]," Hilyer says. "Demand management is positioned as a short-term savings option in a health promotion program. You can see cost savings within 12 months. If you can reduce the utilization of your health plan benefits, there are obvious savings if you’re self-insured, or there are shared savings if you have a risk- sharing option with your health plan carrier."
The 10,000-employee system’s wellness program measures success by its ability to move employees at high risk of costly health problems to the low-risk end of the scale. In place since 1991, Health at Work recently won "gold" recognition by the Omaha, NE-based Wellness Councils of America (WELCOA), the organization’s top honor. Hilyer says he uses WELCOA’s Well Workplace checklist (see guidelines, p. 17) as a model because "they deal with organizational commitment and cultural change, and not just programs offered to participants."
Incentives encourage participation
About 60% of the system’s employees participate in the free, voluntary program, in which they are encouraged to become physically active and taught ways of lowering blood pressure, managing stress, and making other healthy lifestyle changes. Incentives ranging from novelty gifts to $250 gift certificates are used to encourage participation. Beginning this year, employees who enroll in the wellness program and meet certain health criteria will see lower health insurance rates, as well.
Plans also include expanding the program to include more "family-friendly benefits," says Hilyer, such as classes on managing family finances and caring for older dependents.
"That’s the approach we’re taking now," he says. "We’re still doing the traditional things, but we want to respond to employees’ needs and interests. We’re looking at our culture to determine what we need to do, rather than just looking at the literature to see what other companies are doing. We ask employees what they are interested in and deliver it to them. Chances are, if they are going to have success with family finances or an easier time with an older dependent at home, then they are going to start thinking about things like nutrition and weight loss and stopping smoking."
Hilyer says the system’s health promotion program, which also is offered to area businesses, serves as an image-builder, both in the community and within the health care worker population, where it improves morale and productivity.
"Hospitals are positioned in the community to be beacons of good health, not only in providing health care treatment but also for preventing health problems," he says.
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