The Road to Wellness

Firms such as Highsmith and ACIPCO see wellness as a path to physical and fiscal health.

In 1989, Fort Atkinson, Wis.-based Highsmith Inc. looked on the horizon and saw a gathering storm.

“We were faced with a 53 percent increase in our group health insurance premium for the coming year,” recalls Laura Hanson, Highsmith’s manager of learning and development. “ ... That would’ve been our fastest-rising cost of business.”

Rather than brace itself for a direct hit, Highsmith – which distributes supplies, furniture and equipment to schools and libraries – decided to steer out of the storm’s path.

One of Highsmith’s changes in course, Hanson explains, involved developing plans to “integrate wellness into the culture.” The other change involved moving the company’s health insurance coverage to a health maintenance organization (HMO).

“We had to make a number of decisions, and one of them at the time was to switch to an insurance company that would be a better partner in providing wellness opportunities,” Hanson says.

Hanson admits that Highsmith’s wellness program “started out slow.” The company offered discounts on health insurance premiums for employees who took a health-risk assessment and who made improvements to their health. Highsmith also offered exercise and health education classes and began incorporating healthier foods into the company’s vending machines.

As Highsmith’s understanding of wellness evolved, Hanson explains, the company “found the traditional definitions of wellness to be fairly limiting." Consequently, Highsmith today eschews the term “wellness program” in favor of “learning and development” – a rubric that reflects the company’s belief that wellness not only encompasses physical health but also includes emotional well-being, work/life balance, personal relationships and other factors that impact its 220 employees’ health and productivity.

As part of a “more comprehensive and inclusive” strategy to address those factors, Highsmith developed a broad menu of classes, activities and resources in seven categories: job/career development; work/life enrichment; personal well-being; self-care; physical well-being; incentives; and benefits.

“[O]ne can have all the job skills they need to do their job very successfully,” Hanson says. “If they’re suffering from depression, if they have allergies or asthma, if they’re struggling with their own children having difficulties in school – all of that is going to impact their productivity.”
As part of its learning and development initiative, Highsmith offers:

  • Learning opportunities – detailed in an annual course catalog – in each of the seven categories mentioned above. Classes are held during and after business hours at Highsmith’s Fort Atkinson, Wis., headquarters, where most of its employees are based. Classes include “How to Develop a Will,” “Journaling: The Write Stuff” and “Parenting with Love and Logic.”
  • Flex scheduling options to make it easier for employees to attend classes and other wellness activities.
  • An annual on-site health screening for employees and their spouses. The screening – which takes about an hour and is held on company time – measures height, weight, carbon monoxide level, blood pressure, cholesterol and glucose and includes a treadmill walking test and coronary risk profile. After the screening, employees and their spouses meet one-on-one with a health educator from Highsmith’s HMO to discuss their results. Participants also meet with a counselor from Highsmith’s employee assistance program (EAP) provider to discuss their emotional well-being and then meet with a Highsmith health educator to learn more about the wellness resources and services offered by the company.
  • Subsidies on health insurance premiums for employees who are tobacco-free, obtain physical exams and participate in the company’s annual health screening.
  • “First Aid Kit for the Mind,” a class offered during new-hire orientation. The class explains and offers resources for managing stress, depression, relationships and drug and alcohol concerns. During the orientation, a Highsmith health educator discusses personal well-being and the resources available through the company’s EAP.

“We do more than just point a person toward a healthy lifestyle,” the company points out in an application for the Wellness Councils of America’s Well Workplace Award – which Highsmith received in 1994, 1997, 2000 and 2004. “We provide ongoing education and resources addressing physical health, emotional well-being, productivity, personal and professional relationships and performance on the job.”

The Right Thing to Do

Due in no small part to learning and development, Highsmith has been able to keep the gathering storm of rising health insurance costs at bay. While consulting firm Towers Perrin estimates that health care costs for U.S. employers rose 60 percent over the past 5 years, Highsmith’s health insurance premiums during that same period rose just 4.6 percent. All the while, Hanson notes that Highsmith has been able to maintain a “rich” health insurance plan for its employees.

Learning and development also has produced dramatic improvements in employees’ cholesterol, blood pressure and other health measurements. For example, from 2000 to 2006, the number of Highsmith employees in the high-risk category for cholesterol (those with a total cholesterol level of 240 and higher) dropped 66 percent.

Perhaps not at all coincidentally, Highsmith employees tend to stay. According to Hanson, the turnover rate is “in the single digits” and the average employee tenure is 12 years.

Those benchmarks notwithstanding, Hanson emphasizes that company management simply believes that investing in wellness and employee development – Highsmith spends around $170 per employee on such efforts – is the right thing to do.

“We feel so strongly that what we’re doing is best for our company in terms of our profitability, our productivity and the health and well-being of work force,” Hanson says. “It just makes sense for us.”

The Well-Body Club

Around the same time that Highsmith’s wellness and employee development initiative was taking shape, Birmingham, Ala.-based American Cast Iron Pipe Co. (ACIPCO) hired Rebecca Kelly to design and implement a wellness program for its approximately 3,000 employees. ACIPCO – founded by John Eagan in 1905 –manufactures ductile iron pipe, fire hydrants and valves for the waterworks industry as well as electric-resistance steel pipe for oil and natural gas pipelines.

Much like Highsmith, ACIPCO’s interest in wellness was spurred by rising health insurance costs as well as the company’s belief that taking care of its employees is the right thing to do.

“[ACIPCO] is a culture of people wanting to take care of their employees and having third- and now fourth-generation employees,” Kelly says. She adds that companies need to launch wellness programs “for the right reasons – not just because it’s good for the bottom line.”
Shortly after joining ACIPCO in 1993, Kelly created the company’s signature wellness program: the Well-Body Club.

The Well-Body Club is a risk stratification system that places employees in one of four “clubs” – Club 200, Club 50, Club 25 and Club 10 – based on the results of annual screenings for risk factors such as cholesterol, blood pressure, body-fat percentage, glucose, flexibility and frequency of exercise. If an employee’s screening results meet the criteria of Club 200 – the healthiest club – the company pays the employee $200; for inclusion in Club 50, the company pays the employee $50, and so on.

To help employees move up to higher clubs, Kelly developed more than a dozen programs focusing on nutrition, diabetes, smoking and other risk factors. Among the programs’ more successful (and creative) campaigns:

  • “Teams of Three” for the past decade has been challenging employees to watch their weight during the holidays. From mid-November through mid-January, teams of three employees are weighed – as a group – each week by a nutritionist, who offers participants weight-loss tips and healthy holiday recipes. According to Kelly, more than 25 percent of the work force participates, and 95 percent of those participants return to the program the next year.
  • “The 100-Day Challenge” paid 100 tobacco users $100 each for quitting smoking for 100 days. The campaign was just one of many tobacco-cessation initiatives at ACIPCO.
  • “Lunch with Your Nutritionist” gives groups of employees an opportunity to learn about healthy dining choices from an actual nutritionist. As part of the program, a nutritionist uses a pictorial plate planner to show participants what types of foods they should be eating and then joins them for a healthy discussion over lunch – which is paid for by the company.

Membership in Club 200 pays dividends for employees – and ACIPCO. The company estimates that members of Club 10 are absent 17 days per year, on average, while members of Club 200 are absent only 1.25 days. ACIPCO monitors the health care claims of all club members and estimates that employees who move to a higher club typically reduce their health care costs by 20 percent the following 2 years.

In terms of the return on investment (ROI), ACIPCO determined that for every $1 it spends on the Well-Body Club and its supporting programs, it sees a return of $2.19 in reduced health care costs. Factor in reduced absenteeism, and, according to Kelly, the ROI jumps to $3.50 for every $1 spent on wellness.

On-Site Physical Therapy

Kelly – who is a registered dietitian, exercise physiologist, certified diabetes educator and wellness consultant – in January was hired by the University of Alabama to be its first-ever director of health promotion and wellness. However, the 5,000-square-foot Eagan Center for Wellness at ACIPCO’s Birmingham, Ala., headquarters serves as a daily reminder of Kelly’s contribution to the company’s physical and fiscal health.

Completed in 2001, the Eagan Center for Wellness – formerly the site of a company cafeteria – includes strength training and cardiovascular equipment, an aerobics studio, showers, offices as well as facilities for physical therapy.

When Kelly proposed that ACIPCO should build a wellness center that includes physical therapy services for its injured employees, she promised company management that by bringing physical therapy on site – and by contracting with a physical therapy firm rather than using ACIPCO’s health insurance provider – the center would pay for itself. It did.

In just 3 years, the reduction in health insurance claims paid for the construction of the wellness center as well as its equipment and staffing. By offering physical therapy on site, the company is able to reach more workers – Kelly estimates that over 90 percent of physical therapy referrals now act

“We went from employees being off the job an average of 2 1/2 hours a day for a physical therapy appointment to 1 hour,” Kelly says. “And that continues to be a significant cost savings for the organization.”

Sidebar: Strategies for Success

In its guide titled “Seven Benchmarks of Success,” the Wellness Councils of America (WELCOA) points out that “seven basic steps drive the entire process of building a well workplace.”

Those seven steps are summarized here, along with additional comments from Ron Goetzel, Ph.D., director of the Cornell University Institute for Health and Productivity Studies and vice president of consulting and applied research for Thomson Medstat; and Rebecca Kelly, Ph.D., RD, CDE, director of health promotion and wellness for the University of Alabama and former wellness manager for American Cast Iron Pipe Co.

1. Build senior-level support. As WELCOA puts it, senior management “controls the purse strings, the organizational agenda and all of the communication channels.” Goetzel adds that upper management must believe that wellness is “‘part of our philosophy, part of our vision, part of our business strategy ... and core and central to what the company is about.’”

2. Create a wellness team. “Because the majority of organizations have become extremely specialized, most decisions are now made in teams,” WELCOA explains. Consequently, formation of a team comprised of all “the key players” is essential to build support for wellness within the company. Even for employers with limited budgets, Kelly adds, convening a wellness team or committee is a great way to begin “exploring health and wellness initiatives and identifying what the company can do.”

3. Collect data to make strategic wellness decisions. Data – which can be collected from sources such as health screenings, health-risk appraisals, health insurance claims and workers’ compensation records – can indicate where wellness resources should be focused.
4. Craft an operating plan. “Think about it,” WELCOA says. “[H]ow many successful businesses proceed without a plan?”

5. Choose appropriate interventions. According to WELCOA, an employer should craft its wellness program based on factors such as upper management’s goals for the program; prevalent risk factors in its work force; the personality of its work force; the latest research; and the amount of resources the company has dedicated to wellness.

6. Create a supportive environment. “Supportive environments,” WELCOA explains, “significantly increase the likelihood that positive changes in health behavior will take place.”

7. Consistently evaluate outcomes. “You have to keep tracking and monitoring the key metrics here. And they are: health outcomes, economic outcomes, functional outcomes and productivity outcomes,” Goetzel notes. “So, to the extent that you have measurement and listening posts in place, you can tell whether things are working or not, and if they’re not working, what you need to do to fine-tune the program.”

To read WELCOA’s “Seven Benchmarks of Success,” visit http://www.welcoa.org.

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