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Companies taking different approaches to wellness

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ORLANDO, Fla. — A benefits professional says “money talks” when it comes to encouraging participation in workplace wellness and chronic disease management programs.

At the Cleveland Clinic, financial incentives and disincentives have increased participation and improved employee outcomes in company wellness initiatives for 82,000 plan members, Dr. Bruce Rogen, chief medical officer of employee health plans for the Cleveland-based medical center, told benefit and human resources professionals at the Employer Healthcare and Benefits Congress in Orlando, Florida.

“What we found over the years is essentially money talks. Employees and their families get up and pay attention when they are paying less in their premiums, copays and coinsurance,” Dr. Rogen said Sunday.

Cleveland Clinic estimates it has saved $75 million dollars in health costs in the past five years through its wellness programs, which has about 18,000 enrolled members, he said.

Employees are given free fitness tracking devices and free access to onsite fitness clinics, health clinics and smoking-cessation programs, Dr. Rogen said.

The clinic does not offer high-deductible health plans, as they may prevent employees from accessing care, he said.

“If you want a population to change their culture, change their behavior, you need to make doing the right thing as easy as possible,” he said.

Cleveland Clinic also monitors health and pharmacy claims data and information from its fitness programs and tracking devices to gauge employees' progress. Health coaches keep employees on track, he said.

Initially, he said, incentives encourage participation, but “once somebody loses weight and feels better … it becomes an intrinsic motivation. It's no longer about the money.” Rather, employees participate to stay “where they are or continue to improve.”

On the other hand, the World Bank Group plans to approach wellness by focusing on improvable and quantifiable employee health risks, as opposed to catastrophic conditions like cancer, rather than concentrating on treating existing conditions. The bank will target the 15 health risks proposed by Dee Edington, founder, professor and former director of the University of Michigan Health Management Research Center, said Dr. Jules Duval, the World Bank's Washington based senior medical officer. Those risks include weight, high cholesterol, high blood pressure and smoking, among others.

The idea, said Dr. Duval, is that as health risks decrease, so will costs.

“Instead of putting all the focus on the problems that come walking through the door, the goal is to take our population and meet them before these issues come up … and then work actively on these high health risks in a manner that improves outcomes,” he said.

After a population-wide health risk assessment, the World Bank found that its employees showed “higher risk posture” in each of 15 identified high heath risks when compared to a benchmark, except obesity, Dr. Duval said.

The World Bank categorized employees as low, moderate and high risk, with the goal of moving high-risk employees to lower risk categories throughout the program.

To accomplish this, Dr. Duval said the World Bank, which is just beginning to focus on wellness, will establish an onsite clinic, complete with a wellness program and chronic disease management program for employees. Telemedicine “will underline the whole thing,” to ensure ongoing care, he said.

“We want them to understand that we're doing this for you,” Dr. Duval said of the World Bank's employees. “It's not just something that we are suggesting because it's going to be good for the bank; it's part of your overall total rewards package.”