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Middle managers pose greatest challenge to health efforts
ATLANTAGetting employees at all levels of a company actively involved in wellness and disease management initiatives is critical to their success, employers say.
Communicating the importance of these programs to senior management is a priority for Hannaford Bros. Co., said Ellie Udeh, the Portland, Maine-based manager of wellness initiatives for the supermarket chain. The wellness staff meets with senior management twice a year to review national health care trends and the company's past and future cost trends.
"We really try to paint a clear picture to them of what we're up against," Ms. Udeh told attendees at the 19th annual National Managed Health Care Congress held March 5-7 in Atlanta.
As much as possible, the wellness staff tries to demonstrate the results of their programs, although it is often difficult to show how individual initiatives contribute to the bottom line, she said. Sometimes the best evidence of the effectiveness of these programs is anecdotes about how the programs affected the lives of individual employees as senior managers often show more interest in these stories, Ms. Udeh said.
The biggest challenge in getting buy-in for wellness programs, though, is with middle management rather than senior managers who understand the business case for wellness, she said. Middle managers need to understand the value of these programs for individuals, Ms. Udeh said. To this end, the wellness staff has meetings with managers to discuss how they can support wellness initiatives and encourage employees to take concrete action to improve their health. The company also has health educators, usually registered nurses, at all of its facilities, she said.
Hannaford Bros. has implemented "Health Huddles," impromptu meetings where various health topics are discussed. One recent meeting involved educating employees about their typical daily salt intake and how that could impact their health. The meetings are effective because they are interactive and employees can compare results and challenge each other to change, she said.
Offering financial incentives to employees is still the most effective way to encourage participation in wellness and disease management initiatives, according to employers.
Hannaford Bros. provides a $20 per week financial incentive for employees who complete a health risk assessment, are tobacco-free or enter a tobacco cessation program, and participate in disease management initiatives.
The company provides a $5 per week incentive for completing a health risk assessment and participating in a disease management program for employees who do not want to quit smoking.
The incentives have been extremely effective at encouraging participation in the company's wellness programs, Ms. Udeh said. For example, almost 90% of employees and their spouses now complete health risk appraisals, she said. In addition, 95% of people participating in disease management programs accepted calls from the wellness coaches, so the company has taken the financial incentive away from only 5% of those who signed up for the program, she said.
Hannaford Bros. has seen a noticeable impact from its wellness programs. Health risk appraisal data showed a decrease in the number of employees identified as being at risk for stress conditions from 27% in 2005 to 16% in 2006, while the number of employees at-risk for heart disease dropped from 21% to 16%. Identifying these and other risk factors serves as a "wake-up call, an opportunity for (employees) to learn more about themselves," Ms. Udeh said.
In another effort, DaimlerChrysler Corp. boosted participation in health risk appraisals and health screenings among its nonunionized employee population by 88% after offering a $240 financial incentive to those who participated in both initiatives, said Thomas Hadrych, vp, compensation, benefits and corporate services for the Auburn Hills, Mich.-based automaker. "We thought that was pretty good," he said.
The company, which will spend about $2.3 billion to provide health care to its active and retired employees and their dependents in 2007, has focused on identifying the top five risk factors for employees at each of its facilities, screening for risks such as high blood pressure, cholesterol and glucose levels and mental health issues.
Last year, the company conducted 37,000 health risk screenings.
Once the risk factors are identified, the automaker develops targeted programs for these facilities, such as onsite fitness centers, stress and depression management programs and smoking-cessation programs, he said.
When Lowe's Cos. Inc. instituted a maternity management program six years ago, participation in the program was at 17%, so the company decided to encourage participation by covering their employees' $350 deductible if they completed the program, said Bob Ihrie, vp, compensation and benefits for the Mooresville, N.C.-based home improvement store chain.
Even though the incentive program boosted participation to about 50%, Mr. Ihrie said he still considered that level "pathetic."
For Lowe's, the key barrier to participation in disease management and wellness initiatives is turnover, which is about 45% per year. Virtually all turnover, though, occurs in the first six months of employment so wellness programs do have value, he said. For example, Lowe's has provided free onsite clinics, which have gotten tremendous feedback and usage by employees, Mr. Ihrie said.
More than half of Dells employees use health manager
ATLANTAProviding tools that empower employees to become better health care consumers is critical to promoting consumerism.
In an effort to promote consumerism, Dell Inc. launched a variety of online tools to educate its employees on the true costs of health care and allow them to better manage their health, said Richard Felice, area vp, Dell Healthcare West, based in Chandler, Ariz.
The computer company provides, for example, a health care cost summary that details what employees pay for medical, prescription drugs and dental services. The summary outlines the employee's per paycheck contribution, the amount paid toward the deductible, and their copayment or coinsurance costs for the year.
"People really do see what health care costs at Dell," Mr. Felice said during the 19th annual National Managed Health Care Congress in Atlanta.
The summary also provides tips on how employees can more efficiently manage health care costs, such as taking advantage of a health care spending account to pay some out-of-pocket costs on a tax-free basis.
The company provides a Personal Health Manager tool to empower Dell employees and their families to make the best health care decisions, he said. The tool imports records from doctors, health plans, hospitals, laboratories and pharmacies. It translates procedure codes into common and easily understood terms, replacing unintelligible benefits statements, he said. "We take them and convert them into English," Mr. Felice said.
For example, the medications page in the Personal Health Manager tool lists the name and dosage of every drug prescribed to the employee and family members, who can also check for any potentially dangerous drug interactions by simply clicking a button.
The tool also allows participation in live nurse chats in which employees can describe their symptoms and ask questions about health care concerns.
"Dell has enabled me to have resources and that's what companies need to do," Mr. Felice said.
More than 50% of Dell's employees use the Personal Health Manager tool, he said. "If people didn't do it, it was because of inertia," he said.
Dell also provides a "Click `n Learn" library where employees and their families can access information on getting the right health care at the right price, getting the most benefit from medication and getting answers to urgent health questions. The library provides information in both video and printable format.
ATLANTAAbout 400 people attended the 19th annual National Managed Health Care CongressTotal Health Management conference held March 5-7 in Atlanta.
The conference featured sessions on engaging health care consumers, controlling health care costs and building better access to quality health care.
Plans for next year's conference have not been finalized.