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Employee buy-in viewed as vital for success of wellness programs

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ATLANTA—Getting 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.