Wellness programs, on-site clinics assist employees and cut health care costs

Four years ago, the Eau Claire Area School District was implementing a wellness program made up of various groups acting independently of each other — the employee-run wellness committee, the insurance group, the Employee Assistance Program. All these groups were working toward the common goal of healthier employees, but none of them knew what the other was doing.

“All these people were doing their things — which was wonderful — to improve employee health and wellness, but they were all doing it solely on their own, and not in conjunction with the larger group,” said Kay Marks, executive director for human resources with the school district.

This is common for how numerous companies approach employee wellness and encourage healthy lifestyles. As health care costs rise, companies are finding that wellness programs, when effective, can cost little and save a lot of money. But how to have an effective program?

 For the Eau Claire Area School District, one ingredient in the special sauce was to bring those silos — all those separate committees — together into a holistic group. This group looks at overall health and wellness of employees in the district.
“Now we look at data about utilization and health risk assessments. When we look at that piece, then we look at what can we do in the district from a wellness standpoint, what can we have Security Health Plan come in and offer, and what kind of classes can we offer,” Marks said. “So it was when we took a holistic viewpoint that things really started to improve.”
Many organizations have its employees develop the programs in house. At Eau Claire Area School District, the wellness committee consists of employee reps who organize several activities throughout the year, such as informational sessions, a wellness scavenger hunt, a pedometer challenge and a wellness fair. Since all but two on this committee are uncompensated for this additional work, there is very little cost to the district. The district also offers regular fitness classes for employees and has community volunteers give presentations.

“We’ve got 22 facilities in the district, so that’s 22 people out in the buildings, working with their colleagues to promote wellness. And that’s huge, when employees are the ones who are driving it. That’s one of the biggest positives about this program — employees are involved in planning, making improvements, etc.,” said Marks.

Meghan Price, ECASD’s human resources coordinator, believes that encouraging wellness benefits both the district and its staff. “Employees who feel well, physically and emotionally, are able to be their best and provide the best care to co-workers and students. By providing them with wellness opportunities and information, we can provide them with resources, activities information, things they can use to address their own wellness goals,” she said.

 

“Studies have shown that wellness reduces absenteeism, increases morale, reduces health care costs, improves work performance, and a whole host of other benefits. We’re just trying to steer them in that direction so they can find the tools that they need to take care of themselves.”

Forming a near-site clinic

A couple years ago, it was time for ECASD to bid out its insurance, but the district had a fairly big ask. It wanted to implement an on-site or near-site clinic that would be exclusively dedicated to serving ECASD employees and their dependents.

 

Research indicates that near-site clinics, such as the one they were envisioning, are better for everyone involved. Employees develop more of a relationship with the primary care providers and do not feel like just another number, and the hope is that they also go to the doctor more often for preventative care.

 

However, organizations that provide such clinics are generally self-funded and can afford the upfront costs; the district couldn’t do that. Whichever insurance provider they went with would have to bear the costs.

 

Fortunately, Security Health Plan was able to put together a proposal that provided for the near-site clinic, locking in the agreement for a minimum of five years with no more than a 5-percent increase in health premiums each year. “With the health insurance going as crazy as it is these days, this was a wonderful plan for the district to get in on,” said Marks.

 

The clinic opened last fall, and now the district has just over 3,600 employees, spouses and dependents on the Security Health Plan. Employees are not billed for their visits to the near-site clinic, which offers preventative care and wellness checkups as well as urgent care services.

 

The near-site clinic and the emphasis on preventative care is one of two parts of the comprehensive wellness package that Security Health offers the district and many of its other employer groups.

“Research tells us that people who work with their providers more frequently are apt to be healthier,” explains Jay Shrader, director of disease management and wellness at Security Health Plan. Whether the organizations they work with have a near-site clinic or not, Security Health emphasizes primary care as a part of wellness.

The other key element is an on-line health assessment, which is a confidential survey that provides an overall lifestyle score. Security Health then uses that data to determine what risk a member might have for health issues down the line (for example, tobacco use or obesity) and puts together an action plan for that member. Registered nurses and other team members may conduct health coaching and outreach to the member. Security Health also aggregates all that data together to steer future wellness offerings for the organization.

“Wellness at Security Health Plan focuses on modifiable behavior (tobacco use, stress, obesity), so from a health plan perspective, we focus on wellness as part of our primary prevention efforts, which is really about how to keep healthy people healthy, or identify people who are at risk in one of those health behavior areas. Really what we’re trying to do is to keep people from developing a chronic condition before the onset of it,” Shrader said.

“We applaud Eau Claire Area School District and other groups participating in work-site wellness, whether it be through Security Health Plan or another vendor. That’s a huge commitment for any organization to participate in a program like that, and it’s such an important investment in their staff, and quite frankly their community, when they’re investing in their employees.”

 Security Health doesn’t stop at the organization level, however. The company has a large service area across 41 counties, and uses the publicly-available data in those counties to determine the extent of their involvement in wellness in those communities, such as through healthy community grants, new projects or help with planning. Their key priorities for the last few years have been children’s health, healthy literacy and aging health.

“We look across our service area and hone in on where we can make the biggest impact, and often those impacts also improve the health and well-being of our employer groups and their members, so it’s a win-win situation when that occurs,” Shrader said.

On-site care

Most organizations are not able to form a dedicated near-site clinic, even with the help of their insurance company, but they may still want to provide wellness services to their employees beyond an employee-run wellness committee. These employers may bring the provider to their employees rather than sending the employees to the provider.

Optimum Therapy is one such company that will send trained professionals to work with employees on-site, saving the employees’ time and encouraging them to make use of their services.

According to Darrin Schober, owner of Optimum Therapies, most of the employers he works with in this way are manufacturers, so he and his staff are frequently dealing with injuries caused by repetitive motions. But he also has white-collar clients requesting services such as on-site chair massages to relieve muscle strain caused by computer work.

“A lot of times, you’re seeing someone who might be dealing with flexibility issues, they’ve been doing factory work for how many months with the same kind of patterns, so you’re teaching them to break out of some of that stuff. Some of the problems they’re having are just that, flexibility patterns. When they can change their patterns they can do more things on the floor, and they’re happier employees,” Schober said.

“By offering early access to solutions for minor work problems to people in the workplace, whether it be things on the floor or things in the office, if we see people on-site we get those things taken care of and improve their productivity.”

He says the companies he works with are progressive in trying to find ways to help their workforce have a better approach to wellness and to manage their health care costs.

“Employers are looking for solutions. They can’t continue to absorb the increased premiums and increased costs of health care insurance, so they’re trying to find alternative ways to maintain a healthy and well workforce without having to pay more to get it,” Schober said. “The interesting thing is each company has its own needs, so there is no one blanket package. You need to understand the company and what the best impact is going to be and then through working with them, start to develop that relationship to solve their particular problem.”

 

Schober sees the traditional model of health care changing. Where the idea has been to treat the sick, the concern now is with “well care,” helping employees take more initiative to prevent getting sick or injured. He sees this change in attitudes increasing with time.

“When you talk about neuromuscular skeletal problems, where people are having a tough time performing essential physical job demands, physical therapy is perfect for that situation to figure out what the problem is and improve the problem,” he said.

Healthy Jobs Act and beyond

Near-site clinic? Visiting physical therapist? These elements of a well workforce may seem out of reach for a small organization. However, with the upcoming implementation of the Healthy Jobs Act, Wisconsin companies with fewer than 50 employees can apply for a one-time grant that will cover 30 percent of the costs of implementing a wellness program, up to $10,000. The Healthy Jobs Act is expected to begin accepting applications later this year.

According to Wisconsin state Sen. Terry Moulton, one of the sponsors of the bill, “the Healthy Jobs Act takes a free-market approach to preventing chronic disease that will also help Wisconsin businesses control health care costs, reduce absenteeism, improve productivity, and increase employee retention.” He cites the Centers for Disease Control and Prevention’s research that has found that every $1 spent on wellness programs saves businesses anywhere from $3 to $7 in costs.

 

Shrader believes the Healthy Jobs Act is an excellent first step in improving well-being in Wisconsin, giving resources to those who wouldn’t otherwise have access, and providing some perimeters around how that money can be used.

 

“They’ve done a nice job of making sure that evidence-based interventions are included, such as the health assessment that would be required as part of a work-site wellness program to receive the credit,” he said. “It’s going to take some time, but certainly what we hear from our clients and from the market base is that there’s a lot of interest for work-site wellness. Sometimes these small groups just need an extra boost to get headed in the right direction. I think this is going to provide the boost for them.”

The legislation is a sign that this emphasis on wellness is going to continue to grow, Schober said.

 

“We’re seeing in the last few years a significant growth in work-site wellness or wellness in general, whether it’s at the work site or the individual level, because of the Affordable Care Act and other legislation including the Healthy Jobs Act, which is an indicator that Wisconsin is investing,” he said. “With the rising cost of health care and changes in the models of delivery, wellness will only continue to be a more integrated and important piece in an overall health care strategy.”

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