A tried-and-true program

In the contentious debate over health care, everyone agrees with cutting medical costs, making people healthier and improving their productivity.

Yet a decades-old way to do just that is getting little attention: company wellness programs.

At one time, health care overhaul ideas included an employer tax rebate for each employee taking part in a certified wellness program.

But that idea's out for now, even though Nebraska members of Congress say wellness and prevention efforts deserve incentives regardless of whether the health care system changes or not.

A tax advantage for wellness programs would be good medicine, said William Kizer Sr., an Omaha insurance executive who founded the 3,200-employer Wellness Council of America in 1986.

“If they (businesses) could invest something like $100 or $200 per employee into a wellness program and then get that back as a tax credit, I think it would make wellness a universal practice,” Kizer said.

So far a rebate isn't included in the pending House of Representatives bill. It's not on the agenda of a group of senators trying to work out a bipartisan compromise, said Sen. Ben Nelson, D-Neb.

“It's hard to give tax breaks when you're trying to fund a $1.1 trillion plan,” said Rep. Lee Terry, R-Neb.

The House bill, which has many opponents, includes $2.8 billion for research into prevention and wellness and $17.1 billion for promoting prevention and wellness as part of an overall public health program.

But even without new appropriations, employers say wellness programs — also known as health promotion programs — can keep workers healthy and reduce insurance claims, absenteeism and disability costs.

How much savings?

Proponents say a well-run, longtime program can cut costs by 25 percent, returning more than $5 for each $1 spent.

Wellness programs vary widely in scope, which makes it difficult to know how many businesses offer them and how much they save.

Some large companies, such as Union Pacific Railroad, spend millions on a wellness staff and workout facilities. Smaller companies may simply subsidize YMCA dues and hire health agencies to hold annual health screenings.

According to Kizer's Wellness Council of America, 2.25 million people work at “well workplaces” under the council's criteria, including about 160,000 employees at about 200 Omaha-area employers.

“More than ever before, the last three or four years it's been on the tip of everybody's tongue,” said Howie Halperin, executive director of the council. “Companies always are looking at health care costs and at the productivity part. Even if they have layoffs, they've got to keep the folks who are there as productive as possible.”

The employers of 65,000 other southeast Nebraskans are connected to WorkWell Inc. of Lincoln, a part of the Lincoln-Lancaster County Health Department that promotes workplace wellness.

“A lot of people are doing excellent things that aren't necessarily members of our organization,” said Lisa Henning, WorkWell executive director.

Last year, the National Network of Wellness Councils was formed, attracting employers of about 3 million people in 11 states. Criteria to qualify for a federal tax credit are being drawn up by the Centers for Disease Control, in case such a law passes.

“This is one piece of a big puzzle,” Henning said. “It's a part of health care reform.”

Union Pacific, one of four original Wellness Council members, estimated in 2000 that its program cut its health care costs by $40 million a year, more than making up for its $2.3 million annual budget.

Since then, the program has expanded and is so integrated into the company's operations that it's difficult to isolate the financial impact, said Jackie Austad, general director of health promotions.

The railroad company provides fitness centers or pays fees for employees at more than 600 facilities nationally. More than three dozen nurses at work sites oversee wellness activities, among other duties.

Its headquarters cafeteria posts nutrition and smoking cessation information. Other health-related activities, such as newsletters with such tidbits as how to make healthy fast-food choices, are under way regularly.

“It just becomes part of the culture, a way of thinking, a way of behaving,” Austad said. “That whole attitude becomes second nature to everybody. There are huge benefits to individual employees for improving their health, but we are a business and there is a business benefit, too.”

Bruce Lauritzen, chairman and CEO of First National Nebraska, said the banking company's wellness program is effective.

“We're definitely seeing some improvement,” he said.

Smaller companies can save money, too, although it's difficult to calculate because one employee's serious illness can overwhelm other employees' lower costs.

Greater Omaha Packing Co.'s wellness program cuts its insurance premiums by an estimated $4,500 for each of its 825 employees, said Vice President Kathleen Krantz, and improves its absenteeism and retention.

But the objectives of the meat packer's wellness program, which has “platinum” status under Wellness Council guidelines, go beyond money, she said.

“The most important thing is our employees' health,” Krantz said. “When people are engaged in taking care of themselves, you really end up with healthy, productive employees.”

Cassling, an Omaha company that sells medical equipment and services, started its program in 2001 after CEO Mike Cassling read a World-Herald article on rising health care costs. He sent a copy of the article to Lindsay Cosmino, vice president for marketing, with an attached note: “What are we going to do about this?”

Today, Cassling's $60,000-a-year program includes:

Ÿ $500 annual stipends to match health-related spending by employees who participate in the wellness program and have smoke-free households.

Ÿ Free fruit, vegetables, nuts, juice and other healthy snacks instead of vending machines.

Ÿ Discounts on monthly insurance premiums of $20 for single policyholders and $40 for families who participate.

Ÿ “Lunch and learn” sessions, annual health screenings and other regular events.

Cosmino said 94 percent of Cassling's 155 employees take part, and she attributes the company's low turnover in part to the wellness program.

Yet spending on wellness programs is a difficult decision for any CEO because it doesn't contribute immediately to revenue or profits, Mike Cassling said, but it does decrease costs overall.

“But if you don't have senior management's buy-in, pretty much nothing will succeed,” he said.

N.P. Dodge Insurance is among many insurance brokers that encourage wellness programs.

Shane Jacobson, vice president for employee benefits, said some clients try to control health care costs by switching insurance companies to get temporary new-client discounts, but don't take action to improve employees' health.

“If you don't change your population, you're going to run out of options,” said benefits manager Tracy Petersen.

N.P. Dodge has partnered with the College of Nursing at the University of Nebraska Medical Center to offer a program called Maximum Health Solutions.

Student nurses coach clients on wellness techniques. Employees take health assessments and are encouraged to follow up on the results with their physicians to maintain good health rather than waiting until problems arise, said Susan Beidler, associate professor.

Kizer, the Omahan who founded the wellness council, said it continues to gain strength.

“I think corporate America is looking for a way that they can hold down costs,” he said, “and it's a true desire on the part of people who just want to live a healthier life.”

Contact the writer:

444-1080, steve.jordon@owh.com

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