Cost containment

If you’re like most small-business owners or managers, chances are you regularly lose sleep over the rising cost of health care.
But how much do your employees know about the vexing problems that keep you awake at night? In general, employees are unaware of the cost of providing health benefits. Nor are they aware of how their lifestyle choices are contributing to their health status.
Most Americans define health care in terms of access to and payment for medical services. Few think of health care in terms of "self care."
However, it is becoming unbearable for employers to provide the current level of benefits without asking the employee to share more of the responsibility. Companies can no longer afford to accommodate employees who do not make wise health-care decisions or who do not actively participate in their own health.
So, what will it take to get employees aware and involved? The answer for many employers is adding a health plan that offers more flexibility, but will require financial and personal responsibility on the part of the employee.
As that shift takes place, employees will need to make many changes to become more actively involved in selecting and using health-care services. The first – and most important – change will be for employees to become more conscious about the lifestyle choices that contribute to poor health status.
More companies are moving to onsite workplace wellness programs as a means of getting employees involved in lifestyle changes. Company-initiated wellness programs have been around for a long time, but they generally haven’t been successful since they are offered on a voluntary basis with only the most motivated employees participating.
The January 2004 issue of Health Promotion Practitioner pointed out that, "We need to stop clinging to an inaccurate view of reality. The most common mistake that health promoters make is thinking that because they care about health, everyone should. The true reality is that people care most about their health when they’re sick."
So pushing prevention for the sake of being healthy is usually the wrong message. It falls on deaf ears if the person is not actually sick at the moment, or unhappy about his or her weight, or concerned because a neighbor of the same age just had a heart attack. People live for today. They don’t relate to the heart attack that may happen in five years, or diabetes that may develop following several years of weight gain.
How can you encourage your employers to get involved in wellness programs in which you have invested time and money? We can begin by understanding that change is a process, not an event. Here are some suggestions for making this process go as smooth as possible:
Offer appealing, creative alternatives. Programs like 10,000 steps tracked with inexpensive pedometers for weight loss and massage therapy for musculoskeletal problems can be successful alternatives to the usual diet and exercise programs.
Address stress. Research is beginning to show that most disease issues are related to physical, emotional and mental stress. Recent studies attribute as much as 90% of physician visits to be for stress-related illnesses. Solutions can be workplace yoga, Pilates, meditation classes, and chair massages.
Repackage your employee assistance program. Most EAPs are grossly underutilized. Consider marketing your EAP as an onsite component of your wellness program, rather than an outside resource perceived by employees as treatment for mental health, alcohol or drug problems.
Banish the "food police." Instead of inducing guilt by dragging out weight charts and lecturing about the hazards of being overweight, get rid of the "food police" mentality. Focus instead on ways food can increase energy and decrease anxiety and depression by bringing more balance into our lives.
Offer something for everyone. "Traditionally companies offer their employees a health risk appraisal, and then they offer interventions for those at risk, while ignoring, or at least doing less for those with little or no risk," says Dee Edington, director of the Health Management Research Center at the University of Michigan. "It’s important to not only pay attention to those folks at high-risk, but also those with the potential to become high-risk and high-cost."
Use the Internet. Making information available at home or work gives employees the tools to take responsibility for their own health management.
Consider incentives. Another reality is that the majority of people will not participate in wellness programs and practices unless there is a financial incentive. Attaching cash or health insurance premium reduction to participation in health risk appraisals, lifestyle programs or wellness achievements can dramatically increase participation.
Finally, let consumer demand work to your advantage. As health insurance costs rise and employees require employees to pay higher deductibles and more out-of-pocket expenses, employees are becoming more discerning about the type, quality and effectiveness of the health care therapies they choose.
Company sponsored wellness programs and health benefits need to keep pace with current health care trends and technology. At your company, provide the right guidance so that this movement improves not only your employee’s health but also your company’s bottom line.
Connie Roethel, RN, MSH, is president of Complementary Health & Healing Partners (CHHP), a corporate wellness and health promotion services company with offices in Mequon. She can be reached at 262-241-9947.
April 30, 2004 Small Business Times, Milwaukee