Firms pump up the wellness

As healthcare costs soar, employers create incentives to keep workers healthy.

St. Paul Pioneer Press, John Doman
SHOULDER STAND: Employees at Periscope in Minneapolis take a lunchtime yoga class as part of the marketing and advertising agency’s wellness program.

Thirty-nine people suspended for smoking. That might sound like a typical junior high school drama, but for the adult workers at Whirlpool in Evansville, Ind., it's a real workplace conflict.

The appliance company offers non­tobacco users a small bonus every year as an incentive to remain healthy. So when the management caught 39 people sneaking a smoke last month, they took issue with the employees apparently lying on official benefits forms to get the bonus.

"Falsifying company documents is a serious offense," read an official Whirl­pool statement, which added that the company's investigation is ongoing.

The incident at Whirlpool falls into a larger debate about how companies should implement employee wellness programs designed to mitigate the skyrocketing costs of healthcare.

Between 2001 and 2007, health insurance premiums rose 78 percent, according to a report issued in March by the Kaiser Family Foundation.

Many firms have found that getting their workforce into shape is much less expensive than paying for chronic health problems that result from tobacco use and weight issues. While a handful of companies have launched punitive programs, fining or even firing employees who fail to kick bad habits, many are achieving good results with incentives-based programs. Still, some worry that these policies turn the boss into Big Brother.

Programs grow stronger in number

Most companies with 5,000 or more employees have some sort of wellness program, and nearly half incentivize participation with rewards – monetary or otherwise, says Steven Aldana, CEO of WellSteps, a worksite wellness provider in Mapleton, Utah. Wellness programs can include anything from gym discounts to $1,000 annual bonuses for employees who stay fit and don't smoke. While these programs appeared sporadically just five years ago, now they're "exploding across the country," says Dr. Aldana.

For companies looking to maintain their profit margins, it may be a matter of literally cutting the fat. Doctors have linked obesity to costly chronic conditions, such as hypertension, diabetes, and heart disease. Someone with type 2 diabetes, for example, can cost a company up to $280,000 in medical bills before he or she retires.

Numbers like these have employers debating whether unhealthy choices by staffers should affect their share of the premium. "If you get in a car wreck then, trust me, your [insurance] rates are going to go up," explains Aldana. "So it's not like risk rating is new.... It just so happens that we don't do it in healthcare."

Although Lewis Maltby, president of the National Workrights Institute in Princeton, N.J., is sympathetic to cost concerns, he worries that overzealous wellness programs could raise ethical and privacy issues.

"No matter how you slice it, your employer is still penalizing you for behavior that has nothing to do with your job," he says. "And once you say that it's acceptable for employers to start regulating off-duty behavior, you've created a very dangerous situation."

Managers regulating em­­ployee diets and smoking could open a Pandora's box, argues Mr. Maltby. "People who have many sexual partners are at much higher risk than folks who are monogamously married," he says. "If it's OK to charge someone more for the company medical plan because they smoke, then it's just as fair to charge them more … because they don't practice safe sex."

A company stands firm on smoking

In many regards, Howard Weyers has edged his insurance company (Weyco Inc., now owned by Meritain Health) in that extreme direction, albeit without questioning his staff's love lives. For 15 months, he offered a variety of company-funded smoking-cessation programs, including yoga and acupuncture. After that, he fired anyone who hadn't kicked the habit. Only four of 24 smokers opted to quit their job instead of smoking. Now he no longer hires smokers.

In addition, Mr. Weyers's company healthcare plan does not cover injuries incurred through extreme sports like sky diving, bull riding, or snowmobile racing.

"I'm trying to protect the paychecks of my employees and the bottom line of the company, and I don't want to waste it in the healthcare system," says Weyers, now president of the Meritain Health office in Okemos, Mich. "If the employee wants to jump out of an airplane, that's fine, but it's at [his own] risk."

Though Heather Van Gulick, a senior reporting analyst at Meritain Health, had been trying to quit smoking when Weyers introduced the new policy, it made her want to rebel. "It's just one of those childish things that, as soon as somebody tells you that you can't do something, you're gung ho on doing it," she says. Still, Mrs. Van Gulick decided to seize the opportunity and is now happily a nonsmoker.

Most firms have backed off aggressive wellness policies. Clarian Health, a Midwest hospital group, made headlines last summer when it proposed a policy that would fine employees up to $60 a month for unhealthy practices, including smoking and being overweight. But after employee focus groups, it developed a rewards-based system, eliminating all penalties. Now, 92 percent of the company's 13,000 workers participate and can earn up to $720 a year for staying healthy. "When I heard the rumors of the fine, I felt like, that's kind of crazy," says Sheila Posey, a patient representative at Clarian. But the potential new program spurred her into action. Now she works out daily and has lost almost 40 pounds.

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