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Special Report: Creating a Culture of Wellness Helps Companies Tighten Their Belts

Blue Shield of California’s Lodi office was famous for its daily potlucks. Call-center workers feasted every day on chips, dips, candy and other artery-busting foods. Unsurprisingly, 65 percent of them were overweight, and half of those workers were obese.

With the insurer’s health insurance premiums spiking, including a 27 percent increase in 2006, Blue Shield finally decided to practice what it preaches and implement an innovative, comprehensive corporate wellness program dubbed “Wellvolution.”

Five years later, the office is still famous for its potlucks. But workers have swapped Fritos for fruit. Even some cubicles, where employees once grazed on junk food, are now equipped with “walkstations,” which are treadmills that have phones and computers integrated into the machines. Employees are now literally working as they work out.

“Wellness needed a new way of addressing mind, body and spirit,” says Wellvolution director Bryce Williams. “Solutions were stale; they were unengaging, and individuals weren’t participating.”

While successful wellness initiatives can reduce health care costs and increase productivity, poorly implemented programs are simply a drain on company resources. In a country where obesity is a growing problem, wellness programs must be more than mere window-dressing to transform a culture steeped in bad eating habits.

One of the biggest hurdles for corporate wellness initiatives is getting employees to look beyond an “eight-minute abs” approach to better health and buy into programs that may not yield immediate results. “If getting healthy were easy, we would all look like Claudia Schiffer,” says Renya Spak, a principal in health and benefits at the consulting firm Mercer. “I think behavior change is really, really hard, and what is even harder is sustained behavior change. … Being the creatures we are, the biggest barrier is asking the ‘What’s in it for me?’ question. Why should I care and why should I change my behavior?”

     More than 72 million Americans suffer from obesity, which costs employers an estimated $130 billion a year in absenteeism, decreased productivity and short-term disability-related costs, according to separate research from the Centers for Disease Control and Prevention and McKinsey Quarterly. “As the country gets sicker, it’s going to come down to corporations to get the ball rolling,” says Lisa Menninger, a corporate wellness consultant based in Chicago.

A study conducted by Harvard University pegged wellness program returns at about $3.27 per dollar spent in reduced medical costs and $2.73 per dollar spent in reduced absenteeism costs. The report asserts that the adoption of corporate health programs could become invaluable for organizations looking to safeguard both their employees’ health and their finances.

Blue Shield is still in the process of measuring the effects of the initiative, but it projects that, over the course of three to five years, it will see a return of one to two dollars for every dollar invested in the Wellvolution program.

The carrot-and-stick approach is one of the most common wellness strategies. Companies frequently offer financial incentives or penalties to encourage participation in healthy-living programs. But some experts believe employers must think holistically.

Like Blue Shield, some companies are becoming more creative with their wellness strategies. From Biggest Loser-style weight-loss competitions to on-site health care professionals, employers are exploring more engaging and effective ways to motivate workers to change their ways.

Caesars Entertainment Corp., for example, isn’t gambling on employee health. The Las Vegas-based gaming company adopted a preventive wellness approach to diagnose at-risk employees before their disorders caused health care costs to hemorrhage. Full-time wellness pros dubbed “wellnurses” have been assigned to every Caesars property in the U.S., and Caesars dishes out financial penalties to employees who don’t undergo medical screenings and consultations. This can run as high as $20 to $40 extra per health insurance payment cycle. Employee participation in the program is running at about 80 percent, almost 30 percentage points higher than originally anticipated. Emily Gaines, a human resources vice president, says Caesars plans to introduce basic-care clinics on-site in the near future.

For Gaines, the wellness initiative is about more than just dollars and cents. “I love the success stories,” she says. “At our Joliet, Illinois, property, a gentleman underwent screening; it detected early-stage prostate cancer and now he is in treatment. We’re catching a lot of things early so even skeptics at the company are becoming convinced.”

A new chapter
Blue Shield of California also faced skeptical and unmotivated employees. So it decided to completely rewrite the book on wellness. The key was leadership engagement, says Cathy Murphy, vice president of human resources and Wellvolution co-founder. In April 2008, Blue Shield brought its Wellvolution programming to management at a three-day “be well to lead well immersion” in Southern California. Pulling in everyone who managed people statewide, Murphy and her team blended an eclectic mix of presentations and practical exercises. From tutorials led by David Simon, co-founder of the Chopra Center for Wellbeing, to group yoga sessions, Murphy was intent on showing management the value of “wellvolutionizing” employee health.

After three days, the retreat drew to a close with large orange Wellvolution-branded balls dropping from the ceiling to the cacophonous roar of a Wellvolution-styled version of Queen’s “We Will Rock You.” As the reworked lyrics—“We will, we will get fit” and “We will, we will not smoke”—filled the room, the rousing singing showed leaders that Wellvolution was not going to be a typical, humdrum HR initiative.

“It’s fun,” says Sharon Tate, an electronic data interchange manager at Blue Shield. “It’s trying to do something different, do something that’s good for you, but do it in a fun way.” Tate quickly signed up with a group of her peers to do the team-building Wellvolution Challenge, pledging to walk 50,000 steps per week for six weeks. She emerged a month and a half later 20 pounds lighter, having walked what she says is the equivalent distance of a round trip from her El Dorado Hills, California, office to Yosemite National Park.

The exercise challenge is just one strand in a larger web of programs that makes Blue Shield’s wellness initiative unusually comprehensive. The company offers a smorgasbord of health-related tests and solutions spanning the entire wellness spectrum. Wellvolution includes biometric testing, health coaches, farmers markets, healthy eating expos, on-site gyms, gym discounts, and “health day off” rewards for employees buying into the program. Participants also can get discounts on health insurance premiums.

One of Wellvolution’s slogans is, “We’ll meet you where you are,” a maxim aptly reflected in the “wellness wonder” walking workstation. After it was installed in the Lodi office last year, Blue Shield soon added the phone and computer-equipped treadmills at three other facilities. The workstation maxes out at 2 mph, allowing users to walk and work without sweating or sounding out of breath on the phone.

There are only two treadmills in Lodi for its 900 employees, so time slots are at a premium and workers are limited to 45-minute workouts. Currently, the University of California at Berkeley and Harvard University are conducting a 90-day study on the effectiveness of the workstations. That research is scheduled to be completed in May.

The workstations don’t come cheap. They cost “a couple thousand dollars each,” according to a Blue Shield representative. But research suggests that these machines can yield notable results. A 2007 British Journal of Sports Medicine article concluded that if time spent sitting at a desk were replaced with working and walking at only 1 mile per hour, energy expenditure would increase by 100 calories per hour.

While treadmill workstations might help employees in Lodi shed pounds, workers in other locations have different needs. As a result, Blue Shield rolls out such programs as Weight Watchers at Work and Freedom From Smoking meetings depending on the needs and receptivity of a particular office.

Williams stresses that Wellvolution isn’t just about fighting fat; it’s about full-body wellness that brings fitness to both mind and muscle. According to a 2010 Gallup worker satisfaction poll, the U.S. workforce is most dissatisfied with on-the-job stress, even more so than with salary or job security.

Recognizing that employee anxiety could affect the bottom line, Blue Shield devised its own way to beat, or rather bust, stress. Employee groups known as “stress busters” now take short breaks to play games and trade jokes. Other stress reducers include yoga, tai chi, on-site massages and “fiscal fitness,” a money management program.

Blue Shield also realized it had to provide more fruits, vegetables and other nutritious foods in its cafeterias. Indeed, a 2010 Gallup survey found that only 9 percent of U.S. employees say it’s easy to find healthy food at their workplace. But Blue Shield went beyond supplying better food. It also redesigned its cafeterias to encourage better eating habits. “As individuals we tend to go with the flow; we tend to take the first option available to us,” Williams says. “We’ve done a lot with food psychology and our cafeteria design so that health and wellness is actually right at your fingertips.”

Blue Shield structures its cafeterias to make healthy choices the most readily available as employees begin to fill their trays. Special labels designate the healthiest items and display nutritional information like calorie count and fat content. The company also prices its healthy offerings low enough to entice budget-minded browsers.

That isn’t to say the health plan provider is limiting its selection. “You can get a sugary or fizzy drink if you want; it just so happens you have to walk to the back of the cafeteria” to find it, Williams explains.

No time for a nutritious sit-down lunch? No problem. In a pilot program introduced at the company’s El Dorado Hills office, Wellvolution vending machine technology guides users through selections based on their individual nutritional specifications. Whether the employee is looking for organic fare or focusing on calorie or fat management, the machine acts as a personal dietitian as the individual navigates his or her way through healthier offerings.

As an added incentive to make eating healthier even more enticing, Blue Shield donates some of the vending machine proceeds to local charities.

“We really believe we can’t rest on our laurels,” Williams says. “We test new programs rigorously, and if it works, great, but if it doesn’t, we drop it off the map.” Guided imagery, a form of therapeutic mental visualization, and yoga were two programs that didn’t live up to expectations. The programs were scrapped as the company reinvested money in more engaging programming, like the walking workstations.

As it moves forward with Wellvolution, Blue Shield has lofty goals. “The rest of the country is fighting to hold the line in the battle against obesity,” Williams says. “We’re hoping to turn that around in the near future.”

Already, Wellvolution has yielded a 22 percent decrease in smoking and a 22 percent increase in regular physical activity, according to health assessment surveys conducted since 2008. Even more notable, Williams says, Wellvolution boasts an impressive 70 percent employee participation rate, including people like Tammy Ghirardelli. “I’m not one to sit at my desk,” says the claims processor at Blue Shield’s Lodi branch. “I like to move. I have to move.”

Workforce Management, April 2011, pgs. 26-28, 30Subscribe Now!