The Nutley, New Jersey-based health-care company was moving briskly in 1997to the chronic disease management and prevention markets. But an analysis of thecompany’s own health claims that year revealed Roche spent only 3 percent ofmedical-benefit dollars on preventive health measures for employees, even though39 percent of the health claims submitted to the company were the result ofpreventable conditions.
Steve Grossman, vice president of HR, recognized that Roche needed to matchits philosophy of disease prevention and management to its employee healthpolicy. "It’s my job to think about how I can align my HRresponsibilities here at Roche with our mission as a company," he says."At Roche, our business is not only to treat disease but also to preventrisk from becoming disease. We’re here to help people, and our employees arepart of that constituency."
Grossman maintains that while HR saw the potential to positively affecthealth-care costs by focusing on prevention, the primary concern was a healthierworkforce.
"We know that healthier employees have more energy, stamina, andcreativity, and therefore are more productive during their work hours and areabsent less," he says. "So a health program focusing on the mutualbenefits of prevention just made sense."
Working with a crossfunctional team of representatives from the finance,benefits, employee health services, legal, and public relations departments, aswell as the Roche Leadership Board, HR helped to shape a new program called"Choosing Health." HR seeks to provide employees with tools andresources to support healthy lifestyles.
The program includes such oft-neglected aspects of prevention as behaviormodification, health-care decision making, and chronic disease management.Choosing Health is managed by the employee health services department, whichoversees employee health benefits and which reports directly to Grossman in HR.
Individual needs dictate a customized program.
Choosing Health starts at the individual level by assessing employee healthrisks. Every employee receives a 76-item questionnaire within the first year ofemployment at Roche called the Health Risk Assessment (HRA).
A product of San Bruno, California-based independent health service providerStaywell Co., the HRA evaluates the employees’ health risks, self-careknowledge, preventive practices, health history, and current level of interestin health programs. The confidential questionnaire takes 15 minutes to completeand is analyzed by Staywell. A $25 charge for benefits costs is waived foremployees who complete and send in the questionnaire.
Results, in the form of a personalized health profile and health-improvementsuggestions, are sent directly to the employee’s home. No informationcollected for Roche is ever released to a third party, ensuring that employeedisclosures remain confidential. Roche HR receives only aggregated data showingrisks within the general population. HR then patterns preventive health programsafter the health risks and education needs of employees as a group. Ninety-threepercent of employees participated in the HRA in 1998, and 99 percentparticipated in 1999, giving HR a nearly complete picture of employees’ healthneeds.
The first HRA in 1998, for instance, showed that 35 percent of participantsran health risks because of a sedentary lifestyle. Sixty-three percent of thoseat risk expressed an interest in beginning an exercise program, and 48 percentsaid they were actually ready to start exercising.
Molly McCauley, director of wellness for Roche’s employee health services,explains, "Since exercise is a major factor in managing so many otherrisks, such as weight, blood pressure, cholesterol, and stress, we implementedan exercise reimbursement program to encourage employees to utilize companyfitness centers, or to help defray costs of their own individual efforts."
The incentive reimburses employees up to $100 a year for completing 100sessions at a fitness facility or in a group exercise program. Employees may useone of the fully equipped fitness centers at the four major Roche facilities, ormay choose another facility.
Today, 23 percent of HRA participants have reduced their health risks withregular participation in exercise programs. At the Nutley facility alone, 25percent of employees are now active members of the on-site fitness center.
Choosing Health provides routine on-site screenings for ailments that it isimportant to catch early, such as high blood pressure, high cholesterol, andbreast and skin cancers. The program also offers regular "Lunch andLearn" educational sessions on topics like men’s and women’s health,diabetes, arthritis, or whatever the assessment indicates is the greatestemployee need.
An estimated 50 percent of employees have attended on-site screenings andeducational sessions, "a very high percentage for programs of thiskind," says Grossman. "The great thing about having the HRA data isthat we can pinpoint what employees will be most interested in without violatingtheir privacy."
At the same time, the personalized nature of the HRA allows for targetededucation of employees regarding their own health risks. Regular reminders andreports about risk factors are sent to individual employees, along withsuggested action steps to reduce health risks.
Multimedia communication keeps employees informed.
Communication has been crucial in securing the success of Choosing Health."In shifting to prevention of disease, we had to make sure not only that wehad programs available but also that employees were aware of the programs,"says McCauley.
In fact, the various ways in which information reaches employees are asdiverse as the employee population. "We’ve found that employees like themultimedia approach to receiving information," says McCauley. So, inaddition to a guide on self-care from Staywell, employees receive a bimonthlyhealth newsletter and access to services that Choosing Health offers inpartnership with Rochester, Minnesota-based Mayo Clinic: HealthQuest, an onlinehealth information source, and Health Connection, which is a nurse-staffed24-hour health hotline.
Also, with the aid of focus groups and continuing satisfaction surveys, HR islooking at how best to communicate health information to employees. That’squite a challenge in such a diverse workplace, considering Roche boastsemployees in every field from research to sales, with education levels thatrange from high-school diplomas to Ph.D.s. "We have research scientists,computer programmers, drug developers, statisticians, M.D.s, public relationsand sales people, employees of many backgrounds -- a diverse group by anystandard," says Grossman.
McCauley adds, "But we understand this diversity and make sure to gettheir reactions and suggestions as to whether the information reaches themeffectively. If they don’t like snail-mail, we’ll send e-mail instead, butwe keep the flow of information constant. Through constant communication and theprinciple of repetitious learning, we’re always working to make ChoosingHealth the best program we can for our unique population."
The distribution of information and selection of programs seem to be workingfor employees. In a recent satisfaction survey compiled at the Nutley facility,85 percent of program participants indicated that they were satisfied or verysatisfied with on-site programs, 90 percent were satisfied or very satisfiedwith the company’s fitness center, and two-thirds reported that their workenvironment encouraged and supported healthy lifestyle behaviors. Thisencouragement has already translated into tangible results. Since 1998, theaverage lifestyle score has increased from 63 to 68 (100 is the optimal score),with corresponding decreases in health risks.
Built into the Choosing Health program is a stringent evaluation process todetermine its impact and outcomes. "In the long term, we’ll be looking atproductivity measures relative to the Choosing Health program," saysMcCauley. "We expect to see reduced costs in terms of time-loss andhealth-care costs within the next 5 to 10 years." Third-party data analysison a rolling basis ensures that the program keeps up with employee demands. AndHR continues to work with the Mayo Clinic to ensure that employees know aboutthe reliability of the health services offered.
McCauley and Grossman both agree that they see the benefits of preventionevery day in the feedback from Roche employees. "I’ve had employees tellme that just the ability to call the Mayo Clinic and ask for advice on healthissues has made all the difference," McCauley says.
One such example is Ron Gurzinski, public relations director, who says thatthe HRA and subsequent health suggestions were the catalyst for his ownlifestyle modification. Through the Choosing Health program, he has started aweight-control regimen that has resulted in his shedding several pounds.
Thanks to Choosing Health, explains Gurzinski, "I learned more about thekinds of health risks I had. Then Roche came out with [obesity-management drug]Xenical, so I knew the time had come to do something about my health because allthe elements for doing so were aligned."
This alignment of prevention and intervention with employee health is exactlythe goal of HR at Roche. The company now weighs in with a great prognosis forimproved employee productivity.
"Here at Roche, we take medicine from research to real people,"says Grossman. "It all comes back to the concept of mutual benefit, keepingprevention in the balance with the care we show our employees."
Workforce, April 2000, Vol. 79, No. 4, pp. 82-84 --Subscribenow!