In fact, she received several calls—enough to convince her that she needed to contact her doctor before the weekend. Her physician immediately admitted her to the hospital.

"If the health coach hadn’t done that, who knows what would have happened," says Al Rapp, benefits manager, corporate human resources for UPS.

The coach is part of Healthy Connections, Informed Choices—a program the company established in April. Available so far to 90,000 of UPS’ more than 407,000 employees, the initiative gives participants access to someone who will take a holistic view of their health and help them navigate care options.

"People are confused very often by the whole health care system," Rapp says.

UPS persuaded its health care providers to collaborate on the program. The effort involved Aetna, UnitedHealthcare, Cigna and Blue Cross/Blue Shield, as well as companies that supply pharmaceutical, behavioral and disability services.

Two big databases hold a wide range of information about UPS plan participants. The information has been gleaned from medical, disability and workers’ compensation claims, pharmaceutical prescriptions, health risk assessments and demographic surveys. Towers Perrin constructed the databases for UPS.

Aetna and UnitedHealthcare each manage one of the databases. Health coaches sift through the information and contact people who are at high risk—or are heading in that direction. The program is voluntary, and UPS stresses that it is not looking over the shoulders of its employees or nudging them to get help. "It’s between you and your health coach," Rapp says.

The coach, usually a nurse, might recommend a doctor, facilitate a hospital visit or discuss lifestyles. The coach goes beyond the participant’s health and becomes familiar with his or her life.

"It puts that nurse in a position to reach out to the whole family," says John Price, Aetna marketing vice president for national accounts in Atlanta. "Thinking outside the box—that’s what health coaches are trained to do." Coaches can be creative because they have at their fingertips a detailed health profile drawn from many data sources.

By virtue of its size, UPS is forcing vendors to work together to provide "horizontal integration of programs and services," says Sue Willette, national health and productivity management leader at Mercer Human Resource Consulting.

Integrating data to develop employee health programs is "an evolving approach," Willette says. UPS, Pepsi and Tyco International are at the forefront. "They’re leading the way," Willette says. "They’ve got the leverage to define the business requirements to vendors."

So far, UPS is not demanding that its employees shoulder more of their own health costs. Those who work as little as 15 hours a week are eligible for health benefits 30 days after they join the company. UPS spends $2.4 billion annually on health care.

And, thus far, UPS has not turned to high-deductible health plans or health savings accounts. "Our philosophy is not to cost-shift," Rapp says. "The answer lies in consumerism, good choices (and) wellness. There’s not a simple or quick fix."

—Mark Schoeff Jr.