Long before it was trendy to host “walking conference calls,” serve fruit in the break room and offer quinoa in the cafeteria, Omaha companies were thinking about workplace wellness.
In 1982, Bill Kizer, CEO of Central States Indemnity at the time, reached out to CEOs at Union Pacific, Mutual of Omaha and Valmont. The four companies called about 50 prominent Omaha business leaders to a meeting, telling them to bring checkbooks.
The Wellness Council of the Midlands was formed. And for more than 30 years, WELCOM has been a one-stop shop for Nebraska companies looking to establish wellness programs.
Starting in 2014 under the federal Affordable Care Act, there will be new regulations and incentives related to company wellness programs.
Small businesses that meet certain requirements will be able to take advantage of a $200 million pool of grant funding for creation of wellness programs.
The law increases the reward that employers can offer workers who live up to wellness goals, now limited to 20 percent of the cost of health coverage. And businesses with group insurance that offer incentive-based wellness programs won't be able to discriminate based on certain medical conditions.
“Having any form of legislation to support companies in these efforts is positive,” said Rebecca Vinton Dorn, WELCOM's executive director. Nationally, Met Life found that 61 percent of companies with more than 500 employees and 29 percent of small businesses surveyed offered some form of wellness program.
“This is a potential growth opportunity for us ... (and) for businesses to incorporate specific programs that are results-driven but also to receive incentives on program implementation,” Vinton Dorn said.
Originally, WELCOM was a networking outlet, and business leaders would meet to discuss ways of making employees healthier — a forward-thinking concept considering many businesses at the time still allowed people to smoke in their cubicles.
Three decades later, employers find many reasons to pursue wellness programs, including the steady rise in their health insurance costs. A 2010 Harvard University study found that for every dollar spent on wellness programs, medical costs fell by about $3.27.
The Seldin Co. became a WELCOM member in January, and President Bob Dean said, “We have started to see an improvement in the reduction of overall health care claims.”
He said the company is analyzing data it has collected and creating a plan based on employees' risks. The company's Omaha headquarters offers a smoking cessation program, fitness reimbursement, various wellness challenges and a discounted insurance premium for employees who participate in health screenings and a health risk assessment.
Employees can attend Lunch & Learns and take the stairs — which were recently painted to encourage stair use instead of taking the elevator.
“Hearing about the successes and challenges of other companies provides a lot of useful information,” said Dean of its WELCOM participation.
More than 250 companies are WELCOM members, varying in size from three employees to the thousands that work for the state. WELCOM, a nonprofit, has four employees. Companies pay annual membership dues based on number of employees, ranging from $365 to $3,000.
The organization helps companies create a plan, puts them in touch with various health vendors, recommends programs, offers online tools and acts as a general go-to resource through the years.
WELCOM doesn't provide strict how-tos or a best practices manual — Vinton Dorn said each business is unique, so one company's successful program will look different from another's.
“We provide (companies) with a blueprint ... and provide them the tools and recourses to build a culture around wellness,” said Vinton Dorn.
WELCOM's strategy is based on what it calls the Seven C's — getting CEO support, creating a wellness team, collecting data, creating a plan, offering programs based on the data, creating a supportive environment and ultimately evaluating the program's success.
It could take from three to five years for a company to go through the steps and ultimately see an impact on the bottom line, Vinton Dorn estimates.
She said most companies make the mistake of jumping straight to step five. They schedule educational luncheons and health fairs but haven't collected any data to know if these are what employees want or need. Then only about 12 percent of companies actually measure how successful the programs were, Vinton Dorn said.
“(Companies) probably have more data than they realize, they've just never associated it with wellness,” she said, “... like satisfaction surveys or knowing how many prescriptions drugs their employees take.”
Vinton Dorn said it can take six to eight months to do a thorough job of collecting data, and it's not unusual for employees to be skeptical at first. “I think there's always questions whenever you're asking people to fill out surveys.”
But she said if businesses are transparent in their reasoning and reassure employees it's for their benefit, it eventually becomes the norm.
Through data, one business might learn that smoking is its biggest hurdle, while another might find employees are too stressed.
Gautam Gowrisankaran, a professor of economics at the University of Arizona, looked at workplace wellness and concluded that we have yet to prove what does and doesn't work.
Gowrisankaran tested an incentive-based wellness program with employees at a St. Louis hospital. The program targeted six main health concerns: high blood pressure, diabetes, heart disease, chronic lung problems, serious respiratory infections and stroke.
Results showed a large drop in hospitalizations for the six targeted conditions — good news — but increased costs for medications and outpatient visits. The study concluded it's not likely the program saved the hospital money.
But Gowrisankaran said results are about more than the bottom line.
“Cost of health care is just one aspect,” he said, “Are (employees) taking less sick days, less disability time, are they more productive at work?”
Gowrisankaran said one of the most important wellness initiatives companies can offer is a smoking cessation program.
Union Pacific has been part of WELCOM since day one and offers a full tobacco cessation program, including pharmaceuticals.
“We try to get them to quit smoking before all else,” said Marcy Zauha, director of wellness and safety at U.P.
U.P. also has an on-site gym at its downtown headquarters and, for those who travel or don't work from Omaha, the company pays for gym memberships. The railroad also offers one-on-one visits with nurses, telephone counseling with a health coach and online tools.
Looking at a sampling of employees, U.P. found that participants in the program saw a less than 5 percent increase in claim costs from fall 2011 to fall 2012. The increase in claim costs for nonparticipants was three times that.
Although U.P.'s wellness program is more established than most, it faces hurdles.
“As the baby boomers have started to retire, we're seeing a new group come in. The way they approach health and wellness is different than the people retiring today,” Zauha said.
To adjust, the company started offering more of its health resources online. The idea is to meet employees where they are.
Other organizations, like the Greater Omaha Chamber of Commerce, have a different challenge — money. The chamber consists of 47 full-time employees and a couple of part-timers and, with limited funding, it can't risk having unsuccessful programs.
“We conduct an annual interest survey and design programs and activities that meet those needs,” said Laurie Pieper, the chamber's human resources director.
The chamber books health speakers, offers a weekly yoga class and made vending machines healthier, all at no cost to employees. In a recent weight-loss challenge, a third of chamber employees logged 189 hours of physical activity and lost nearly 2 percent body fat.
The chamber, Union Pacific and Seldin are examples of the diversity WELCOM serves, and thus its challenge. “How do we provide services to companies across that continuum of budget, size, industry?” said Vinton Dorn.
Whether businesses are looking to save on health care costs or, as she puts it, to just do what's right by employees, it's a challenge that isn't going away. And WELCOM has carved a local niche for itself by providing support.
“We kind of grew up together through the wellness era,” said Zauha of U.P.'s connection to WELCOM. “They were always our benchmark, helping us to move to the next step.”
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