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Attachment 4 - Lecture notes 1-3

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Hist & Historians (HIST 300)

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40

DOI:฀10.1089/act.2013฀•฀MARY฀ANN฀LIEBERT,฀INC.฀•฀VOL.฀19฀NO.฀1฀฀฀ ALTERNATIVE฀AND฀COMPLEMENTARY฀THERAPIES FEBRUARY฀

Rising health care costs and the soaring incidence of chron- ic disease are just two of the health challenges faced by busi- nesses that are striving to prosper. To address these problems, employers increasingly turn to innovative wellness program- ming to improve their employees’ health and increase their bottom line. Improved research showing significant return on investment and healthy outcomes have fueled the corporate wellness movement. While the concept of corporate wellness is not new, what is new is that increasing research has demonstrated both the fis- cal and physical benefits of a well-designed wellness program. This article shares expert insights regarding the current state of corporate health–related challenges and reviews integrative programming that is helping businesses thrive.

The Problem

One of the biggest challenges facing corporations today concerns health spending. A 2010 Bravewell Collaborative Report reviewing the medical and corporate literature on the cost-effectiveness and efficacy of integrative medicine notes: “Nearly 60% of all after-tax profit is spent on corporate health benefits.” 1 The report states that “80% of those costs are spent on 10% of employees.” Emphasizing that prevention of disease is less expensive than treating disease, the authors of the report comment: “Nowhere is this more apparent than in corporate health care spending.” Kenneth R. Pelletier, PhD, MD(hc), a professor of medicine and director of the Corporate Health Improvement Program (CHIP) at The University of Arizona School of Medicine, in Tucson, comments on these challenges: “Larger companies may even be spending as much as 75% of their after-tax profits to meet the medical costs for their employees, dependents, and retirees. That is staggering. This spending goes toward employ- ees’ medical premiums, short-term and long-term disability, medical payments, and internal clinics and staff.” Pelletier states that small businesses have an extra challenge because they do not have the negotiating power of a very large company that has thousands of employees and can negotiate

for favorable benefits and reduced costs and premium ratings. “Large companies are paying less per worker per year for medical expenditures, whereas a small or intermediate-size employer does not have enough employees to negotiate,” Pel- letier says. He adds: “As a result, these companies are actu- ally paying a higher percentage of medical costs relative to the numbers of the companies’ employees.” Regarding the Bravewell statistic that 80% of the costs are spent on 10% of employees, Pelletier comments:

There is an irreducible risk in the workforce population. It may be 10% of the population, and, in some compa- nies, this number may be as high as 20%. But it consists of that group of people who are going to become sick, and we can’t avoid this scenario. Some individuals are going to have pregnancy complications, contract various diseases, or have heart attacks no matter what we do. Then, about a third of the workforce population has risks that are modi- fiable. If we modify those risks, we may avoid disease. The remaining part of the population is healthy, and we want to keep it that way. I believe it is important for corporate wellness programming to focus most intently on the pop- ulation with modifiable risk factors—intervene early and help individuals to make behavioral and pharmacological changes that will alter their trajectories, turning them to- ward health.

Don Hall, DrPH, CHES, founder of Wellsource, Inc., in Clackamas, Oregon—a pioneer in the wellness industry pro- viding innovative online wellness tools, consulting, and guid- ance to help businesses develop successful wellness programs— states that research shows that most of the devastating and very costly health problems are largely preventable through lifestyle changes. He comments:

For example, the Harvard Nurses’ Health Study found that, if people avoided all of the risk factors for type- diabetes, these people prevented 90% of all type 2 diabe- tes. 2 In other words, 9 out of 10 cases of diabetes could be prevented by living a healthier lifestyle. Yet, in every

Making the Case for Corporate Wellness

Jane Hart, MD

Interventions Benefit Employees and Bottom Line

41

ALTERNATIVE฀AND฀COMPLEMENTARY฀THERAPIES฀•฀FEBRUARY฀฀2013฀฀

MARY฀ANN฀LIEBERT,฀INC.฀•฀VOL.฀19฀NO.฀

company, 1 out of every 3 adults has prediabetes. One out of every 3 employees is obese. The majority of employees do not have regular exercise programs. Nearly half of all employees have blood cholesterol levels over the recom- mended upper limit for good health. One out of 3 adult employees has prehypertension. And we can go on with common statistics that we will find in every company.

Pelletier outlines additional challenges putting pressure on corporations today in terms of addressing both the health care needs of the companies’ employees and improving the compa- nies’ bottom line:

There are at least four global forces putting pressure on corporations today. One is that the workforce is shrink- ing in size because of downsizing and layoffs and a bad economy—more and more work is being done by fewer employees, and that puts a lot of strain on employees’ health. The second is the aging of individuals in the work- force, which means an increase in chronic diseases, such as obesity, metabolic syndrome, hypertension, chronic pain, cancer, and heart disease. The third is that, in the United States, medical care costs are much greater than in any other nation on earth, and those medical costs add to the cost of every product and service. This makes our ability to compete internationally much more difficult. Finally, the fourth and last big item is that the large companies in the United States are global, and the international nuances about how we maintain health for employees around the world are very different. For example, metabolic syndrome may be a problem globally, but, in the United States, it may be due to consum- ing too many white potatoes and, in China, it is from eating too much white rice. So, the risk factors are different in dif- ferent geographic regions, and companies are beginning to look at some of these issues to contain their costs globally.

While rising costs and illness may be the bad news, the good news is that the Bravewell Report emphasizes what so many experts are saying, and that is that preventive measures that focus on “strategies that support health and wellness, such as those found in integrative medicine lifestyle change programs, are successfully decreasing health care costs in corporations nationwide.” 1 Let us take a look at some of the research and initiatives that demonstrate the benefits of wellness programming.

Research

Today, most experts agree that the case has clearly been made in favor of the beneficial impact of well-designed well- ness programs on employee health and companies’ bottom line. Improved research methodology and increasing numbers of well-designed wellness programs have lent credibility to the field of corporate wellness.

Pelletier comments: “There are more than 200 studies that have been conducted since about 1974 looking at the results of interventions in worksites. Every single one of them has shown clinical effectiveness. About 90 of those studies have been evaluated for cost outcomes, and all of the studies except one demonstrated positive cost outcomes.” He concludes: “The data now are quite compelling that, when programs are well- designed, well-implemented, and sustained over time, they im- prove health and reduce costs.” One review, cited in the Bravewell report, examined 23 arti- cles that included 120 peer-reviewed studies of comprehensive health-management programs put in place by employers to decrease health care costs,3 The review showed that “in 2005, the employers experienced an average 26% reduction in health care costs and an average $5 returned for every $1 invested in worksite health promotion initiatives.” 1 Another study examining the benefits of workplace health promotion specifically looked at the clinical benefits and cost- effectiveness of a 6-month worksite health program utilizing cardiac rehabilitation and exercise training for patients with cardiac problems. 4 Participants in the study included 308 em- ployees and 31 spouses, who were randomly assigned to either: an active intervention, which consisted of worksite health edu- cation, nutritional counseling, smoking cessation counseling, physical activity promotion, selected physician referral, and other health counseling; or usual care. Health-risk status was assessed at baseline and at 6 months after the intervention. Total medical claim costs were obtained for all participants the year before and the year after the intervention. This study showed significant improvements in quality- of-life scores; behavioral symptoms, including a decrease in depression, anxiety, and hostility; body fat; high-density li- poprotein cholesterol; diastolic blood pressure (BP); health habits; and total health risk. The study authors report that 57% of employees categorized as high-risk at baseline were converted to low-risk status, and comment: “Average em- ployee annual claim costs decreased 48% for the 12 months after the intervention, compared with the control group, whose costs remained unchanged, thus, creating a sixfold return on investment.” While much of the corporate health research is initiated by health care professionals, Harvard health economists conduct- ed their own meta-analysis on costs and savings from well- ness programming and found that “medical costs fall by about $3 for every dollar spent on wellness programs and that absenteeism costs fall by about $2 for every dollar spent.” 5 The study authors comment that “the wider adoption of such programs could prove beneficial for budgets and productivity as well as health outcomes.”

Effective and Innovative Programming

Hall states that, for wellness programs to be effective, compa- nies need systematic, well-planned, and comprehensive programs that incorporate key elements to be successful. He comments:

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ALTERNATIVE฀AND฀COMPLEMENTARY฀THERAPIES฀•฀FEBRUARY฀฀2013฀฀

MARY฀ANN฀LIEBERT,฀INC.฀•฀VOL.฀19฀NO.฀

Conclusion

In terms of the future, Pelletier comments that he is very opti- mistic that there is a real shift now in the corporate world from emphasis not only on particular programs and interventions but also on creating a “culture of health.” “There is an expectation on the part of the company that health is something good for the workers, good for the company, good for the bottom line, and this awareness is only going to increase,” Pelletier says. In fact, the Bravewell Report suggests that well-designed wellness programs should include “a strong culture of health,” which includes “environmental interventions, such as modifi- cations to the cafeteria and vending machine options.” 1 Hall also comments on creating a “healthy culture” at the worksite:

While individual changes are important for any effective wellness program, so is creating a healthy environment at the worksite, such as providing access to healthy foods and less access to junk foods, policies for healthy meals at all company functions, flexible time for exercising at work, ac- cess to facilities or onsite equipment to be more active, bike racks and showers, walking courses nearby, policies that en- courage healthy family life, etc. One of the greatest forces for changing behavior is to make the environment in which we work one that fosters good health habits not poor ones.

In terms of the future, Hall states that he would love to see every company provide a well-planned, comprehensive well- ness program that is effective for helping people achieve their full potential of health—physically and mentally. He would like a program that helps prevent the major chronic diseases that are so devastating, such as diabetes, obesity, cancer, heart disease, anxiety, and depression. “One of the best trends that I see today is companies that integrate incentives for participating in their wellness program into the employees’ portion of their health care insurance pre- mium,” Hall says. “Employees who participate and are show- ing progress may pay $50–$100 a month less for their portion of health insurance. What this does is increase participation rates from a typical 20%–30% of employees to 80%–90% or more. That should be the goal of every organization; if one re- ally expects to see major reductions in health care cost for the whole company, one needs everyone participating.” Hall reports that companies that have done this find that, for every dollar they invest in wellness, they may save $3–$

in decreased expenses and improvement in productivity. While the number of businesses providing some form of employee wellness programming has been increasing, Hall calls for fur- ther action on the part of American businesses, which may benefit us all:

We need to improve the health of our nation and reduce the overwhelming costly medical care that is burdening every business in America. We need leadership and com- mitment from every company to design wellness pro- grams that will begin to meet these needs. The good news is that if we do this, everyone will benefit—the employee with better health and a longer life, the business with low- er medical-care costs and increased productivity and less work time lost, and the nation, because we become more productive and competitive in the world market. We will never go wrong by investing in the health and productiv- ity of our workforce. n References

1. Guarneri M, Horrigan BJ, Pechura CM. The efficacy and cost-effectiveness of integrative medicine: A review of the medical and corporate literature. A Bravewell Collaborative Report. June 2010. Online document at bravewell. org/integrative_medicine/efficacy_cost/ Accessed November 7, 2012. 2. Hu FB, Manson JE, Stampfer MJ, et al. Diet, lifestyle, and the risk of type 2 diabetes mellitus in women. N Engl J Med 2001;345:790–797. 3. Serxner S, Gold D, Meraz A, Gray A. Do employee health management programs work? Am J Health Promot 2009;23:iii,1–8. 4. Milani RV, Lavie CJ. Impact of worksite wellness intervention on cardiac risk factors and one-year health care costs. Am J Cardiol 2009;104:1389–1392. 5. Baicker K, Cutler D, Song Z. Workplace wellness programs can generate savings. Health Aff (Millwood) 2010;29:304–311. 6. Hall D. 6 Key Steps to a Successful Wellness Program. Wellsource, Inc. Online document at wellsource/site/download/asset/16/22/92/ d74a25beda67df14bbcf09fd655f9 Accessed December 26, 2012. 7. Kimbrough E, Lao L, Berman B, et al. An integrative medicine interven- tion in a Ford Motor Company assembly plant. J Occup Environ Med 2010; 52:256–257.

Jane Hart, MD, is a clinical instructor in internal medicine and chair of the Integrative Medicine Committee at Case Western Reserve University School of Medicine, in Cleveland, Ohio.

To order reprints of this article, e-mail Karen Ballen at: Kballen@liebertpub or call (914) 740-2100.

Copyright of Alternative & Complementary Therapies is the property of Mary Ann Liebert, Inc. and its content

may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express

written permission. However, users may print, download, or email articles for individual use.

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Attachment 4 - Lecture notes 1-3

Course: Hist & Historians (HIST 300)

29 Documents
Students shared 29 documents in this course

University: Indiana State University

Was this document helpful?
40
DOI:฀10.1089/act.2013.19105฀•฀MARY฀ANN฀LIEBERT,฀INC.฀•฀VOL.฀19฀NO.฀1฀฀฀ALTERNATIVE฀AND฀COMPLEMENTARY฀THERAPIESFEBRUARY฀2013Rising health care costs and the soaring incidence of chron-
ic disease are just two of the health challenges faced by busi-
nesses that are striving to prosper. To address these problems,
employers increasingly turn to innovative wellness program-
ming to improve their employees’ health and increase their
bottom line. Improved research showing significant return on
investment and healthy outcomes have fueled the corporate
wellness movement.
While the concept of corporate wellness is not new, what is
new is that increasing research has demonstrated both the fis-
cal and physical benefits of a well-designed wellness program.
This article shares expert insights regarding the current state
of corporate health–related challenges and reviews integrative
programming that is helping businesses thrive.
The Problem
One of the biggest challenges facing corporations today
concerns health spending. A 2010 Bravewell Collaborative
Report reviewing the medical and corporate literature on the
cost-effectiveness and efficacy of integrative medicine notes:
“Nearly 60% of all after-tax profit is spent on corporate health
benefits.”1 The report states that “80% of those costs are spent
on 10% of employees.” Emphasizing that prevention of disease
is less expensive than treating disease, the authors of the report
comment: “Nowhere is this more apparent than in corporate
health care spending.”
Kenneth R. Pelletier, PhD, MD(hc), a professor of medicine
and director of the Corporate Health Improvement Program
(CHIP) at The University of Arizona School of Medicine, in
Tucson, comments on these challenges: “Larger companies
may even be spending as much as 75% of their after-tax profits
to meet the medical costs for their employees, dependents, and
retirees. That is staggering. This spending goes toward employ-
ees’ medical premiums, short-term and long-term disability,
medical payments, and internal clinics and staff.”
Pelletier states that small businesses have an extra challenge
because they do not have the negotiating power of a very large
company that has thousands of employees and can negotiate
for favorable benefits and reduced costs and premium ratings.
“Large companies are paying less per worker per year for
medical expenditures, whereas a small or intermediate-size
employer does not have enough employees to negotiate,” Pel-
letier says. He adds: “As a result, these companies are actu-
ally paying a higher percentage of medical costs relative to the
numbers of the companies’ employees.”
Regarding the Bravewell statistic that 80% of the costs are
spent on 10% of employees, Pelletier comments:
There is an irreducible risk in the workforce population.
It may be 10% of the population, and, in some compa-
nies, this number may be as high as 20%. But it consists
of that group of people who are going to become sick, and
we can’t avoid this scenario. Some individuals are going to
have pregnancy complications, contract various diseases,
or have heart attacks no matter what we do. Then, about a
third of the workforce population has risks that are modi-
fiable. If we modify those risks, we may avoid disease. The
remaining part of the population is healthy, and we want
to keep it that way. I believe it is important for corporate
wellness programming to focus most intently on the pop-
ulation with modifiable risk factors—intervene early and
help individuals to make behavioral and pharmacological
changes that will alter their trajectories, turning them to-
ward health.
Don Hall, DrPH, CHES, founder of Wellsource, Inc., in
Clackamas, Oregon—a pioneer in the wellness industry pro-
viding innovative online wellness tools, consulting, and guid-
ance to help businesses develop successful wellness programs—
states that research shows that most of the devastating and very
costly health problems are largely preventable through lifestyle
changes. He comments:
For example, the Harvard Nurses’ Health Study found
that, if people avoided all of the risk factors for type-2
diabetes, these people prevented 90% of all type 2 diabe-
tes.2 In other words, 9 out of 10 cases of diabetes could
be prevented by living a healthier lifestyle. Yet, in every
Making the Case for Corporate Wellness
Jane Hart, MD
Interventions Benefit Employees and Bottom Line

Students also viewed

Related documents