Employee wellness plans should include entire company, not just sick workers

A study of employees at a west Michigan hospital showed some of the most unhealthy workers that University of Michigan researchers had ever seen.

But in four years, the workplace wellness plan at Allegiance Health in Jackson, Mich. had fueled some of the biggest improvements in employee health that those same researchers had ever witnessed.

The researchers were studying the hospital system to evaluate the health risk changes in employees in the four years after Allegiance implemented a workplace wellness program. The "It's Your Life" program was unique because it included all employees, not just unhealthy ones, said Douglas Wright, a researcher at the U-M School of Kinesiology Health Management Research Center, and lead study author.

Most wellness programs start with a health assessment and only the employees who meet pre-determined benchmarks of poor health qualify for additional assistance, Wright said.

It's Your Life began in 2002, and Allegiance offered employees $200, spread over 24 paychecks, to take a health risk appraisal, be screened, attend three counseling sessions and complete three health learning modules. In subsequent years, the company lowered the incentive to $190 but gave it to employees in the form of a gift card that was filled with small amounts of money each time the employee completed another requirement. Having immediate access to the money earned, rather than waiting for it to show up in a paycheck, appeared to be associated with increased participation.

Researchers collected data from three different employee groups based on the number of times each participated. Over four years, participation increased and the number of high risk employees decreased in all groups, Wright said. The yearly participation rate rose from 38 percent the first year to 77 percent by the fourth year. After four years, the four-time participants decreased in 10 of 15 health risks, the two-time participants decreased in nine of 15 risks, and the one-timers decreased in 12 of the 15 risks.

"In the four-time participation group, the percent low risk people went from 51 percent to 64 percent, that's a huge jump," said Wright. "It's a big deal when you see that much improvement."

Allegiance started with 51 percent of its employees classified as low risk, which is much lower than normal, and 19 percent as high risk, which is above average, Wright said. The number of high risk workers fell to about 12 percent over the four years. Studies have shown that employees who are high risk cost more in healthcare and lost productivity.

One of the reasons the program was so successful was because it was comprehensive, said Dee Edington, director of the HMRC. Edington has appointments in the School of Kinesiology and the School of Public Health.

In other words, the program helped keep healthy workers from getting sick because it included them in the wellness plan, he said. "It's a lot cheaper to keep employees low risk than to move them from high risk to low risk," Edington said.

The project was designed to be implemented in three stages. The first stage uses Allegiance as the pilot to test the effectiveness of the wellness program. The second phase expands It's Your Life to six of the largest employers in the area, and the third stage expands the program to all employers in the county and any community organizations that want to participate.

A cost analysis is pending to see if the savings are great enough to justify the incentives and the cost of the wellness programs, said Wright.

The study appears in the Journal of Health & Productivity.