BUSINESS INSIGHTS | FALL 2011 EFFECTCase Study:
A Wellness Program in Action
by Kevin KirschInternational Cruise & Excursions, Inc. (ICE) is an 825-person call center at which agents earn a base of $10/hour but can move well into six figures based on sales commissions. But finding success can be difficult. Outbound sales average about 1 percent, making the call center a high-pressure, stressful environment. Marnie Zei, ICE’s executive director of human resources, noticed rising health insurance claims and raised the question: what can we do to help prevent these claims? She shared her insights about ICE’s wellness program with EFFECT.
How did your program originate?
In 2006, we started looking at where our claims and costs were coming from, and they were lifestyle related—lots of muscular skeletal claims with the neck and back, and we had diabetes and obesity related concerns, too. These are problems that can arise when you are stressed. But they aren’t chronic diseases; all of these can be fixed. So we tried to attack those—help people reduce their stress levels, start exercising, and get them to think about what they eat.
What did you do?
Instead of dealing with stress by sitting in a smoking area, we provided other options. We opened a fitness center with personal trainers and massages. And we subsidized the cost. We added healthier options in the cafeteria and added an on-site health clinic staffed by a nurse practitioner (NP).
The NP has been especially beneficial. Employees value the NP's clinic because they don’t need to take time off to check for basics like strep throat. There is no co-pay, and the clinic is in our health plan and won’t prescribe a drug that isn’t covered.
For skeptics of such programs, what’s the bottom line value?
Since it’s hard to determine if your efforts are saving someone from having a stroke in the future, it’s hard to know what your return on investment is. But we compare the visits to our clinic to Blue Cross Blue Shield (BCBS) benchmarks, and we’ve found that we’re spending a whole lot less than the benchmarks on clinic, urgent care, and ER visits. Our NP is taking a lot of the fever and sore throat complaints, which keeps trauma at the ER, so we’re not paying for ER services for a sore throat walk-in.
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Why do you think your wellness initiative has been successful?
Part of the success hinges on our educational component. People may not know they are borderline diabetic, so we offer quarterly wellness lunch and learn sessions.
We also provide incentives on medical insurance. Employees can get $20 off their health insurance premiums if they meet 2011 blood pressure and BMI thresholds, and if they sign an affidavit agreeing to abstain from tobacco products. Our nurse practitioner gathers the lab work and HIPAA ensures that HR doesn’t know anyone’s individual results, just whether they are hitting their blood pressure targets (and other measurement points) to qualify for a premium reduction.
How does it work?
People sign up during annual enrollment and about 100 of the 600 who enroll in health insurance are participating in the incentive. They complete their health risk assessment online through BCBS, and we don’t get individual results, just group results (e.g., “55 percent of participants smoke”). We had to do a lot of education to make sure employees knew HIPAA prevented us from seeing their personal results.
What do employees say about it?
They think the clinic is phenomenal. They like the mobile on-site mammograms and the nail salon, which we call “the spa.” They also like incentives. For instance we have a walking club, and BCBS gave us Diamondback baseball tickets for participants. Everyone got a pedometer and a chance at the tickets. It went on the honor system, but people seemed to like it.
We also market wellness as a benefit, and we received an award from the Arizona Wellness Council. So it can also attract job candidates. But it’s as much about cost savings for us as it is a benefit for employees.
What are your goals?
We’re trying to help employees see that we’re all in this together ... that if we’re all healthier, the claims will stay lower.
I get emails from our people grumbling about health care costs. Statistics show that 80 percent of health care is basic lifestyle stuff, wearing a seatbelt, eating right, getting exercise, and so on. So we’re trying to help employees see that we’re all in this together; that the cost sharing is carved in stone and that if we’re all healthier, the claims will stay lower. We had a bad year last year because of big claims. We can change that—together.
What advice do you have for an organization that is considering wellness offerings?
Look at where your costs are coming from and try to attack it that way. If you figure that out, you can attack it. And an easy way to start that investigation is to look where your claims are coming from.
Also, set up a program that works for your type of organization and setting. We considered having a bike-to-work incentive. But Phoenix is so sprawling that it doesn’t make sense. Also, wellness offerings can require a monetary investment, and it can be hard to convince management to give money to such a program. So make sure you have buy-in.