No Smokers Allowed, Higher Premiums for Overweight Individuals, Mandatory Blood Pressure Tracking . . . These are Just Some of the Wellness Initiatives Employers are Implementing in an Effort to Combat Rising Health Care Costs

Employers across the country are making headlines with the methods they are employing to reduce health care costs and improve the health and productivity of their employees.  

• Tobacco-free hiring policies will apply at the Hollywood Casino in Toledo, Ohio, when it opens later this year, according to a January 6, 2012 article in USA Today. Likewise, the Geisinger Health System in Danville, Pennsylvania begins its nicotine-free hiring next month.  The article also reports that Idaho's Central District Health Department voted last month to stop hiring smokers.

•  In November, the Richmond Times-Dispatch reported that Bon Secours Richmond Health System will no longer hire employees who test positive for nicotine during pre-employment screenings.

• The Cleveland Clinic takes wellness very seriously as reported by Ezra Klein’s WONKBLOG in the Washington Post on October 16, 2011. Having instituted wellness initiatives as far back as 2005, the clinic now tracks its employees’ blood pressure, lipids, blood sugar, weight and smoking habits. Employees with abnormal results are required to take steps to get their health issues under control or lose insurance rebates.  

• Similarly, the Dallas Business Journal reported on September 22, 2011 that starting on January 1 of this year Baylor Health Care System won’t hire anyone who uses nicotine.

• Even the government is looking at wellness incentives as a way to save money.  In April 2011, the Wall Street Journal reported that Arizona’s governor is proposing a $50 fee on smokers and on obese enrollees in the state's Medicaid program.

With a health crisis looming, both in terms of money spent on health care—premiums have risen 131 percent since 2001 according to the Kaiser Foundation—and in the increasing health issues facing Americans—if Americans do nothing to improve their health, it is projected that by 2023 there will be a 42 percent increase in cases of the seven chronic diseases and a whopping $4.2 trillion in treatment costs and lost economic output—what is an employer to do?

Many employers that roll out wellness programs provide incentives for participation, such as gift cards or cash prizes.  While this may still be the case in the coming years, you may also see more employers moving forward with a stick approach.  I expect that in an effort to save money on escalating insurance costs, many companies will tie health insurance premiums and rebates to participation in personal health assessments, screenings by doctors, maintaining a healthy weight, keeping pre-existing medical conditions under control and steering clear of nicotine products. 

The Cleveland Clinic is a prime example of how well this approach can work.  Since 2005, their workforce has lost a collective 250,000 pounds, blood pressure has been reduced, smoking has declined from 15.4 to 6.8 percent of employees, and health care costs are down.

Has your company instituted penalties for unhealthy workers?  If so, what have you done and what are the results?  If you have not yet taken these steps, are you considering do so?

The Wellness Workdays Team is here to help your employees give up smoking forever! Freshstart® is a group-based tobacco cessation support program offered by the American Cancer Society. The Coaches / Certified Cessation Counselors at Wellness Workdays are trained to help your employees plan a successful quit attempt by providing essential information, skills for coping with cravings and group support. For more information and to get started, visit www.wellnessworkdays.com

 

Health Risk Assessments: Only a Piece of the Puzzle

You may have been asked to take a Health Risk Assessment (HRA) or Personal health Assessment (PHA) or you may be the one putting forth the policy at your organization—either way, by now most employees and employers are familiar with Health Risk Assessments. According to the National Survey of Employer-Sponsored Health Plans, conducted by Mercer in November 2011, more than 70% of large employers and 34% of smaller employers offer Health Risk Assessments to their employees.

A recent article in Employee Benefit News, Companies find health risk assessments a waste of time, money is based on a survey of 25 large employers (3,000 to 300,000 employees) and only tells part of the story. The HRA can be very effective if used as part of a comprehensive wellness plan.

It’s important to note that an HRA is a tool that evaluates employee health risks. It cannot replace screenings for conditions such as cholesterol, high blood pressure and diabetes; and it cannot provide a health diagnosis. It is designed to identify risk factors and should be used in conjunction with health screenings and other initiatives.

The HRA is not a one-time tool—it needs to be administered periodically so that employees can monitor and track their progress. Used in isolation, an HRA is not enough for employers to realize a reduction in health care costs. Used in combination with other measures, the HRA is a key component in developing a comprehensive wellness program and offers significant benefits for both individuals and their employers.  

Individual Benefits Derived from an HRA

•  Identifies health risk factors
• Raises awareness of risks and the consequences of not making positive health changes
• May prompt employees to seek additional screenings (cholesterol, high blood pressure, diabetes, etc.
• Allows employees to monitor their health risks over time
•  May prompt employees to adopt healthy behaviors thereby reducing health risks

Organizational Benefits Derived from an HRA

• Identifies employee health risk factors, including preventable health risks
• Measures absenteeism and presenteeism
• Can predict health care costs
• Provides insight into employees’ willingness to change 
•  Identifies health needs/risks that can be used to design a wellness program
• Monitors employees’ health and changes in health risk status
• Measures the success of wellness programs by comparing data from year to year  
• Identifies moderate or high risk individuals for referrals to specific programs or carrier intervention such as  a disease management program
• Controls health care costs
  

To be effective the HRA data must be reviewed, evaluated and acted upon. Determine which health risks are most prevalent in your company and design the components of your wellness program accordingly. Integrated into a wellness initiative, the HRA is the cornerstone of a successful, behavior change programs.

Staying Healthy: Tips for surviving the holiday season

by Megan Miraglia, MS, RD, LDN
WW Account Manager

Holiday season has officially begun. Decorations are out, radio stations are buzzing with holiday music and you may be stressing out about surviving another calorie loaded and germ induced holiday season. With the right tools of healthy eats and stress busting physical activity, you won’t only stay healthy and manage your weight this holiday season, but will ring in the New Year with a fruitful start.

Get moving.

Have a plan to incorporate physical activity into your day and stick to it. Plan ahead and pencil in a walk, trip to the gym or hike into your planner. Value the time you set aside to exercise as you would an appointment with your boss.  Physical activity will power you through the holidays with more energy, rev up your metabolism, stomp out stress and improve overall health. Enlist a friend, co-worker or family member to help you stay on track and add some social fun to your exercise.

Eat right.

Try incorporating these 5 super foods into your diet to provide you with the right nutrients to fight off colds, holiday stress, stay energized and prevent overeating to ward off that extra notch on your belt loop.

1. Vegetables – Try incorporating more vegetables into soups, stews, chili’s, and casseroles. Have a platter of fresh, cut-up vegetables on hand in the fridge for a quick snack to help you reach your heath goals.
2. Beans – Beans are full of fiber to keep you full longer, improve heart health, reduce cholesterol levels and provide necessary b-vitamins to help boost energy levels.  Try a 3-bean soup, black bean chili, or Indian dahl with lentils. Experiment with different sides dishes for your next social get together.
3. Fish – Load up on omega-3 fatty acids to incorporate more healthy fats, reduce cholesterol levels and keep skin glowing. Try serving omega-3 rich salmon, tuna or haddock instead of the usual saturated fat loaded red meats like steak or roast beef at the holidays.
4. Fruit – Reap the benefits of all the vitamins, minerals and antioxidants found in brightly colored fruit by topping your morning cereal, oatmeal, toast or bagel with cut-up fruit. Serve fruit for dessert this holiday season. Try an angel food cake trifle with vanilla Greek yogurt, cinnamon and fresh berries or oranges.
5. Yogurt – Add extra calcium to your routine to maintain bone health, heart health and manage weight. Try replacing dips and sauces that call for sour cream with unsweetened, plain, Greek yogurt. Top your salmon with a dollop of dill infused Greek yogurt for added flavor with a calcium boost.

One final tip: listen to your body. It takes 20 minutes for your stomach to signal your brain that it’s full. Think that extra serving of mashed potatoes or slice of pie is calling your name? Wait 15 -20 minutes by sipping on some water, chatting with another guest or circulate around the room. Still feeling the urge for an extra helping? Go for a lower-calorie option such as vegetables, salad or fruit.

Enjoy the delicious holiday foods in moderation and remember to bring the focus back to the people and relationship.

The Benefits of Eating Locally

The widespread recalls of spinach, peanut butter, turkey and cantaloupe in recent years are prompting more and more individuals to question where and how their food is grown, raised and harvested. There are some startling facts about the nation’s food consumption that have prompted a nationwide movement to eat locally produced food:

• Each food item in a typical U.S. meal has traveled an average of 1500 miles

• If every American ate just one meal a week composed of locally and organically raised meats and produce, we could reduce the nation’s oil consumption by more than 1.1 million barrels of oil every week

While the environmental impact of food consumption is certainly a good reason to think about changing your buying habits, it is not the only reason to eat locally. If you have ever eaten a tomato fresh from the vine, a succulent peach plucked from a tree or asparagus on the day it is harvested, you know that local food is fresher and tastes better than mass-produced food available at your local supermarket.

Just as importantly, there is less chance of contamination when buying local foods as there are fewer steps between your food's source and your table. Local food is also less likely to contain chemicals. Even if a local farm is not certified organic (and many are not due to the cost), small farms tend to be less aggressive with chemicals and often practice sustainable farming—a method of raising food that is healthy for consumers and animals and does not harm the environment. 

Local farms also offer more variety than supermarkets.  How often do you eat tomatoes with names such as the Arkansas Traveler, Black Krim or Golden Egg?  Have you ever eaten Purple Majesty, Mountain Rose or Yellow Fin potatoes? In addition to being delicious and packed with nutrients, the crop variety produced by local farmers helps preserve a wide agricultural gene pool, which is an important factor in long-term food security. Shopping locally allows you to build and support your local economy and preserve green space and farmland. You benefit by knowing where your food comes from and being connected to the individuals who grow the crops, raise the animals, farm the honey and bake the bread.  There are many resources on buying food locally—from sites on food co-ops to farmer’s markets to lists of CSAs —community supported agriculture (which allow you to buy a share in a farmer’s crops and received produce weekly). Depending on where you live, like the less temperate Northeast, you may think that eating locally and seasonally is difficult, but this does not have to be the case.  There are many online resources for eating locally in any season.  A number of farmer’s markets are also staying open all winter long and there are many cookbooks that feature recipes based on the ingredients that are in season in your area.

On November 21, 2011, Nancy Stewart will have an article in the Boston Globe on a related topic. Check out her article for some additional insights from myself and other wellness experts. Thanks!

Additional resources: 

List of Massachusetts winter farmer’s markets

Finding the Food to Fill MyPlate

The MyPlate image, released by the United States Department of Agriculture (USDA) this past summer, is the current gold standard for eating within the United States. The plate is divided into 5 categories by food group, including dairy, fruits, grains, vegetables, and protein. Although there was controversy following the plate’s release, from questions as to why animal protein is seen as equal to plant-based protein or why grains weren’t defined as “whole” versus “refined,” the overall message of the plate is clearly to encourage greater consumption of fruits and vegetables.

However, there is another pressing issue that was raised in response to this new standard: do we have enough food to make it a reality? In the United States, we produce 4 highly subsidized crops: corn, soy, wheat, and cotton. Unfortunately, I’m not referring to corn on the cob. These four crops are not made for human consumption, but instead for animal feed and processed foods. Fruits and vegetables on the other hand, are considered “specialty crops” and therefore are not subsidized by the U.S. government.

So, what do you suppose would happen if every American man, woman, and child adopted the MyPlate style of eating? You guessed it – experts cite that we won’t have the fruits and vegetables to feed everyone. While the messaging for a healthy diet is provided, the access is still a challenge.

This isn’t a new issue, in fact, it was the first comment made by many professionals in the field of nutrition upon the release of the MyPlate icon. But I bring this up now because of the unprecedented circumstances that we find ourselves in. For the first time, a Super Committee has been formed to determine how we can cut substantial funding from the national budget. A large portion of this is being targeted at the Farm Bill, the legislation that controls crop subsidies.
 

Secretary of Agriculture Tom Vilsack recently spoke on this very issue:
"Over the past 60 years, yields per acre of major crops -- corn, soy, wheat, and cotton -- have doubled, tripled, and in some cases even quadrupled. At the same time, livestock production and specialty crop production have become far more efficient. […] Congress must find ways to support research that is focused on crop production and protection, on livestock production and protection.”

While specialty crops may have become more efficient, they certainly have not “doubled, tripled or quadrupled” the way that subsidized crops have, mainly because there is no incentive to grow them. While Secretary Vilsack is correct, funding for research is needed, there must also be consideration for reducing subsidies for the foods we are looking to reduce, and increasing them for the foods we are looking to increase…namely whole grains, beans, fruits and vegetables. Consider this – last year, the U.S. spent $5.97 billion on subsidies (for corn, soy, wheat and cotton, etc.) whereas the American Heart Association spent $724 million (’07-’08 figure) to promote heart health and prevention. If we spent as much money on preventing diseases of lifestyle caused by a highly processed diet, we might be headed in the right direction.

How Skipping the Doc Can Cost You Money

There are a million different excuses for skipping out on regular doctor’s appointments. A packed calendar, overbooked physicians, and a plain lack of desire to sit in that waiting room for an extra hour all top the list, but there is a new reason that people are cutting back on health care: cost.

Results recently published by Consumer Reports found that 48% of individuals were skimping on medication and other forms of health care, a 9% increase from last year. Additionally, 48% of people taking a prescription medication either delayed a doctor’s appointment, procedure, or medical test to save money. Within that group, 28% of individuals said they took a significant risk with their health by either not filling a prescription, taking an expired prescription, or sharing a prescription with someone else.

With the rising costs of life’s many necessities, as well as the consistently challenging economy, every family has to reconsider what is most important. However, your health should always be a priority. By skipping out on doctor’s appointments and necessary prescriptions, you could be costing yourself thousands or more dollars down the road in health care costs. Preventive medicine is meant to be just that, a means of preventing future ailments. But without regular visits to the doctor, it can be nearly impossible to stay on top of silent and expensive issues like heart disease and hypertension.

Taking a broad approach to your wellness can help keep long-term costs down. If you find yourself on medications to maintain cholesterol, heart health, or diabetes, take strides to work on weight loss and increased physical activity. The healthier you are, the lower your health care costs will be. A well-rounded wellness program ensures that you attack the health care issue from both sides – regular doctor’s appointments become a necessity, as does a healthier approach to life. Paying the upfront costs of doctor’s visits, a better diet, and regular physical activity will help you hit the jackpot later in life.

            

Exciting New Developments In the World of Nutrition!

Several exciting new developments have taken place in the world of the nutrition in the past two weeks! First, the American Dietetic Association announced their new name, the Academy of Nutrition and Dietetics (AND), at the annual Food and Nutrition Conference and Expo (FNCE) in San Diego, CA. This name change, effective as of January 2012, was made to bring attention to the scientific research and expertise of the professionals in the field of dietetics. The inclusion of the word “nutrition” was done to help consumers more readily identify the primary goal of the academy: to translate and communicate nutrition-science to the public

As a registered dietitian, I am excited about this new development in our field. Our goal is to have an academy of educated professionals that you can rely on for nutrition information, and this name change clearly identifies AND members as the go-to experts for nutrition!

The Food and Nutrition Conference and Expo provided an opportunity to hear about new developments in research and science within the nutrition field. A couple of the most interesting presentations:

A Fresh Look at Processed Foods:

·      Most of the calories in the American diet come from ‘Ready-to-Eat’ processed Foods (soda, candy, juice drinks, cold cuts).

·      In contrast, only about 300 calories a day come from minimally processed foods (milk, coffee, tea, eggs, chicken, beef etc). ? fruits, vegetables?? Where do they fit?

·      However, while processed foods make significant contributions     to nutrients we want to limit (saturated fat, sodium and sugar) they also make significant contributions to the nutrients we want to encourage (potassium, B12, folate).

·      The message: make smart decisions when choosing processed foods.

Satiating Effects of Taste and Texture:

·      It takes only 1 exposure to a food or flavor to develop a flavor aversion.

·      “Fullness” is a learned, internal cue – Individuals in France reported ending dinner when they felt full or food stopped tasting good whereas individuals in America reported stopping a meal when the plate was empty or the TV show had ended.

·      Satiety is affected by both quantity and quality of food – low quality, refined foods, even in high amounts, can feel less satiating and a balance of carbohydrate, fat and protein is key.

Finally, the ‘Nutrition and You: Trends 2011’ survey was released with some interesting findings about the American public’s views of nutrition. Some key highlights:

·      67% of those surveyed listed television as the most frequent source of nutrition information.

·      Registered dietitians were listed as “very credible” sources of nutrition information by 71% of respondents.

·      With increasing rates of obesity and type 2 diabetes, half of Americans still believe they are doing enough to achieve balanced nutrition and a healthy diet.

·      92% of respondents believe that whole-grain bread is healthier than white bread, however, only 48% had increased consumption since 2008.

·      82% of people who didn’t want to change negative dietary habits listed “I don’t want to give up the foods I like” as a reason for avoiding change (up 9% from 2008).

There were many more findings from the survey, which can be found here. Clearly, we still have many challenges to overcome in terms of healthful eating and making smarter nutrition choices. This survey is a motivating factor for our dietitians at Wellness Workdays as we continue to work hard to spread our nutrition messages !