CEO Letter to Clients
Does Your Organization Have What it Takes?
A chemical company client averages 90 percent participation in its health risk assessment offered to employees. But achieving this didn’t happen by accident. Several key factors are in play.

Does your company have what it takes to drive high participation in 2010?

Let’s find out. Below are several things that can dramatically affect engagement in the culture of health you are looking to create:

• Cultural assessment. What you think your company endorses may be different than the beliefs and values that are actually being played out. To uncover internal barriers to achieving higher participation, consider conducting a cultural assessment to determine the difference between your current culture and your desired state. This information can then be used to design solutions to support meaningful cultural change.
• Targeted incentives. Your employee population is like your own personal DNA. To motivate action, it pays to know what incentive will prove meaningful to your unique population. One client uses a $600 health care premium reduction as its incentive, while a different client offers paid-time off to drive participation. Both work with their respective populations.
• Marketing. Employees will not participate in a program if they don’t know it exists. But communication about the program requires more than just posters and e-mails. It takes “evangelizers” who can talk up the benefits of the program across the company. And if you have a younger population, it may require alternative mediums—such as videos or social networking—to connect with employees. Are you doing what it takes to engage 100 percent of your population?
• Measurement and evaluation. Without data, it’s impossible to determine which programs are producing the best and most quantifiable results—both in lowering health care costs and boosting productivity. The need to regularly measure and evaluate your program can not be overstated.

Need help addressing these key factors? Let HealthFitness assist you. We are committed to providing solutions that affect employee health and productivity and deliver ROI that reduces health care costs and improves financial performance for our clients.

To learn more, I encourage you to contact your program manager.

Yours in good health,

Gregg Lehman

Inside HealthFitness
Netting Employees with the Web—Why Technology Drives Engagement
Technology-driven tools such as Web portals and online healthy lifestyle programs are expected to increase 100 percent or more during the next three years, according to a recent Buck Consultants survey.¹

The reason?

These tools help engage dispersed populations. They also are an essential medium for interacting with a younger workforce, as research shows 92 percent of individuals, ages 18-29, regularly use the Internet. Among all adults, 79 percent use the Internet.²

To build a culture of health for our clients by effectively engaging their employees, HealthFitness offers a variety of online tools and programs.

These include:

• eHealth: Our eHealth platform provides educational resources, cool tools and calculators, and interactive trackers to support employees to achieve personal health goals.
• Walk This Way®: Walk This Way® motivates employees to enhance their overall health and increase their physical activity through walking and finding ways to increase their daily movement. When offered through our eHealth platform, participants can track steps, log progress, view tips and resources, and receive weekly educational and motivational e-mails to stay engaged.
• Great American Fitness Adventure (GAFA): Available through eHealth, GAFA motivates participants to step up physical activity with the opportunity to virtually visit 70 U.S. national parks and recreation areas in 70 days. Participants exercise, track their activities, earn “park stickers” and receive daily tips.
• Feel Like a Million: Available through eHealth, Feel Like a Million is a 12-week, online game show-themed program that encourages participants to practice daily behaviors that increase energy and reduce stress while earning virtual dollars and receiving daily tips and healthy recipes.
• Health risk assessments: Individuals can access our INSIGHT® Health Risk Assessment electronically, in a secure online environment, to learn their current health status and receive personalized feedback to better manage their health, behaviors and risks.
• Health coaching: With EMPOWERED™ Health Coaching, participants can choose how they interact with their coach—via phone and/or online secure message board. They also have access to a variety of online behavioral tracking tools and resources.

Visit www.hfit.com to learn more. Interested in learning about online programs to offer your population? Please talk with your program manager.

¹ “WORKING WELL: A Global Survey of Health Promotion and Workplace Wellness Strategies,” Buck Consultants, accessed Jan. 4, 2010.

² “Trends in Internet Use: How Public Radio Fits In,” Pew Internet and American Life Project, accessed Jan. 4, 2010.

Screening for a Screening Partner? Be Sure to Ask These Questions.
U.S. employers are expected to see an increase in medical benefit expenditures of 7 percent in 2010, marking record-high costs for both employers and employees, according to Towers Watson¹.

To contain health care costs and reduce the rise of chronic disease, more employers are adopting comprehensive health management programs. And as part of these programs, solutions such as biometric screenings—which promote good health decisions and offer convenience as an incentive—are expected to grow.

Interested in offering on-site screenings to your employees?

HealthFitness Worksite Screening Manager Sue Earley recommends that you ask the following questions when screening potential partners:

1. Staffing. Does the provider use their own staff or outsource all of their screeners? And if they do outsource, how do they select their partner? The goal is to have the screening event go off without a hitch. A quality screening provider will require all screeners to be trained on protocols for data security, customer service and professionalism to ensure this happens.
2. Data integrity. How is confidentiality maintained during the screening? How educated is the staff on what constitutes protected health information? And how is employee data stored? The provider should adhere to stringent practices that make certain private health information remains private.
3. Promotion. How does the provider help you promote the event and engage your employees to participate? “Build it and they will come” only works in the movies. With screenings, it takes more than a poster to motivate employees to get their blood drawn for a cholesterol check. Be sure you choose a provider that is an expert at empowering individuals to take action.
4. Quality control. What processes does the provider have in place to ensure best practices and continuous improvement with its screening process? Look for one that is committed to providing the best experience for you and your employees.
5. Flexibility. Does the provider offer your unique worksite the flexibility that your workforce demands? A quality provider will offer you many options in scheduling, in the selection of biometric tests, and in how your employees can actually access the screening process.
6. Ability to coordinate multiple locations. If you have multiple employee sites, does the provider have the logistical expertise to service these sites? A company with operational excellence for coordinating screening events at numerous locations will have a track record for doing so and strong client and employee satisfaction ratings that validate their abilities.

HealthFitness has been providing worksite screening services for employers since 1992. To learn more about HealthFitness’ screening solution, click here or talk with your program manager.

¹ “Towers Perrin Health Care Cost Survey Shows Employer-Sponsored Medical Benefit Costs to Rise 7% to Over $10,000 for the First Time,” accessed Jan. 4, 2010.

Best-in-Class Practices and Awards
State of Nebraska Governor Walks the Talk and Proves the Power of Active Senior Leadership
Active, visible senior management support for healthy initiatives can be a critical lever to affect employee behavior. Just ask the State of Nebraska.

The state launched wellnessoptions, a comprehensive health management initiative for its 17,000-plus employees, in July 2009.

Governor Dave Heineman is leading by example and effectively driving the initiative through a variety of tactics:

• He actively participates in Walk This Way®, a walking program, challenges direct reports to keep up with his step totals, leads group walks and challenged state employees to achieve 360,000 steps through the program before March 31, 2010. To date, approximately 40 percent of enrolled employees have met or exceeded their distance goal, including the governor. More than 500 state employees have reached 1 million steps, including 60 that have achieved over 2 million steps.
• He recognizes employee lifestyle achievements and Walk This Way successes through a “Wellness Wall of Fame” posted on the company’s eHealth Website. Wall of Fame participants describe the impact of wellnessoptions on their health and can have their picture taken with the governor. One Wall of Famer, for example, lost 70 pounds and was able to stop taking medicine for high cholesterol and high blood pressure, thanks in part to participation in Walk This Way.
• Gov. Heineman speaks highly of the wellness program at speaking engagements, highlighting the importance of the program to manage health care costs.

Services available through wellnessoptions include a health assessment, biometric screenings, EMPOWERED™ Health Coaching, and condition management coaching.

Learn Best Practices for Measuring ROI with Health Coaching
Join HealthFitness Chief Medical Officer Jim Reynolds, M.D., for a 60-minute Health Intelligence Network webinar on “Health Coaching Evaluation: Measuring the ROI on Healthcare Utilization and Costs,” held Jan. 13, 2010, at 1:30 p.m. EST.

Reynolds will co-present the webinar with Elizabeth Rula, M.D., clinical research manager at the Center for Health Research at Healthways Inc. Together, they will discuss the challenges of evaluating and reporting on a health coaching ROI and how each organization is responding to these challenges.

For additional information on the webinar, visit www.hin.com.

Industry Insights
Health Care Reform Update: Senate Passes Bill; House-Senate Negotiations Underway
On Dec. 24, 2009, the U.S. Senate passed the Patient Protection and Affordable Care Act by a vote of 60 to 39. House and Senate leaders are now working to merge their versions of health care reform legislation into one bill.

The Patient Protection and Affordable Care Act includes several workplace wellness provisions, such as:

• Authorizing $200 million in grants to help small-business employees access comprehensive workplace wellness programs.
• Allowing employers to offer premium discounts and other awards for up to 30 percent of the total premium to individuals who satisfy a health standard. The Secretaries of Labor, Health and Human Services, and the Treasury may increase the reward to up to 50 percent of the cost of coverage if the Secretaries determine that such an increase is appropriate.
• Requiring the Centers for Disease Control and Prevention to study and evaluate best employer-based wellness practices and provide an educational campaign and technical assistance to promote the benefits of worksite health promotion to employers.

Buzz from Recent Research
Body Mass Index and Waist Circumference Predict Death from Heart Disease
A recent large 10-year study published in the European Journal of Cardiovascular Prevention and Rehabilitation found that half of all fatal heart disease cases and about a quarter of nonfatal cases are attributed to having a high body mass index (BMI) or waist circumference.

In the study, Dutch researchers measured both BMI and waist circumference in more than 20,000 men and women aged 20-65 years between 1993 and 1997. During a 10-year follow-up period, BMI and waist circumference data were then correlated with hospital records and cause-of-death data.

The results showed that among people who were overweight or obese, 54 percent of all fatal heart disease cases and about 20-30 percent of nonfatal heart disease cases were attributed to being overweight and obese.

Overweight and obesity were defined as follows:

• Overweight: BMI between 25 and 30 or a waist circumference between 94 and 101.9 cm for men and 80-87.9 cm for women.
• Obesity: BMI of 30 or greater or a waist circumference of 102 cm or greater for men and 88 cm or greater for women.

Source: van Dis I, Kromhout, D, Geleijnse, JM, Boer, JM, Verschuren, WM. Body Mass Index and Waist Circumference Predict Both 10-year Nonfatal and Fatal Cardiovascular Disease Risk: Study Conducted In 20,000 Dutch Men and Women aged 20-65 Years. European Journal of Cardiovascular Prevention and Rehabilitation. 2009 Dec;16(6):729-34. Smoking Increases Risk for Colon Cancer
A large study published in the December issue of Cancer Epidemiology Biomarkers & Prevention found that long-term cigarette smokers have a higher risk of developing colorectal cancer.

This study’s findings supported the International Agency for Research on Cancer’s decision to affirm that there is sufficient evidence to link cigarette smoking and colorectal cancer. This association was found in both long-term current smokers as well as former smokers when compared with lifelong nonsmokers. However, among former smokers, risk of colorectal cancer decreased with greater time since cessation.

To study the association between cigarette smoking and risk of colorectal cancer, researchers followed 184,187 people during 13 years (1992-2005). The researchers controlled for other colorectal cancer risk factors, such as not getting screened, obesity, physical activity as well as a high intake of red or processed meats.

The study found that current smokers had a 27 percent increased risk of colorectal cancer and former smokers a 23 percent increased risk compared with people who had never smoked. The greatest risk, 38 percent higher than never smokers, was found in people who had smoked for at least 50 years.

However, people who stopped smoking before age 40 or who had not smoked for 31 or more years had no increased risk.

Source: Hannan LM, Jacobs EJ, Thun MJ. The Association Between Cigarette Smoking and Risk of Colorectal Cancer in a Large Prospective Cohort from the United States. Cancer Epidemiology, Biomarkers & Prevention. 2009 Dec;18(12):3362-7.