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How do you get 96% of an employee population of 25,000 to participate in a wellness program? According to one extremely proud wellness professional, it’s a combination of top-down marketing, effective communications, and a significant financial incentive.
"Our program is offered to nonunion employees around the world," says Beverlee Gilmore, corporate health promotion manager for Caterpillar Inc., based in Peoria, IL. "We have about 67,500 employees around the world. Of those, 25,000 employees and their spouses are eligible for the program, and 96% participate right now."
Employees receive a "significant reduction" in their insurance premium (Caterpillar would not release the exact figure) if they complete the health risk assessment (HRA) that is the first component of the company’s "Healthy Balance" program. Other components include:
• a self-care book;
• nurse counseling service;
• an audio health library;
• local initiatives offered by individual sites, including an EAP manager, exercise classes, and other on-site activities.
Even before the incentive was offered, the program drew a participation level of around 50%, notes Gilmore. "We got higher participation levels than expected because of our communication techniques," she offers.
The program was first rolled out in 1997. About 21 other companies were benchmarked to determine the program components. "The development process started about a year prior to the actual rollout," says Gilmore. "Through those efforts, we identified some of the major issues we wanted to look at."
The No. 1 health issue at Caterpillar was cardiovascular disease, so Gilmore and her staff searched for scientific evidence to support initiatives that actually reduce cardiovascular disease.
"We’re a self-insured employer, and one of our major corporate initiatives was to reduce health care costs," she explains. "We have a high retention rate, and because employees stay with us a long time, we have an aging work force. All of those issues make a healthy work force very important to Caterpillar."
Premarketing started at the executive office level, she notes. "We wanted to get their support first. That support then cascaded down through the organization, through administration, then first-line supervisors, so they would understand the business case for the program, and then we rolled it out to the employees. We know how important their health is to them, and we wanted to get them to assume some personal responsibility for their health," says Gilmore. To help instill that sense of responsibility, spouses were included, and employees were given take-home packets about the program.
Ongoing communications continue with the HRA, which is repeated every six months. "It helps tell us what we need to focus on, and it also serves as a needs analysis," Gilmore explains. "In addition, it provides individual feedback to the employees to help them understand what they can do to improve their lifestyle. That feedback also refers them to other components in the program."
The information is stored in Caterpillar’s "data warehouse," which enables the company to capture data on health risks, medical claims, and drug costs, so aggregate numbers can be identified for the administrative offices and for managers at individual locations. "This way, they can find out what the health risks of their local employee groups are, and they can also track the results of the program," says Gilmore. She says she has five full-time employees on her wellness staff, and they, in turn, are supplemented by about 70 volunteers at local sites primarily in the United States. In addition, there are other coordinators worldwide.
In the company’s quarterly employee newsletter, Gilmore’s staff not only focus on specific health risk issues, but they also share the results of the program.
The Healthy Balance program was recently recognized for its excellence by receiving the C. Everett Koop National Health Award. Naturally, the selection committee was impressed with the program’s participation level. "Even Dr. Koop said during the presentation that our participation level of 96% was exceptional," says Gilmore. "They also noted that we have substantiated all of the data and medical claims."
Some of those data were as impressive as the 96% participation. For example, overall doctor visits were reduced by 17%, and hospital days were cut by 28%.
To what does Gilmore attribute this success? "I think that by focusing on individual risks, giving the employees the information they needed and helping them understand what they could do for themselves all increased awareness," she says. "When you are asked how many days you have been absent from work, how many days you have gone to the doctor, and how many days you have been in the hospital, it really brings attention to these issues." In addition, she notes, the program includes a nurse triage system; if an employee has an everyday health problem they need help with they can talk directly to a nurse, and that nurse will suggest the appropriate level of care.
While Gilmore is extremely pleased with the results of the program, her pride extends beyond the quantifiable data. "We have used a customer survey during the program, and I’m particularly proud to find that our employees feel very positive about the program, that it enhances their view of Caterpillar as an employer," she says. "A significant number of employees have actually told us they had changed their behavior as a result of the program. We also got a high percentage of the employees to fill out the survey. I feel they now are really engaged in the process; and through increased awareness, we have created a greater understanding of just how important health is."