A key to combating rising health-care costs and demands for care from an increasingly unhealthy work force might be as simple as something your mother always told youfor example, eat your vegetables. At least, health plans and employers here are hoping that simple solutions can help.


While employers cant control some causes of the steep annual increases in health-plan premiums, such as the aging of the population or the high cost of advancing medical technology, theyre using preventive-care efforts, such as health-risk assessments and wellness programs, to fight the battle of the bulging health-insurance budget.


With current health-care trends, employers are looking to squeeze the dollar out of health care as best they can, says Mark Patrick, a benefits practice leader with the Spokane office of Mercer Health & Benefits LLC. Theyre seeing that the best impact they can have is by making employees healthier, rather than just trying to manage health patterns that are already there.


Mark Newbold, a consultant with Spokane-based Moloney ONeill Benefits Inc., also says that employers and health plans are taking prevention-based approaches.


There is an acknowledgment that everyone needs to be more proactive about health care, Newbold says. If we can get employees to make better decisions about their health through work-site health-promotion programs, then we can improve the bottom line of business clients.


Health-promotion programs typically include a health-risk assessment survey that employees fill out, sometimes in addition to undergoing tests that measure body mass, bone density, cholesterol levels, glucose levels, and blood pressure. Individual results are compiled and given to employees, and aggregate results, which dont identify employees, are given to employers, Newbold says. Then, the health plan or a so-called health coach, working under contract, tailors a wellness program for each employees health situation. Even though employers arent given individual employees health assessments, they still often give their work forces incentives to adopt healthy habits, such as walking or eating healthful foods.


Although not all risk-assessment and wellness programs cover employees families, programs usually are more effective when they include covered family members, because illnesses in a family can increase an employees absenteeism and lower their productivity, Newbold says.


Moloney ONeill, which brokers plans for about 750 employer-employee groups in the Inland Northwest, advises its clients to implement wellness programs, and in recent years, more employers have been embracing the concept, he says.


While employers might not see immediate results from their health-promotion programs, its important for them to keep in mind the long-term benefits that a healthier work force provides, he says. Those benefits include decreased absenteeism and increased productivity at work, and fewer cases in which preventable diseases, such as Type-2 diabetes, strike employees, he says.


Patrick says health-risk assessment and wellness programs have started to gain ground with Mercers clients over the past two years, and about 10 percent of the companys 350 Spokane-based clients have launched such programs. He expects more companies will jump on board in the next few years, especially because health-care coverage for workers who have chronic medical conditions costs employers four times as much as coverage for healthy workers.


Those are the types of statistics that hit you in the face, and you say, Hey, Ive got to do something about this, Patrick says.


As evidence of the growing wellness program trend here, Premera Blue Cross, Group Health Cooperative, and Asuris Northwest Health, the three biggest health plans in Eastern Washington, all have started offering various health-risk assessment and wellness programs.


Seattle-based Premera, which has 280,000 members in Eastern Washington, began offering a variety of health-management programs about a year ago as part of its strategy to achieve better health and more sustainable costs for its customers, says Dr. Dave Johnson, a Spokane-based regional medical director with Premera. Employees take a health-risk assessment survey, then receive health scores based on benchmarks for their demographic groups. They can receive different levels of lifestyle coaching, depending on the severity of their health risks, through medical self-care books, monthly newsletters, and online fitness training tools, Johnson says.


Every time Ive given the management a report, employers are taken aback by how much risk there is in the population, he says.


Some employers give employees incentives, such as extra money in their health savings accounts, additional vacation days, or casual dress days, to get employees and their spouses to participate in the program, Johnson says.


Its about getting behavior change, and thats not easy, he says.


Changing behavior


Washington Trust Bank, which is one of Premeras Spokane-based clients, has been pleased with the initial success of a health-promotion program it started last year, says Katy Bruya, the banks director of human resources.


Premera supplies the banks employees with a health-risk assessment survey, then Indianapolis-based Summex Corp. provides confidential health coaching under contract to participants whose high cholesterol levels, excess weight, or other factors put them at risk for more severe health complications, Bruya says. To help employees achieve their health goals, Washington Trust offers discounts on pedometers, holds walking competitions, and provides thick, rubber tubes with which employees can exercise at their desks. Also, it has made efforts to remove items with high-fat content from workplace vending machines, Bruya says.


More than 500 employees and spouses took the health-risk assessment test last year, and Bruya expects more people will take the test when its offered again this month. A few years will pass before the company can collect some baseline data about employee health and track changes in the number of claims that are filed, but those results are worth the wait, she says.


I have yet to see any company that hasnt experienced frustrations with the rising cost of health insurance, she says. We want to curb those costs and make our employees more productive, but were also doing it because its the right thing to do.


Another company here thats implementing a health-promotion program is Hollister-Stier Laboratories LLC, which started its My Life program last April, says Arlie Robinson, the companys human-resources manager and former president and chairwoman of the Spokane-based Inland Northwest Business Coalition on Health, a department of the Spokane Regional Chamber of Commerce that seeks to stabilize health-care costs for employers here. Participating employees at Hollister-Stier Labs take semiannual work-site health-screening tests and work with trainers to improve their health.


Of the companys roughly 375 employees, 110 participated in the program initially, and Robinson expects that more will participate in the next screening in April. They can receive up to a 20 percent discount on their health premiums, depending on the margin of their lifestyle improvement, Robinson says.


Hollister-Stier offers smoking-cessation classes and walking programs. The company also has removed vending machines and instead stocks the lunchroom with fruits, vegetables, and yogurt.


Unfortunately, as a society we just want to take a pill instead of exercise more and eat better, she says. But, we have to do something different, because we cant continue to pay more for health care while our employees arent getting any healthier.


While most companies that implement health-promotion programs have more than 50 employees, an insurance company in Rathdrum, Idaho, gears its health-promotion service toward smaller businesses. Last year, that company, Redman & Co. Insurance Inc., which offers home, life, automobile, and health insurance, formed a subsidiary, named Employers Alliance, to offer health-risk assessment tests and health coaching programs to its customers through an arrangement with Portland-based Reliant Behavioral Health LLC, says Eric Redman, the Rathdrum companys president. The annual fee Employers Alliance charges companies for its services can vary, but typically amounts to $20 per employee.


About 20 North Idaho employers are using Employers Alliances services, Redman says. The subsidiary works mostly with small manufacturers, service-related businesses, grocery stores, and a North Idaho school district, he says. Small employers tend to be less interested than large employers in health-promotion programs, but small businesses should promote healthy lifestyles because they need their employees to function at full capacity, he contends.


Some of our employer base has been excited, and some weve had to convince, he says.


Employers Alliance is seeing more interest in its health-promotion program, and is talking with another North Idaho school district about enrolling in it, he says. While its too early yet to be able to correlate participation in the program with reduced claims, customers can see the benefit, he says.


The insured customer is having to take more responsibility for some of their costs, and investing in health not only controls expenses but enhances work force health, he says. The bottom line is that it decreases health risks, and thats gained a lot of importance in this day and age.


Contact Emily Brandler at (509) 344-1265 or via e-mail at emilyb@spokanejournal.com.