Mainstreaming Wellness: Partnership Provides Big Dividends for Employer and Employees

The Institute for Healthcare Consumerism 09.25.2013

By Reno Berg, CEO, Mainstream Living, and Laura Vanden Bosch, Director of Public Relations and Marketing, Mercy Medical Center — Des Moines

Mainstream Living in Des Moines, Iowa has always been focused on meeting the needs of vulnerable populations. Since 1975, Mainstream has connected people with physical and mental disabilities to services that enhance their quality of life, such as special needs employment, learning centers, and community based programs. The organization realized six years ago that it needed to do more if it wanted to truly thrive. It needed to extend that same mission of improving quality of life to its own employees.

At the time, Mainstream Living was seeing health insurance premium increases of double digits—20 percent in one year alone. The poor health of its employees was reflected in the high prevalence of obesity, diabetes and tobacco use. Mainstream Living decided that, while slowing the continual increase in premiums was important, it was just as crucial to help its employees focus on their own health. Creating a culture of wellness would lead to healthier employees who can provide a better service to those who need them.

Partners in Wellness
Mercy Medical Center — Des Moines is an 802-bed acute care, not-for-profit Catholic hospital located on three campuses. Mercy Medical Center is Iowa’s longest continually-operating hospital and has a lengthy history of fulfilling its mission to promote healthy communities. Although Mercy had worked with employees for many years, it decided to redouble those efforts in 2006. That was the year Mercy contracted with Aegis Health Group to develop collaborations with employers through the Workforce Health Initiative. Mercy established its Workforce Health Initiative with a dual purpose: to advance its goal of creating healthier communities while collaborating with local employers to help combat rising health care costs and increased premiums. Soon after Mainstream Living’s management resolved to improve its employees’ health, it learned about Mercy’s Workforce Health Initiative. It seemed like the perfect fit. Mainstream Living enrolled in the program.

Mercy recommended kicking off the initiative by encouraging each of Mainstream Living’s 500 employees to fill out personal health assessments (PHA). PHAs are easy-to-complete, confidential online surveys that collect information on each participant’s health habits and history. Then, during Mainstream Living’s benefit fair that year, it offered metabolic syndrome checks that measured each willing employee’s waist circumference, weight, blood pressure, cholesterol and glucose level. The data collected from employees resulted in a goldmine of baseline data that provided an accurate dashboard of the health of Mainstream Living’s workforce. It highlighted which health risks and conditions affected its employees the most as a group. But, just as important, Mercy was able to create a health profile for each participant who offered recommendations for health improvements where risks and obvious conditions were noted. It also identified the highest risk employees who were already well on their way to suffering catastrophic illnesses because of their alarming metabolic statistics.

Based on the information gathered during the baseline data collection period, Mercy created a customized program of healthy lifestyle classes to reduce its employees’ health risks. It included smoking cessation classes and programs targeting obesity and diabetes. Other offerings included regular health screenings, metabolic syndrome programs, stress management and health and wellness programs based on needs identified through the screening process. To encourage participation, employees were offered a $600 reduction in their annual health insurance premiums. Those employees who were flagged as being high risk—about 50—were asked to attend a six-month wellness program offered by the hospital, which included classes they attended on company time.

Although employees were suspicious and somewhat negative at first when it came to participating in the screenings and classes, their outlooks changed as they began to see results. Mainstream Living added an additional component of Mercy’s Workforce Health Initiative: wellness coaches who meet with employees one-on-one to provide individualized health recommendations and follow-up. The coaches are located in Mercy’s community-based Quick Care clinics and again employees are able to attend their appointments on company time. To date, 150 Mainstream Living employees with two or more risk factors have been referred to the program.

Mercy and Mainstream Living continue to collect employee health data through PHAs and metabolic screenings on an annual basis. The updated results are used to gauge improvements in overall employee health and return on investment in the Workforce Health Initiative. As a result of the wellness coaching and other health and lifestyle programs offered by Mercy, Mainstream Living’s employees are healthier than they have ever been. The company has fewer tobacco users and the percentage of overweight or obese employees has decreased. Mainstream employees have also had fewer hospitalizations and office visits. Absenteeism has improved significantly and productivity, as measured by lost work time, is at an all-time high.

A Commitment with Big Dividends
After year three (2008) – in which the company sustained the 20 percent increase in premiums – Mainstream Living began to see an extraordinary reversal of the trend. Over the next five years, the non-profit’s health insurance premiums declined by 18.6 percentage points as compared to the double-digit increases they were previously experiencing each year. Mainstream Living’s annual employee healthcare insurance premium renewal fee increase for 2012 was just 1.4 percent. According to the organization’s broker, this is the lowest increase in the company’s history. It follows 2011’s 4.46 percent increase, the first one ever that was less than 7 percent. As a result, employee health insurance contributions have not increased in the last few years. Mainstream Living’s employees appreciate the tangible results they have achieved in enhanced health, better management of risk factors and lower costs for their health insurance. Staff members currently pay just $35 per month for individual coverage or $50 for family coverage.

Mainstream Living and its broker both credit these steady declines to the company’s engagement in the wellness programs offered through Mercy Medical Center’s Workforce Health Initiative. Mainstream Living plans to maintain its partnership with Mercy in meeting its employee health and wellness needs. With positive, downward trends in health insurance costs and the high level of employee participation in the Workforce Health activities Mercy provides on an ongoing basis, mainstreaming wellness into the culture of Mainstream Living has paid big dividends over the long term.

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