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By addressing the health risks of their employees, companies can save potentially millions of dollars in healthcare and disability costs, as well costs associated with lost productivity. Achieving this is well within reach, as 25 percent of healthcare expenditures can be attributed to modifiable health risks, such as stress, tobacco use, body weight, physical activity and nutritional habits.

For example, getting one smoker to kick the habit for good can save approximately $1,623 in annual medical costs; encouraging one overweight or obese employee to become active can save approximately $499 in total costs; while helping one employee better cope with stress can save approximately $765 in medical costs--as much as $1,352 for individuals with coronary heart disease.

According to studies conducted by Dr. Dee Edington and researchers at the University of Michigan Health Management Research Center, health costs, including both medical and disability, increase as the number of dangerous risk combinations increase. Through coaching and other health interventions, shifting an individual from the high category of dangerous risk combinations to the low category can save as much as $4,078 in annual costs.

According to the research, the earlier individuals become involved in their health status, the sooner risks are minimized and healthcare costs are reduced. Research also shows that employee productivity decreases as health risks increase. In other words, employees at medium or high risk are less productive than lower risk employees. Conversely, employees at lower risk are more productive.

"Health" can't be defined narrowly. Health is not just the absence of sickness, and it's not just related to the body. It also encompasses the emotional and social well-being of individuals. Similarly, costs to businesses are much broader than just the cost of medical benefits.

A survey recently conducted on behalf of Cigna reveals that 46 percent of America's full- and part-time employees missed work at some point in the last six months (on average for three days). Of those, 47 percent cited illness or a chronic health condition as the reason, but a significant number--22 percent--reported missing work for family-related reasons, such as caring for a sick child or other family member, or coping with a variety of family-related issues.

Moreover, the survey revealed that 61 percent of respondents came to work on average nearly seven days while they were sick or coping with a variety of issues, such as sick children or family concerns, and in a typical week spent nearly 2.5 hours resolving personal issues while at work.

According to the same survey, 66 percent of respondents said a lack of sleep has had an impact on their work performance, with 50 percent saying they were less productive, 42 percent saying they were unable to focus, 28 percent saying they made mistakes and 12 percent reporting they fell asleep on the job.

These findings should be a wakeup call to employers: The physical and emotional well-being of their employees, as well as their ability to be productive, have a direct impact on what happens in the workplace. How well employees serve customers, how efficiently employees perform their jobs, and how often they actually report to work at full capacity are all tied to understanding their health status and health risks. A well-designed health assessment with strong analytics can paint a picture of the current situation and provide a road map for employers.

Armed with the knowledge that reducing health risks improves employee health and productivity and reduces costs, and provided with a picture of the health status and risks of its workforce, what should a company do?

Depending on the results of the health assessment, a company might offer its employees a variety of lifestyle management programs, such as smoking cessation or weight management programs, as well as coaching programs designed to help employees manage stress, cope with a disease, increase physical activity, improve nutrition and sleep better. But how can companies convince their employees to use these programs to maximize their effectiveness and create a healthy, productive workforce?

First, know the needs of your employees and introduce programs that address those particular health needs. If very few employees use tobacco but a large percentage of employees are overweight, it makes sense to place more emphasis on exercise, weight loss and healthy eating programs.

In some cases, offering incentives might motivate employees to participate in wellness programs, but that is not always the case. So it's important to understand what motivates your employees.

How well do you communicate with your employees in general, and are they receptive to company communications? The more you understand your employees and how receptive they are to the information you provide, the more likely you are to implement winning programs with wide acceptance and participation.

Second, support for wellness programs must permeate the organization, starting at the top. Without the support of top executives, it will be impossible to create a culture of wellness that encourages all employees to focus on their health and use the programs you offer.

But support doesn't stop at the executive suite. All levels of management must support the company's initiatives, including line supervisors. If line supervisors don't allow time for employees to participate in programs, those programs won't be successful.

Third, find champions within the company that can validate the programs. Nothing speaks louder to employees than their peers who have quit smoking, lost weight, survived a serious illness or improved their lives by adopting a healthier lifestyle through the wellness programs you offer.

Fourth, recognize that one size doesn't fit all, so use multiple vehicles to reach employees. Many employees are on the phone all day, while others travel a large part of the time and are harder to reach. Some are techno-savvy and want information via the Web, while others prefer more traditional communications. Find ways to communicate with employees--and deliver programs--that meet them where they are, whether that's through the mail, e-mail, posters, text messages or even podcasts.

Fifth, give it time. Making behavior changes to reduce health risks is no easy task. It doesn't happen overnight, and one communication will not magically convince people to change. The important thing is to move the dial a little bit at a time. Building a culture of wellness in the workplace that motivates and inspires people to focus on making healthy changes requires a sustained effort and organizational support.

But remember the payoff. It's worth the effort and worth the wait.

JODI ARONSON PROHOFSKY, PH.D., LMFT, is senior vice president of operations for Cigna's health solutions unit.

August 1, 2008

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