DaimlerChrysler Corporation is an international automotive and transportation company with over 95,000 employees throughout the United States. The DaimlerChrysler/UAW National Wellness Program, which began in 1985, is a negotiated benefit between DaimlerChrysler Corporation and the In-ternational Union, UAW. Several national health and fitness service providers are contracted to deliver the Wellness Program to active employees. All U.S. sites with 500 or more employees have on-site contracted health and fitness business partners (over 100 FTEs) to administer the Program. The DaimlerChrysler Human Resources Department provides operating funds for the Program and with the UAW, provides administrative oversight. The Program provides high quality, cost-effective wellness activities that empower employees to improve their health and become wise health care consumers while containing health care costs.
Narrative Description of Program
DaimlerChrysler Corporation is an international automotive and transportation company with over 95,000 employees throughout the United States. The DaimlerChrysler/UAW National Wellness Program, which began in 1985, is a negotiated benefit between DaimlerChrysler Corporation and the In-ternational Union, UAW. Several national health and fitness service providers are contracted to deliver the Wellness Program to active employees. All U.S. sites with 500 or more employees have on-site contracted health and fitness business partners (over 100 FTEs) to administer the Program. The DaimlerChrysler Human Resources Department provides operating funds for the Program and with the UAW, provides administrative oversight. The Program provides high quality, cost-effective wellness activities that empower employees to improve their health and become wise health care consumers while containing health care costs. Specific Program objectives for 2000 include:
- Screen 37% of population to assess risks and interests
- Increase percent of employees who have fewer than 3 health risks
- Increase participation in the NextStepsTM Program (phone-based lifestyle intervention targeted to high-risk individuals) by 1% at each site
- Decrease percentage of smokers by 6%
Employees voluntarily participate. Targeted education programs, based on identified health risks and interests, provide an opportunity for individual health improvements. Interventions tailored to individual sites customize the program for each population while maintaining the objectives and quality standards required of all sites.
Focused education programs support employees throughout the process of lifestyle change. The stages of change model is used for tailoring programs such as smoking cessation, weight management, cholesterol management and fitness activities. Program formats may include one-time workshops, multi-session classes, individual counseling, or self-directed modules. Maintenance strategies include ongoing awareness, interactive campaigns, group support, incentive opportunities, follow-up and cultural support with on-site services (e.g., fitness facilities, cafeteria/vending programs, and walking routes).
Health plans that administer DaimlerChrysler Health Care Benefits are the primary managers of chronic disease conditions. The focused intervention model, NextStepsTM, a personalized case management program administered via telephone risk counseling, supplements these efforts. Employees are further educated on self-management through publications on available hospital services and worksite self-care education.
The Program prides itself in achieving high standards in health promotion. Awards include:
- Well Workplace Gold Awards (WELCOA, 23 in 1998, 8 in 1999)
- Governor's Council on Physical Fitness (Gold Award, 1997)
- Healthiest Corporate Cafeteria (Physicians Committee for Responsible Medicine, 1997)
|Program Name||DaimlerChrysler/UAW National Wellness Program|
|Company Name and Address||DaimlerChrysler Corporation and International Union, UAW1000 Chrysler Dr., CIMS 485-07-21Auburn Hills, MI 48326-2766|
|Contact Person||Theresa Bartlett, M.D.Senior Manager, Medical Utilization & Analysis|
|Program Category||Web enabledChronic diseaseHigh riskWorksite based|
|Total number of individual participants||44,298|
|Number of currently actively enrolled||32,752|
|Access to Program||All active U.S. employees|
|Program targeted at Healthy People 2000 and/or Healthy People 2010 goals||Yes|
|Program goals (in priority order)||(1) Empower employees to be wise health care consumers and improve their health(2) Keep low-risk employees in the low-risk category(3) Target high-risk employees with focused interventions(4) Provide cost effective wellness activities designed to contain health costs|
1. Impact of StayWell Programs on Chrysler Health Care Costs, 1999
Researchers at the University of Rochester used a multivariate regression analysis to estimate the effects of the Wellness Program on 1997 healthcare cost1. The study included 38,318 employees from 10 Chrysler sites enrolled in either traditional indemnity insurance or PPO insurance between 1992 and 1997 and who completed at least one Health Risk Assessment (HRA)2. To detect and control for possible selection effects, program effects were split into two components: the impact on health care costs of each risk factor and the effect of each program on the probability of having a risk factor.
Results show that HRA completion is associated with significant and substantial cost reductions. Employees who completed one, two or three HRAs on average had lower 1997 health care costs of $112.89, $152.29 and $134.22, respectively. Employees who had completed at least one HRA and participated in an additional wellness activity had an average cost savings of $200.35 per year. Regarding the association of health care costs and the presence of health risks, most of the health risks were shown to increase costs.
2. StayWell Impact Analysis, 1997
The same methodology described above was employed in this study to compare healthcare costs with employees’ health risk profiles between 1991 and 19953. Savings estimates revealed that Wellness Program participation was associated with significant savings in dollars per employee from 1991 to 1995, with the highest dollar savings achieved in 1995 ($16 per employee per month).
3. Health Risks and their Impact on Medical Costs, 1995
A study representing 6,000 life-years of UAW/Chrysler employees over a three-year period confirmed risk-cost linkages4. Results showed individuals with the following health risks had higher claims costs as compared to those at low-risk:
- Smokers, 31% higher
- Unhealthy eating habits, 41% higher
- Stress, 24% higher
- Mental health risks, 13% higher
- Employees outside the healthy weight range, 143% higher hospital inpatient utilization
Results have shown that one health risk, in one individual, costs an average of $170 annually (in 1995 dollars). Assuming that reducing risks also reduces associated costs, based on Steelcase research, annual cost savings could approach $170 per individual per risk reduced per year5.
4. Management Summary Data
Data based on 18,638 employees who completed an HRA in 1999 and at least one other HRA in the past (average time between completion 3.4 years) showed the following changes in risk:
- Eating habits improved 16%
- Smoking risk decreased 15%
- Participants with six or more risks decreased 6%
- Participants with less than three risks improved 5%. Based on the changes in the health risks of repeat participants, the Program estimates annual savings of $5,908,6006.
5. Focused Intervention Model
In an analysis of StayWell’s NextStepsTM Program (a year-long, telephone lifestyle risk counseling program), conducted on six different organizations, results show participants improved their health behaviors to a greater extent than people with comparable risk profiles who chose not to participate in the intervention7. Participants improved their overall risk status, as compared to non-participants, by an average of .85 risks. On average, NextStepsTM participants reduced their health risks by 12% while non-participants actually increased their health risks by 2%. This study has been accepted for publication in the American Journal of Health Promotion.
6. Health Activity Center Physical Performance Data
Data from general fitness assessments at the Health Activity Center provide evidence of measurable improvements in cardiovascular conditioning and blood pressure measurements.
7. Participant Satisfaction
Satisfaction surveys are conducted upon completion of programs (courses, screenings, and work-shops) on an ongoing basis. Satisfaction rates exceeded 95% in both 1998 and 1999.
1 Zwanziger, J., Davis, C.. Impact of the StayWell Program on Chrysler health care costs. Report prepared for Daim-lerChrysler Corporation and the International UAW Union by CORE Analytic, Inc., 1999. Manuscript to be submitted for publication at the conclusion of the doctoral student's dissertation.
2 The reliability and validity of StayWell’s health risk assessment technology has been developed and field-tested over a 20-year period and has been subjected to rigorous validation testing. See supporting documentation on Health Risk Assessment Development in Section III.
3 CORE Analytic, Inc.. StayWell impact analysis. Internal report prepared for DaimlerChrysler Corporation and the International UAW Union by CORE Analytic, Inc., 1997.
4 Anderson, D., Brink, S., Courtney, T.D.. Health risks and behavior: their impact on medical costs. Unpublished research report prepared for The Chrysler Corporation and the International UAW Union by the StayWell Company and Milliman & Robertson, Inc. Milwaukee, 1995.
5 Edington, D.W., Yen, L.T., Witting, Pl. The Financial Impact of Changes in Personal Health Practices, Journal of Occupational and Environmental Medicine, 1997; 39: 1037-1046.
6 Estimates based on the StayWell Impact Model (SIM), developed from databases compiled over a five-year period, containing a complete history of more than 50,000 employees. The SIM has been reliability tested by the consulting firm Milliman & Robertson, Inc. This normative data adjusts for age, sex and race. (See supporting documentation on the SIM documentation cost information in Section III.)
7 Gold, D.B., Anderson, D.R., Serxner, S.A.. Impact of a phone-based intervention on the reduction of health risk. American Journal of Health Promotion. Manuscript accepted for publication, 2000.
Reviewers were very impressed this program, which was noted to be large, well-designed, comprehensive, and to make good use of internal and external expertise. Financial impact was projected using a variety of econometric methods. The program has won multiple awards. Participation rates have increased over time, and satisfaction rates are high (95%). The program has evolved (57%) over 15 years. The pre-post analyses represent good quasi-experimental design. Provision of a benefit to employees worked by both company and union is a major strength.
The very extensiveness of the program limited space for description of interventions and some reviewers felt that the evaluation lacked focus. A paper is said to be forthcoming and reviewers urged more formal presentation of results, with peer review. Some results are based on Staywell models and these are felt to overstate results in general. Nevertheless, the analyses were felt to be sound and thorough and used multivariate procedures for adjustment.