The WE Energies Health Enhancement Initiative has been in operation for about a decade. It has achieved a cumulative 85% participation rate since its inception and annually enrolls about 50% of its employees in the program. Initiative goals, including health and financial improvements, are well aligned with its overall program design. An integrated strategy encompasses health management, safety, work-life balance, disease management and a supportive work environment Employees are offered a significant annual incentive of $300 to complete a health risk assessment (HRA), which in turn, drives several health promotion programs. A University of Michigan longitudinal analysis of cost trends showed lower medical, absence and workers’ compensation cost increases for participants compared to non-participants. For example, participants’ health care cost increases averaged 8.9% over 6 years compared to 13.3% for non-participants. Annual medical savings were estimated as averaging $264 per participant. Additionally, significant risk reductions have been achieved across most risk categories over a three-year period.
Program Description
Narrative Description of Program
We Energies’ Health Enhancement Initiative (HEI) is the health-management effort that integrates employee health and wellness, safety, work-life balance, disease management, environmental influences (food services, facilities), benefits resources/health care consumerism and the employee assistance program. In 1997, the company’s Joint Health Care Committee, formed to address challenges in health benefits, developed a three-part strategy including managed care, health education and health promotion as a means to stabilize health care spend. HEI became the delivery mechanism for health education and promotions. HEI’s vision is to move employees and their families toward healthier work environments and lifestyles to achieve reduced health care costs, improved productivity and enhanced quality of life.
HEI’s flagship program is the Lifestyle Rewards Program. More than 85% of employees have participated in the program since inception. Annually, more than 50% of all employees participate and 50% have participated for 3+ years. Historically, the program has offered an annual incentive (up to $300) for completing various activities that drive healthy behaviors. In 2006, the program’s focus was changed to strengthen individual accountability for health and to link positive health behaviors to measurable outcomes and risk-reduction goals. Lifestyle Rewards’ wellness criteria focus on demonstrated outcomes driven by the active practice of positive health behaviors. Outcomes and behaviors include measuring key biometric values, lifestyle practices, safety and productivity, and health care consumerism.
Lifestyle Rewards requires use of the Health Risk Appraisal (HRA). HRAs are used to capture much of our health-risk data, which is used to evaluate success and to determine the health needs and interests of our employees.
We plan to continue the Lifestyle Rewards Program, using the current wellness criteria, and will continue to require completion of the HRA in order to continue to drive individual accountability for health and vitality.
Contact Summary
| General Information | |
|---|---|
| Program Name | Lifestyle Rewards |
| Company Name and Address | We Energies - Health Enhancement Initiative333 W. Everett St. A219Milwaukee, WI 53201 |
| Contact Person | Susan Bloomberg, MS, CHES, Program Manager |
| Program Information | |
| Program Category | Worksite-based |
| Year begun | 1998 |
| Total number of individual participants | Average of 55% of target population (5,300) |
| Number of currently actively enrolled | 2,978 |
| Access to Program | All employees, and varied targeted subgroups depending on year (i.e., high risk; high BMI). |
| Program targeted at Healthy People 2000 and/or Healthy People 2010 goals | Yes |
| Program goals (in priority order) | (1) To support employees in maintanence of positive health behaviors (to ensure vitality now and in the years ahead). (2) To encourage and motivate employees to improve their health/health behaviors where needed. (3) To address the outcome/results of health behaviors in the areas of key biometric values, lifestyle practices, safety and productivity and health care consumerism. (4) To be a key corporate strategy for health care cost containment. |
Evaluation Summary
Narrative Description of Evaluation Results
Lifestyle Rewards (LSR) health incentive program is voluntary and available to all employees annually. Participants’ participation and health experience are tracked by the University of Michigan’s Health Management Research Center. Areas of evaluation focus are health status, medical and productivity impact and cost implications.
Health Risk Status
HRAs evaluate 15 behaviors, measuring the health risk associated with each behavior. Participants receive a personalized health-status report. HEI receives an aggregate report on employee health.
HRA analysis indicates that our population’s greatest risk factors include BMI, safety belt use, physical activity, blood pressure and stress management. Over time, these risks have improved, although BMI has shown the least amount of change. Though BMI scores fluctuate slightly over the years, when compared to other utilities, our BMI is 4% less than average.
Overall, the average number of risks per person has steadily decreased (from 2.5% to 1.9%). The number employees categorized as low risk continually increases, while the number of high-risk employees has decreased by 30%. In a matched comparison over three-years, the number of low-risk employees increased by 8.7%.
Excess Costs
To link health management with company costs, we measure expenses associated with medical care, pharmaceutical demand, absenteeism and worker’s compensation and compare them to health-risk groups. Costs for employees that don’t participate in LSR are also compared to the various risk groups. The base cost includes both medical-related expenses and productivity measures. As risks increase, so does the excess cost. Employees classified as moderate risk exceed the base cost by 50% while high-risk employees double it. Over the last three years, the portion of total cost attributable to excess health risks has sharply decreased (25% to 19.6 %). To manage excess costs, we strive to maintain low risk individuals, while reaching out to the high risk to improve their risk status.
Cost Trends
In 2000, the baseline cost across participant and non-participant groups was very similar. Over the years, a divergence has been seen. The linear pattern in the chart below shows that LSR participants have had the least percent of growth (8.9%) over the 6-year period. While the people that do not participate in LSR have a slightly greater slope than those that do, it is the non-participants’ whose growth rate is the greatest (13.3%).
For all company-insured employees from 1999-2005, our participant vs. non-participant cost trend (all 4 cost measures), shows an overall savings of approximately $264 per employee per year.
Cost Comparison by Participation
(Medical, Pharmacy, Absence, and Worker's Compensation)
% growth as the baseline (Year 2000: $5,190/year)*
Annual Increase was adjusted for the CPI respective to medical and productivity.
Cost Savings
To date, the program has achieved $10.1 million in savings (an ROI of 1.73), and has lowered the average health risk of the population, despite its increasing age.
Keeping current participants engaged while attracting new participants is critical to the company’s financial goal for health care cost stabilization. HEI will continue to administer the Lifestyle Rewards Program as a key component of our overall health care strategy and desire to improve employee health status now and into the future./p>
Evaluation Documentation
Critique
The following are verbatim remarks made by the reviewers:
A
- We Energies has done a very good job of collecting HRA data and has used incentives to maximize participation. They have also done a very nice job of analyzing this data.
B
- Clear program goals, including health and financial outcomes, are aligned with supporting program design
- Integrated strategy encompassing health management, safety, work-life balance, disease management and supportive work environment, all supported by incentive program
- Well-designed and clearly communicated incentive strategy with menu of program options to accommodate entire eligible population. The one exception to clear communications is that it was not clear from communications how qualification for some incentives is measured.
- HRA administered annually to assess trends in health risks and related health outcomes and link to program participation
- Financial outcomes analysis, including direct medical costs and two indirect cost components – absence and workers compensation.
C
- Seemingly well-designed comprehensive health management program.
- Uses a $300 incentive amount (pre-tax) to encourage a range of Wellness participation, completion and achievement purposes.
- The program has been in operation for approximately 10 years.
- Uses U of M’s HRA and data analytics.
- Have continued to examine health risk relationship to annual health costs.
- Proportion of health cost due to excess risk has declined from 25.7% to 19.6% of total claims cost over the last three years.
- Participant health care average cost growth rate had largely stabilized at 8.9% over 6 years while non-participants experienced a 13.3%].
- $264 was identified as the average annual savings per participant.
- They are monitoring risk migration and its implication for health cost experience.
- They have provided evidence of peer reviewed article, but the article was a descriptive look at the health risk prevalence and health cost relationships of the work force rather than an evaluation of the effectiveness and impact of the We Energies program.
D
- Good longevity, excellent participation rates
- Good incentive (up to $300)
- Corporate commitment
- U. Michigan evaluation
- Solid trend-based cost savings
- Risk factors down around 20%
- JOEM peer-reviewed evaluation
E
- 85% participation since inception – annually 50+% participation
- Annual incentive of $300 to participate (which is high)
- U of M longitudinal analyses of cost trends show different cost increase gradients for participants vs. non-participants
- Fig. 3 shows significant risk reduction comparing 2006 and 2003 in most risk categories
- Generally well structured incentive program
F
- Overall a good program and well written application. They were able to demonstrate cost outcomes and favorable risk reduction.
G
- Participation greater than 50% annually. Program sustained since 1998. Makes up to $300 available as an incentive based on achieving select wellness criteria. Based on HRA has documented reduction of high risk and growth of low risk populations.
- Compared participants and non-participants, documenting a difference in the growth of health care costs equating to $264 less per employee per year in the participant group.
- HRA used to drive “wellness” interventions.Condition coaching strategy in place.
H
- Published study results; assessment of time away from work as well as medical, Rx costs.
- Good comprehensive programs.