Quaker Oats Company

Narrative Description of Program

Comprehensive worksite health promotion at Quaker protects our human and financial resources and adds to our competitive advantage. By firming wellness, prevention, and safe behavior as preferred lifestyle choices for over 10,500 employees and their dependents, we avoid unnecessary health care cost, enhance productivity, and reduce absenteeism and turnover. We also enable employees to experience Quaker's commitment to the wellness of its workforce. This integrated program is funded through the Benefits Department and comprises three key components:

Live Well-Be Well offers worksite wellness interventions that reduce lifestyle-related risk and build individual responsibility for health care costs Health Risk Appraisal (HRA), Stress Management, Nutrition and Weight Management, Back Care, of employees and their families. It includes Smoking Cessation, Blood Pressure Control, Cholesterol Control, Employee Assistance Program, Fitness Centers, and Health Resource Centers. These program elements and services are coordinated by the Corporate Health Services staff in collaboration with local-facility management.

Quaker Flex provides financial incentives, up to $500 per family annually, within our flexible benefit plan, to employees and spouses who meet any of eight healthy-lifestyle criteria. Employees and spouses may earn up to $140 each for making the following lifestyle pledges:

• At least 20 minutes of aerobic exercise at least three times a week,
• Use of seat belts, care seats, and helmets when driving,
• Not to drink to excess, use illegal drugs, or misuse prescription drugs, and;
• No use of tobacco products in the last six months and no use of them in the future.

Employees and spouses may also earn up to $110 each for completing a health risk appraisal, including screening for blood pressure, cholesterol, and weight. Participants' risk factors must be within guidelines, or document current intervention for out-of-guideline health risk indicators, in order to receive full financial credit for the HRA screening. The plan also features a Health Budget Account whereby employees' pre-tax contributions are matched 25 percent to the allowable limit. A similar matching feature is provided in a Dependent Care Budget Account.

Informed Choices represents an educational program that teaches employees to ask questions about their own health and related medical care. The program helps create a "shared choice" consumer model rather than the traditional passive-patient relationships with providers. The program includes consumer-oriented publications, group meetings, and hospital pricing data where available.

Participation

Employee participation in Quaker's comprehensive health promotion program is substantial as evidenced by :

• 72-percent employee participation in Health Risk Appraisal. (Exhibit A)
• Increase in employees pledging a healthy lifestyle (Exhibit B)
• Employee Assistance Program utilization of 5.9 percent for 1994, an increase horn 4.9 percent in 1993. (Exhibit C)
• Twelve of Quaker's 35 facilities have on-site fitness centers and eight have similar off-site arrangements. Only one location had an on-site fitness center in 1988.

Current Quaker Health Status

Quaker employees' health-risk status is better in 10 out of 13 areas compared to a normative group. This norm group represents a cross-section of the U.S. workforce and is comprised of more than 50,000 salaried and hourly employees from 27 different US industries. These comparisons are based on the latest HRA for over 10,900 Quaker employees and spouses. (Exhibit D)

Health Status Improvements

Quaker has documented a decrease in 12 out of 13 health risks within its employee population for repeat HRA participants since 1983. (Exhibit E)

Cost Impact

From the inception of Quaker's wellness-inclusive medical cost management in 1983, hospital admissions, total hospital days, and the average hospital stay have decreased significantly. (Exhibit F) Additionally, the compounded annual rate of increase has been 7.6 percent, significantly lower than the pre-program increase or medical-cost inflation.

Based on the documented health-risk changes alone, Quaker now saves at least $1.4 million annually. (Exhibit G) In addition, the mortality risks among 4,252 repeat HRA participants has decreased 2.8 percent, more than double the national normative levels. (Exhibit H)

Program Recognition

In October, 1992, Quaker received the National Gold Well Workplace Award from the Wellness Councils of America. The application process is peer reviewed and based on stringent criteria that include meeting Healthy People 2000 objectives in the workplace. (Exhibit I) Our wellness programs have also been widely recognized and described in several other wellness publications. (Exhibit J-K)

• Quaker Oats Company

The following assessment of program strengths and weaknesses has been abstracted from reviews by the Task Force on Program Selection of The Health Project. Where weaknesses are postulated, it must be taken into account that the review Task Force is very critical, that no programs are perfect, that the Award Winning programs have been selected from over 300 candidate programs and represent the very best, that the materials reviewed may have been incomplete, that suggested deficiencies may have resulted from incomplete understanding of the program by the reviewers or that any problems may have been corrected since the time of review.

Evaluation: The Quaker Oats "Live Well - Be Well" program, has since 1983, produced significant employee population shifts into lower health risk categories, with savings of at least $1.4 million annually. Mortality risks improved at double the national average for 4,000 in the health risk assessment program. Documented statistics 35 locations with repeat health risk assessments, show a decrease in 12 out of 13 health risks. Financial incentives reward achievement of eight healthy lifestyle criteria.

Cash incentives for participation. The program is comprehensive. Financial benefits are up to $500 per family. Participation rates are 72 percent. The program appears effective at decreasing health risks together with a slowed increase in medical costs. Hospital utilization was down. Estimated savings were 1.4 million dollars per year. The StayWell program was implemented in this setting. The use of multiple strategies such as education interventions, fitness facilities and financial incentives is commendable. The basic evaluation program is in place. The EAP linkage is good.

The description of the program could be clearer. Estimated cost reductions are indirect. There are no controlled studies. The savings are calculated but there is not representation of offsets by the cost of the program. Evaluation by the StayWell computer projections is a relatively superficial evaluation mode. Evaluation protocol may not be sufficiently rigorous to establish reported cost-savings.