Positive Health Improvement Program Results

By Karen O’Hara

L.L. Bean, the Maine-based company known for its environmental advocacy, durable apparel, and outdoor equipment, also has developed a reputation as a progressive company with regard to the way it manages the health and wellbeing of its workforce.

But there has been a learning curve to get to that point, according to Deborah Roy, a certified occupational health nurse and the company’s corporate director of health, safety, and wellness.

Ms. Roy cited L.L. Bean’s analytics and anecdotal experience during a presentation on Positive Outcomes of Health Improvement Programs at the recent American Association of Occupational Health Nurses (AAOHN) national conference in Atlanta.

“We got into wellness 29 years ago,” Ms. Roy told hundreds of occupational health nurses in the audience. “We didn’t know then how to collect relevant data. We did it because we thought it was the right thing to do.”

Fast forward to 2011: While L.L. Bean’s senior management appreciates the healthcare cost savings associated with keeping benefit plan recipients healthy, occupational health staff members still need to produce meaningful metrics to justify wellness interventions and their role in the company.

“You always want to have ammunition ready for the doubters,” Ms. Roy said. “Many of us are in organizations that have bits and pieces…It is really important to look at this as a strategy – what works, what doesn’t work. For us, it was mainly about getting aggregate data so we could identify risks and do something about them.”

Lifestyle Program

L.L. Bean’s branded Healthy Lifestyle Program features telephonic health coaching in response to personal health questionnaires (the HRA/coaching vendor is WebMD) and biometric test results. The 84 percent of benefit plan members who voluntarily participate in the program pay reduced rates for their health insurance: a 30 percent share for participants compared to 45 percent for non-participants.

Health improvement activities include an onsite fitness center, group exercises; stretch breaks; an employee assistance program to address behavioral health issues; and health education opportunities via classes, intranet, and newsletters.

L.L. Bean has a tobacco-free campus and offers healthy choices in its cafeteria. The campus features walking paths and employees may join an outdoor club. The corporate culture supports employee engagement and encourages exercise breaks during the workday.

Performance indicators used by L.L. Bean include medical costs, presenteeism (working at diminished capacity because of illness or injury), and work absence. Table 1 compares health risk results from 2007 to 2010. Tables 2-3 feature return-on-investment data over a three-year period.

Factors affecting ROI over time include coverage for preventive care, a transition from co-pay to deductible programs, a move toward increased contributions to health savings accounts, and a workforce culture that favors an active lifestyle. “We don’t know with 100 percent certainty everything that went into the decline in costs,” Ms. Roy said.

Another Way to Measure

To assess the effectiveness of a conditioning program, L.L. Bean followed 12 randomly selected volunteers, six from its customer service division and six from material handling. While the cohort is small, the methodology is considered replicable.

 The 12 participants were pre- and post-tested and results were compared to a control group. Of those undergoing conditioning, half were at high risk due to physical inactivity. The participants attended 45-minute exercise classes three times per week for 12 weeks to improve cardiovascular fitness, strength, and flexibility. Among participants:

  • there was an 18.5% increase in productivity as measured by units/hour;
  • duration of exercise increased from 15 minutes to 29 minutes during the study period;
  • 54.5% reduced their body mass index;
  • obesity rates decreased from 36 percent to 27 percent;
  • 90% increased physical activity;
  • 91% increased the number of push-ups and curl-ups they could do.

The company spent about $5,000 on the program, including lost work time and instructor fees, and it got about a $10,000 return on its investment in terms of avoided annual potential healthcare costs. “Not bad for a tiny pilot,” Ms. Roy commented.

Resources and References

  1. CDC Behavioral Risk Factor surveillance system: www.cdc.ogv/brfss
  2. Health Enhancement Research Organization (HERO): www.the-hero.org
  3. Relationship Between Modifiable Health Risks and Group-level Health Care Expenditures; Anderson, David R., et al.; American Journal of Health Promotion, Vol. 15(1), 2000.
  4. National Norn for Health Risks; Centers for Disease Control and Prevention, retrieved March 7, 2011; www.cdc.gov/brfss

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