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Staying healthy: your job or your employer's?


Exercise  This is the time of year, especially in Florida, when we are more conscious of how we look. Who wants to put on a swimsuit if you haven't worked out in months, maybe years?

So who is to blame for our out-of-shape bodies? Our boss who expects us to crank out more work with fewer bodies around to help or ourselves for not making the effort to be healthy?

I was invited to University of Miami's wellness center on its medical campus in downtown Miami and witnessed dozens of employees exercising in a palatial facility at lunchtime. Sure, beats packing on the calories from chomping on an overpriced sandwich. Of course, it's a lot easier to exercise when the gym is close by your office and your boss encourages you to exercise by giving you flexibility. Still, plenty of UM employees don't bother.

These days, employers are becoming much more mindful that they need to do something if they want to keep their healthcare increases from soaring out of control. But how far can they go in coaxing their employees to get fit? I tackled the topic in my Miami Herald column today


The Miami Herald

Balancing Act: Fitness pays in the workplace

It is lunchtime and dozens of workers at University of Miami's medical campus are running on treadmills, stretching in yoga classes and lifting weights in an on-site gym the size of a football field. Anne Auguste emerges from a spinning class drenched in sweat and proclaiming she feels energized.

``I look good and I feel good,'' Auguste says. ``If you work here, there's no reason not to be physically fit.''

The University of Miami has spent $40 million to build and maintain two on-campus wellness centers and offer programs to get its employees fit and healthy. It even has offered financial incentives to encourage participation from those less enthusiastic than Auguste, such as $150 medical premium credit for participating in an online health assessment and a 20 percent rebate on their wellness center membership.

But like many other employers, the university still is grappling with whether its investment in wellness pays off and how far to go in coaxing employees to participate.

As wellness programs continue to proliferate, this question becomes increasing valid: With employers picking up more healthcare costs, whose business is it if you are healthy -- yours or the company you work for?

``It's not clear where the line is or should be between personal responsibility and employer involvement,'' says Dr. Kevin Volpp, director of University of Pennsylvania's Center for Health Incentives.

In the last few years, corporate wellness programs have been fueled by employer desire to curb increases in healthcare costs, cut back on absenteeism and make employees more productive. Even when other benefits were cut during the recession, experts say companies continue to add wellness programs. Now, with healthcare reform ready to kick in, more employers are poised to dangle financial incentives and use creative measures to keep get their workers healthier.


Beginning in 2014, under health reform, employers can offer greater incentives to employees for participating in corporate wellness programs or meeting certain health targets. Those incentives can include reduced premiums, cash rebates or merchandise. At least a third of U.S. companies already offer financial incentives or are planning to introduce them, according to Volpp.

Some employers have gone a different route, coaxing participation in wellness programs through heavy-handed measures. Whole Foods CEO John Mackey caused a stir earlier this year when he announced employees' biometric screenings would determine what discount level they'll receive on health insurance. Those with BMI over 30 would not qualify for a discount at all.

Critics call Mackey's heavy-handed way of measuring health ``arbitrary'' and claim it gives a bonus to those who already are genetically thin.

Yet, as America fights a seemingly intractable obesity problem, healthcare costs are soaring. And with the new healthcare reform law, more companies may have to deal with the burden.

``Employers have to do something. Waiting for workers to get healthier on their own just isn't working,'' Volpp says. ``Most employers are still trying to figure out what's appropriate.''

If employee health is a personal matter, often employees know how to get healthy, but aren't taking action.

Gary Levin says he had all kinds of excuses for avoiding exercise and only took action when his employer stepped in. After a company-administered health risk assessment, Levin, administrative director of Florida Cancer Data at University of Miami, received an e-mail invitation encouraging participation in a cardiovascular group program three nights a week. They offered him a financial incentive to sign up.

Levin meets with a trainer who works with a small group looking to lose weight and build strength. His participation means he must leave his office by 3:45 p.m. three times a week, requiring flexibility in his schedule. ``They have given me motivation and opportunity.''

Of course, the danger in incentives is that employees will collect and fall back into their old behavior. Volpp points out that changing behavior long term, particularly with weight loss, is difficult, tricky to measure, and often does not pay off for employers.


A Miami food distributor pointed out to me: ``Why should I spend money on long-term results when there's no guarantee that the employee will stick around. And, by adding financial rewards, will that really change a person's behavior? It's like paying your kids to study.''

Rose Stanley, work-life practice leader with WorldatWork, a global human resources association, believes it would take at least three to five years before a company would see significant results in reduced costs.

The University of Miami realized it stood a better chance of employee participation if its culture supports wellness. It has instructed managers to encourage staff to attend wellness classes and to be flexible in allowing them time to go; managers also are evaluated on how actively they promote wellness in their departments.

Jennifer Cohen, director of UM Benefits, says figuring out return on investment is ``like finding the Holy Grail.'' The university just began tracking wellness spending in January 2009 and expects it to take years to determine a possible payoff.

``You can't measure what you save when someone avoids going to the emergency room,'' Cohen says, however, ``At the end of the day, we know it's better to help people get healthy. There's inherent value.''

© 2010 Miami Herald Media Company. All Rights Reserved.

Read more: http://www.miamiherald.com/2010/06/29/v-print/1707531/fitness-pays-in-the-workplace.html#ixzz0sLiPP6oZ