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CEO
Letter to Clients
Health Care Reform is on the Move, but Not Everyone is Waiting for Federal Legislation. Here’s Why.
During the past month, lively activity in Washington, D.C., suggests President Obama’s conviction that “health care reform cannot wait, it must not wait, and it will not wait another year,” is gaining traction.
This April, Congress began work on sweeping legislation to revamp the nation's health care system. Two influential U.S. Senators, Ted Kennedy, chairman of the Senate Health, Education, Labor and Pensions Committee, and Senate Finance Committee chairman Max Baucus vowed to work together to present legislation overhauling U.S. health care by June and formally launch the reforms in 2009. Also last month, Obama signed an executive order establishing the White House Office of Health Care Reform. This office will coordinate executive departments of the administration’s policy to provide quality, affordable and accessible health care and to slow the growth of health costs. As you are likely aware, Obama’s health care reform agenda includes a focus on prevention as a means to rein in medical care costs. Yet, many companies, impatient to reduce operating expenses, are not waiting for federal legislation to pass to reel in health care costs and improve the productivity of their workforce. According to a recent survey by Watson Wyatt and the National Business Group on Health, companies continue to add wellness and health management programs to promote healthier behaviors among their workers—despite the recession and recent cutbacks in some benefit programs. Employer interest in programs that promote a healthier workforce continues to increase, the survey found. For example, nearly six in 10 companies (58 percent) offer lifestyle improvement programs, up from 43 percent in 2007, while 56 percent offer health coaches compared with 44 percent in 2007. The number of weight management programs is also on the rise, offered by 52 percent of companies, up from 42 percent in 2007. Our client Piedmont Natural Gas is just one example of a company that continues to keep its commitment to employee health in the current environment. And proof that its health management program works is tangible in the form of contained health care costs and improved employee health. Just two years after launching its program, health risk assessment results showed employees achieved significant risk reductions in areas such as blood pressure, cholesterol, nutrition and physical inactivity. Piedmont also achieved another critical milestone: It avoided raising employee and company contributions to medical premiums in 2009. To read details about Piedmont’s comprehensive approach to employee health, download our new issue brief, “The Competitive Edge of Piedmont Natural Gas’ Strong Culture of Health,” available for free at
http://www.hfit.com/briefs.cfm. Along with Piedmont, we recognize engaging employees as part of the solution to rising health care costs is something you, too, view “cannot wait” another year. We understand that you require programs that affect your bottom line today—and we’re pleased to partner with you to improve employee health and productivity to meet this critical requirement. Yours in good health,

Gregg O. Lehman
Inside HealthFitness
Exciting Initiatives Underway with Our Science Advisory Board
To ensure the quality and relevance of our solutions, HealthFitness draws on the subject matter expertise of our five-member Science Advisory Board. These independent professionals are nationally recognized in areas such as nutrition and obesity, exercise and fitness, behavior change, outcomes research and managed care.
At the end of March, our Science Advisory Board members met with our Research Development and Outcomes team to share their perspective on emerging market trends and the effect of President Obama’s administration on our business.
From these discussions, the board identified increased market interest in several key areas, including:
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Integrating wellness initiatives into worksites.
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Managing employee health across the continuum of care and providing all employees with tools to take action with their health
- regardless of whether they are simply contemplating a change or are looking for support to maintain health improvements.
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Understanding the impact of health risks on absences and productivity for employers.
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Social networking capabilities that give individuals an opportunity to share their struggles and successes of reducing health risks.
At the meeting, our Science Advisory Board members said they have seen an uptick in the number of employers that believe health management saves them money—especially during the current economic conditions. In fact, an April 6
Inc. magazine article affirmed this, citing a Buck Consulting survey and resources that said, despite the need to reduce operating costs, workplace health initiatives are one area where CEOs are not willing to make cuts.
Looking ahead, HealthFitness will consider how to be proactive with the trends identified by the board.
Additionally, HealthFitness will work with our board members to identify collaborative research projects that demonstrate the impact of healthy behaviors on chronic disease. The initial research areas HealthFitness and our Science Advisory Board will investigate involve nutrition and exercise and their effect on diabetes and cardiovascular health. HealthFitness expects to identify specific projects by late May 2009.
For additional information on the expertise of our Science Advisory Board members, visit
http://www.hfit.com/sboard.asp.
HealthFitness Launches New Employee Health Partnership with State of Nebraska
This April, HealthFitness announced a partnership with the state of Nebraska to develop and administer a comprehensive health management program for more than 17,000 state employees. This program makes Nebraska one of the first states to offer workers a comprehensive plan for health insurance designed to encourage healthy lifestyles.
Set to launch July 1, Nebraska’s WellnessOptions program will offer lower premiums and better coverage for certain screenings to eligible employees who complete a confidential health assessment. In subsequent years, state employees and their covered spouses who enroll in the WellnessOptions plan will receive lower insurance premiums when they complete the health assessment as well as participate in basic biometric screenings and coaching/education programs.
“HealthFitness is thrilled to partner with the state of Nebraska and help improve the health and well-being of their 17,000 public servants,” said Gregg O. Lehmann, president and CEO, HealthFitness. “We look forward to collaborating with the state and their employees to deliver measurable results with health improvement.”
For Nebraska’s WellnessOptions program, HealthFitness will provide health assessments, screenings, an eHealth portal, EMPOWERED™ Health Coaching and programs for condition management.
“WellnessOptions will have a strong focus on education and preventive care,” said Carlos Castillo, director of the Nebraska Department of Administrative Services. “Through this program, over time, we hope to slow the increase in health insurance rates for employees and the state.”
HealthFitness’ Ed Framer Contributes to Book on How to Build Healthy, Productive Companies
HealthFitness’ Director of Health and Behavioral Sciences Ed Framer, Ph.D., and Yosuke Chikamoto, Ph.D., HealthFitness’ former director of research, contributed a chapter to the
American College of Sport Medicine’s Worksite Health Handbook: A Guide to Building Healthy and Productive Companies, 2009.
The chapter, “The Assessment of Health and Risk: Tools, Specific Uses and Implementation Processes,” covers information on assessments, measurement and evaluation.
The handbook is designed to provide practical ideas, approaches and solutions for implementation as well as examples of best practices and successful programs that will support efforts in creating interventions that improve both workers’ health and business performance.
The book is endorsed by the International Association for Worksite Health Promotion, a new ACSM affiliate society, and is available through retailers such as Barnes & Noble and Amazon.com.
Reinforce Healthy Behaviors with These Low-Cost, Effective Tools
Employee newsletters are the workhorses of internal communication. And, there are good reasons for that standing: flexibility, low cost and ease of use among diverse populations. When used strategically for the right reasons and tactically with the right content, employee newsletters can effectively connect and communicate with even the busiest readers.
With health-related information, newsletters can serve as an awareness-building and educational tool for almost all populations. They provide timely and action-oriented information on health, safety, productivity and other topics. Plus, newsletters not only reach employees; they are often shared with family members and dependents.
In partnership with Personal Best, a provider of publications, HealthFitness can integrate targeted newsletters and educational brochures as part of a comprehensive plan to engage employees in healthy behaviors.
Examples of available newsletters include:
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TopPerformance - a monthly two-page newsletter with information on coping with pressure, work/family balance, workplace conflict, communication, time management and more
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HealthLines - a
monthly eight-page newsletter with comprehensive
articles on health, lifestyle behaviors, safety,
healthy eating, recipes, and more; offers the widest
options of customizations
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ShiftWorker - a monthly two-page newsletter with articles written to address shift-work issues such as sleep, digestive and heart problems, family conflicts and more.
“Health-focused newsletters are a great way to maintain the visibility of health promotion. Broad topic newsletters can be customized to include front- and/or back-page articles specific to the employer and program. Or, by selecting a specific topic, such as shift work, you can send these newsletters to the home and reach this hard-to-reach group,” Tanja Madsen, director of program development, HealthFitness, said.
Additionally, HealthFitness offers more than 100 educational brochures on topics ranging from weight management and stress management to nutrition and workplace productivity.
“Educational brochures are ideal for events such as the National Employee Health & Fitness Day, health fairs, and topic-specific events such as a blood pressure screening or a healthy cooking demonstration, where people are interested in the topic and would benefit from a take-away that recipients can then share with their family members,” Madsen added.
Many newsletters and brochures are also available in Spanish.
For additional information or a complete listing of brochure and newsletter topics by title, contact your program manager.
Best-in-class Practices and Awards
Innovative Programming Reduces Impact of Obesity on Employees and Client Health Care Costs
Studies show obesity is linked to the development of many of the costliest diseases such as diabetes, heart disease, cancer and high blood pressure—chronic conditions that account for nearly three-fourths of health care spending in the U.S.
Additionally, obese workers cost an estimated $42.29 billion in lost productivity, an excess of $11.70 billion compared to normal-weight workers.
To help reduce the impact of obesity on our clients’ health care costs, HealthFitness is committed to delivering innovative programming that improves employee health. Below are just a few examples of how our programming is delivering results:
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A “Fittest Winner” program at the Toyota Fitness Center in Torrance, Calif., motivated 264 participants to lose a total of 1,195 pounds this year. The Fittest Winner is a play on the popular NBC TV show, “the Biggest Loser.”
Forty-four teams of six employees participated in the eight-week weight-loss competition, which ran February through April 2009. The objective of the program is to be the team with the highest percentage of weight loss.
As part of the program, HealthFitness’ on-site team provided sessions focused on strength training, cardio workouts and nutritional counseling, and offered team boot camp classes. To track their progress, participants weighed in every two weeks at the fitness center.
“The Fittest Winner is a great program,” wrote a participant on the post-program survey. “It got me away from sitting in front of my computer. I have made a lifestyle change due to the program, which has made me feel better about myself. I also knocked off 21 pounds and several inches off my waist.”
HealthFitness has managed the Toyota Fitness Center in Torrance, Calif., since 1996. The 25,000-square-foot facility includes a swimming pool, tennis courts, basketball court, two group fitness studios, an outdoor jogging track, and a variety machines, free weights and class offerings. The fitness center has a membership of 2,300, representing 76 percent of eligible employees.
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At the West Wood Health and Fitness Center in Pewaukee, Wis., 26 members enrolled in T.E.A.M. West Wood-94 Day Challenge, a free weight-loss challenge. After 94 days, the winner lost 30.1 pounds and average weight loss per person among the group was seven pounds.
HealthFitness’ on-site team partnered with a local radio station (94.6 on the dial, which is why the program was called the 94-day challenge) to provide the program and generate community excitement.
To participate, members had to write a 500-word statement about why they wanted to partake in the challenge. They also had to commit to activities such as weekly weigh-ins, group fitness classes and/or personal training sessions. Additionally, participants met with a dietitian and life coach every other week to help keep them on track. Participants ranged in age from 30-70.
Upon completion of the program, one participant said, “I am now so much more aware of my eating weak spots, so I am able to avoid them by not putting myself into those situations.”
HealthFitness has managed West Wood since 1997. West Wood currently serves more than 5,000 members and is a medical model-based fitness center that provides the full spectrum of fitness services for ProHealth Care, a regional provider of primary and critical care.
Let HealthFitness Help Put Your Program in the Spotlight
Win recognition for the cost savings that your health improvement program generates from health risk improvements by applying for a C. Everett Koop National Health Award. HealthFitness is happy to partner with you to pull together your application.
The Health Project, a private-public organization formed to generate attitudinal and behavioral changes in the American health care system, sponsors the awards. The Health Project seeks programs that improve health by reducing health risks, reduce medical care costs, and can definitively document effectiveness at these goals.
Program categories (programs may be in more than one) include chronic disease, high risk, innovator/vendor, insurance, integrated systems of care, Web-enabled, productivity enhancing and worksite-based.
Visit http://www.sph.emory.edu/healthproject/ for additional information or talk with your program manager. The deadline for applications is May 29, 2009.
Industry Insights
Tailored Messaging Key to Participant Engagement—Insights from AJHP Conference
Health educators, exercise physiologists, and other industry colleagues gathered at the American Journal of Health Promotion Conference in San Francisco this March to share effective methods to enhance and retain participation, contain medical cost increases and achieve other critical outcomes in health promotion.
Highlights of presentations included:
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“Best Paradigms for High-Impact Health Promotion Programs,” by James Prochaska, Ph.D., director and professor of the Cancer Prevention Research Center at University of Rhode Island. Prochaska is known for his “stages of change” theory, which identifies five stages that participants undergo while adopting a behavior change. These include pre-contemplation, contemplation, preparation, action and maintenance.
In his presentation, Prochaska discussed the need to extend the reach of health promotion programs to participants in the pre-contemplation (no thought of changing, now or later) and contemplation (thinking about changing) phases to increase the probability of progressing these individuals to action. To achieve this, he recommends that companies tailor communication to these groups with a message of “wherever you are at, we can work with that.”
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“Tailored Messaging,” by Ken Resnicow, Ph.D., professor of health behavior and health education at the University of Michigan. Resnicow presented his findings from several studies on the impact of tailored messaging based on emotional triggers to drive behavior change. Typically, health promotion communication and messaging are tailored to populations based on gender, age, ethnic background or education. His research shows that messages individually tailored to personal values and emotions can strongly increase the likelihood of a participant undertaking a behavior change and maintaining it.
HealthFitness Co-Presents with Eastman Chemical Company on Effective Incentive Strategies at Industry Conference
Employers, insurers, health care providers and population health professionals attended the DMAA Integrated Care Summit this March in Austin, Texas, to share successful strategies for improving employee health and productivity.
At the conference, Gregg Lehman, Ph.D., HealthFitness president and CEO, and David Sensibaugh, director of Integrated Health, Eastman Chemical Company, co-presented a case study on “Using Incentives to Engage Employees in Health and Productivity Programs.” The session examined the use of a graduated incentive approach to first engage and then maintain participation in employee health and productivity programs.
Using a new incentive structure, participation in the health risk assessment increased from 30 percent to 94 percent. To receive the incentive the second year,
Eastman Chemical Company
employees were required to participate in the health risk assessment plus one or more health improvement programs. This earned a 90 percent participation rate.
Learn more about Eastman Chemical Company’s unique incentive structure and culture of health by downloading a free issue brief, “Applying 21st Century Benefit Design: A Culture of Health in Action,” at
http://www.hfit.com/briefs.cfm.
Buzz from Recent Research
Daily Diet of Red Meat Increases Risk of Dying
People who eat more red or processed meat have a higher risk of dying, especially from cardiovascular disease and cancer, than those who eat less red or processed meat, according to a new study from the National Cancer Institute.
In the study, researchers looked at the diets of more than half a million people, ages 50 to 71, during a 10-year period. Those who ate the highest amount of red meat (62 grams per 1,000 calories or the equivalent of a small steak per day) were found to have a 30 percent higher risk of dying from any cause than those eating the least amount of red meat (about 10 grams per 1,000 calories). Cardiovascular disease and cancer were the two most common causes of death. Red meat included all types of beef and pork, including ham, bacon, steak and hamburgers as well as meats in foods such as pizza and stew.
In addition, those eating the largest amounts of processed meat, such as bacon, sausage, cold cuts, ham and hot dogs, also had a higher risk of dying (25 percent higher in women and 16 percent higher in men) than those who consumed the least.
The study also found that those who ate the most white meat seemed to have a slightly lower risk of dying compared to those who consumed the least. White meat included chicken, turkey and fish.
Researchers estimate that 11 percent of deaths in men and 16 percent of deaths in women during the study could have been prevented by reducing consumption of red and processed meats.
Red meat contains important nutrients needed for overall good health, such as protein, iron, zinc, B vitamins and selenium. The key is to eat red meat in moderation (no more than 18 total ounces per week or 2.5 ounces per day), choose lean cuts, and have very little, if any, processed meat.
Sources: Sinha, R. et. al. Meat Intake and Mortality: A Prospective Study of Over Half a Million People.
Arch Intern Med. 2009: 169(6):562-571.
http://www.cnn.com/2009/HEALTH/03/23/healthmag.red.meat.lifespan/
Where We’ll Be Next
HealthFitness looks forward to meeting you
at these upcoming events.
Health & Human Capital Management Series Executive Forum on Rewards and Incentives to Improve Employee Health
World Congress
May 12, 2009
Chicago
AHIP's Institute 2009: Changing Economy, Changing Health Care, Changing Lives
America’s Health Insurance Plans
June 3-5, 2009
San Diego
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