CEO Letter to Clients
Industry Moves to Meet Employees Where They Are
You’ve seen the headlines, and if you attended the 18th Annual Art and Science Health Promotion Conference, in conjunction with the International Health, Racquet and Sportsclub Association, in San Diego earlier this month, you heard the buzz.

The health management industry is undergoing an interesting transformation. Several health clubs now offer health coaching, and some vendors have launched health coaching directly to consumers. These and other trends validate the importance of meeting people where they are, and providing individualized support to adopt healthy lifestyle choices. At HealthFitness, we see many companies adopt the same approach with employees and realize measurable results.

This movement is a marked departure from the traditional mindset of companies to treat employee health by providing care only when people were sick and cutting benefits to control costs.

Today, forward-thinking companies are embracing the preservation of health and prevention of disease, and addressing the health care needs of their entire employee population, not just those who are ill. In line with this new way of thinking, many are also shifting the ways they provide health management to employees.

To improve employee health, we see employers strive to provide opportunities that make healthy choices easy choices, and they accomplish this by providing employees with the freedom to choose how to achieve their personal health goals. Within today’s changing face of health management, this means offering individualized guidance through multiple touch points—a customized Website, face-to-face interactions and telephonic support.

Our experience shows that providing employees with a choice of delivery options to fit their preference generates increased participation—and ultimately improved outcomes—for employers and the health management programs they offer.

And for employers, the benefit of providing these health management programs is they retain a role in influencing and guiding the information, tools and support employees receive to get and stay healthy, ensuring effectiveness and ROI.

Yours in good health,

Gregg Lehman

Inside HealthFitness
New eHealth Offering Helps Keep Employees Moving
Walk This Way®, HealthFitness’ walking program, is now available on our eHealth platform. Walk This Way is designed to encourage participants to enhance overall health and physical activity levels by accumulating 10,000 steps or by walking 30 minutes each day. Walk This Way includes an easy step tracking tool, comprehensive guide and log book, automatic motivational e-mails, step conversion calculator and more.

With Walk This Way on our eHealth platform, clients have the ability to customize program length from 12 weeks to 12 months–or any length in between. Plus, it’s also turnkey, allowing clients to offer the program even if they do not have on-site HealthFitness staff.

Walk This Way on eHealth is available for clients and accounts that are billed by HealthFitness; this program cannot collect money directly from participants.

To learn more about Walk This Way available on eHealth, contact your program manager.

Using Early Injury Prevention to Reduce Medical Costs, Absenteeism
Companies that embrace a culture of health know preserving health and preventing injuries is an effective way to avoid rising health care costs.

Overexertion, repetition, awkward postures, improper work techniques and other physical stress can cause musculoskeletal injuries such as tendonitis, carpal tunnel syndrome, strains and sprains, wreaking havoc on employee health and proving costly for employers in terms of health care claims, absenteeism, presenteeism, and reduced productivity.

According to the Bureau of Labor Statistics, musculoskeletal injuries account for 34 percent of all lost-workday injuries and illnesses. Additionally, the U.S. Department of Labor reports that musculoskeletal disorders account for roughly $1 of every $3 spent for workers' compensation.

To cultivate a culture of health, many employers are adopting a systematic early intervention program to address these issues, resulting in fewer injuries and associated costs among employees. For example, HealthFitness has been delivering an early intervention program for one of our clients, an energy company, since 2000 to reduce repetitive strain injuries and human suffering.

HealthFitness has a team of 12 employees who partner with the company’s 12,000 office workers to address early signs of discomfort before there is need for medical interventions. This program achieves more than 85 percent resolution of early injury symptoms, providing our client with substantial savings in medical claims, workers’ compensation costs, lost days, disability claims and human suffering.

HealthFitness’ Early Intervention Injury Prevention Program involves a three-phased approach. The first phase includes an ergonomic workstation assessment, risk identification, education in safe work practices, and implementation of corrective actions. If symptoms persist, the next phase involves a clinical evaluation, complete with a health history and medical tests. The final phase includes a work conditioning exercise program for flexibility, strength and endurance, and continued education and training in safe work practices to address early injury symptoms. Employees’ length of time in the program ranges from two to 16 weeks.

To learn more about HealthFitness Early Intervention Program and our complete menu of JOBFIT injury prevention and treatment programs, contact HealthFitness Regional Vice President of Occupational Health Dave Thoreson, dave.thoreson@hfit.com, 952.897.5266.

Inside Our Science Advisory Board: Meet Bruce Sherman
To ensure the quality and relevance of our products and services from scientific and technical perspectives for our clients, HealthFitness formed a Science Advisory Board of health industry experts in 2007.

Our six-person board applies expertise in nutrition and obesity, exercise and fitness, behavior change, outcomes research and managed care to the programs and services developed by our Research, Development and Outcomes group.

One of the experts on our Science Advisory Board is Bruce Sherman, M.D.

Sherman is the medical director, global services, for The Goodyear Tire & Rubber Company and the director of health and productivity initiatives at the Employers Health Coalition of Ohio. His work involves the development and implementation of customized, integrated strategies to control organizational health care costs and improve workforce productivity.

He has previously consulted with regional and multinational corporations, developing value-based health and productivity management strategies. He has served as medical director for a national worksite health care vendor, and as a pulmonologist and medical intensive care unit director at Mt. Sinai Medical Center, Cleveland.

Sherman received his bachelor’s degree from Brown University, his master’s degree from Harvard University, and his M.D. from New York University School of Medicine. He is board-certified in internal medicine, pulmonary medicine and critical care medicine, and is a member of the clinical faculty at the Case Western Reserve University School of Medicine.

Learn more about other members of our Science Advisory Board by clicking here.

Industry Insights
Recent Survey Identifies Trends with Incentives
A growing number of employers believe incentives are an important component of health and productivity programs, and offer a positive return on investment (ROI) shows a recent survey sponsored by the National Association of Manufacturers, the ERISA Industry Council and IncentOne.

The survey tabulated results from 242 companies, ranging from major U.S. corporations and mid-sized to large manufacturers. Of those responding companies, 75 percent offer health management to their employees, and almost half include incentives with those programs.

Key findings include:
• The most common incentive offered across health management is premium reductions, with 40 percent of companies using these as incentives. A strong second is cash or bonuses, offered by 29 percent of companies.

• Almost two-thirds (62 percent) of companies offering incentives had not attempted to measure ROI for their programs, and only 14 percent indicated they had successfully measured ROI. Among respondents that were willing to estimate ROI for their programs (whether or not actually measured), more than 75 percent estimated an ROI greater than break-even.

• Among those companies offering programs with incentives, 14 percent have successfully measured ROI. Another 16 percent are currently trying to do so. More than one-quarter (26 percent) of companies are finding a ROI of 1:1 or better, and 10 percent are finding a ROI greater than 2:1.

• Among those companies offering programs without incentives, three out of four indicated that incentives should be used.

Report Highlights Socioeconomic Challenges to Choosing Health; Commission Charged with Removing Obstacles
Income and education directly exert a powerful influence on health disparities in the U.S.—potentially as powerful as medical care or genetics—finds a new report.

Robert Wood Johnson Foundation released the report, which looks specifically at how education, income, race and ethnicity play a role in Americans’ health. The report, Overcoming Obstacles to Health, by researchers at the University of California, San Francisco (UCSF), found that:

• Poor, less educated and minority Americans on average die up to six years earlier than their wealthier, better educated counterparts.

• Middle-class Americans on average die up to two years earlier than more affluent Americans.

• In addition to living longer, more affluent Americans and their children live healthier lives than middle-class and low-income American families.

• Compared with college graduates, adults who have not finished high school are four times as likely to be in fair or poor health.

• Compared with adults in the highest income group, poor adults are three times as likely to have a chronic illness such as asthma or diabetes.

To identify short- and long-term strategies to improve the health of all Americans outside the health care system, the foundation formed a new Commission to Build a Healthier America.

The national, independent, two-year health commission will investigate how factors, such as education, environment, income and housing, shape and affect personal behavioral choices through an extensive inquiry that will include regional field hearings.

To learn more, visit www.commissiononhealth.org

Thought Leaders Gather at HERO Conference, Discuss Best Practice Scorecard
More than 60 thought leaders, corporate executives and other stakeholders attended the Health Enhancement Research Organization (HERO) Think Tank in Dallas-Fort Worth, Texas, in February. The Think Tank’s mission is to move employee health management forward as a measured strategy to enhance the health and well-being of employees, control health care costs, and improve work performance.

In addition to HealthFitness executives, several of HealthFitness’ clients also attended, including Pfizer and Florida Power and Light.

At the meeting, HERO discussed an updated version of its Employee Health Management Best Practice Scorecard. The scorecard is a self-administered instrument that helps employers, providers, and other stakeholders learn about and determine employee health management benchmarking and best practices.

The scorecard identifies benchmarks and defines best practice in critical core components, including corporate culture and leadership commitment, strategic planning, communication/marketing/promotion, benefit design, incentives, and program outcomes. The scorecard is available at no charge. Visit www.the-hero.org to learn more.

HERO is a national, research-oriented, not-for-profit coalition of organizations with common interests in health promotion, disease management, and health-related productivity research. The HERO Employee Health Management Best Practice Scorecard is protected by copyright and owned by HERO.

Best-in-Class Practices and Awards
Duke Medicine Creatively Engages Employees to Quit Tobacco
When Duke Medicine announced its campus was going tobacco-free in July 2007, HealthFitness partnered with the medical center to enhance additional smoking cessation options for Duke faculty and staff.

To support employees to quit, Duke began to offer free enrollment to company-sponsored tobacco cessation programs to all employees—regardless of benefit status—in October 2006. Since smoking by another member of a household can influence a person’s ability to quit, Duke also made all tobacco cessation programs available to spouses and same-sex partners through 2007.

Duke’s tobacco cessation program offerings include:

• Stop Smoking Personal Action Guide—How-to-quit basics in a 16-page booklet

• Living Free Web-based program—Three-week personalized program and three months’ support

• Partners in Quitting Telephone counseling—Nine calls and six months follow up

• QuitSmart® class—Three-or four-class series uses QuitSmart kit

• QuitSmart kit—Proven methods and tools in self-directed program

Additionally, Duke employees who participated in these programs and were enrolled in a Duke health plan could receive stop-smoking prescription drugs such as Chantix or bupropion with no co-pay for up to a three-month supply.

To date, these options are successfully driving participation. In 2006, 231 employees enrolled in a tobacco cessation program, up from 119 in 2005. Last year, 820 Duke faculty and staff signed up to “kick the habit” successfully. After six months of enrollment in a tobacco cessation program, 38.6 percent of participants reported quitting smoking and 39.8 percent of participants reported using less tobacco.

Research shows a number of interventions are known to improve smokers’ ability to quit, including counseling, nicotine replacement therapies and bupropion. Studies also show that insurance coverage for smoking cessation interventions both encourages their use and increases quit rates.¹

George Jackson, M.D., director, Employee Occupational Health & Wellness, Duke Medicine, and Jason Horay, HealthFitness program manager, will discuss strategies behind the medical center’s tobacco-free initiative at the 13th Annual Health Management Congress in Orlando, Fla., this July.

1 “Employer-sponsored Insurance Coverage of Smoking Cessation Treatments,” American Journal of Managed Care, September 2006.

HealthFitness Partners with Client Employee for Remarkable Recovery
Sensis employee Kathy Reid had high blood pressure and cholesterol, and exercised infrequently. She also smoked a half-pack of cigarettes per day. But this all changed in June 2005 after she survived a near-fatal heart attack. At the time, she was only 45 years old.

The event spurred her to take steps to reduce her health risks. And she credits HealthFitness Program Manager Jason Patti and the site’s other HealthFitness staff as being instrumental in her recovery during the past two years.

Upon discharge from the hospital, she began a walking program and attended cardiac rehabilitation. She gradually worked up to her current exercise routine: a minimum of 30 minutes a day, six days a week. Since June 2005, she’s lost 23 pounds, gained control over her cholesterol and quit smoking.

“Because of HealthFitness’ presence at Sensis and your assistance with establishing my new exercise routine, my cardiologist released me from cardiac rehabilitation in favor of Sensis’ new fitness center and HealthFitness’ on-site trainers,” said Reid.

“The assistance that you gave me during that new and difficult period gave me not only guidance in physical exercise and fitness, but also encouragement as well as informative resources when I needed it most,” she continued.

Reid is frequently asked to share the story of her remarkable recovery. She was chosen as the inspirational honoree for the Syracuse, N.Y.-region American Heart Association’s 2008 Heart Walk.  In addition, a Yale University research program, which focuses on young women (under 55) who are in treatment for heart attack, will feature her story in their newsletter to be released in March.

Sensis is a global provider of air defense, air traffic control, airline and airport operations management, and data integration and distribution. HealthFitness manages and staffs the Sensis Fitness Center.