HR Magazine

Better than the company gym

Better than the company gym – importance of communication in employee wellness programs

Scott Campbell

A widespread prevention message using newsletters, self-care guides and telephone counseling reaches employees and their families and makes the bottom fine healthier.

Health experts have calculated the average real cost of poor employee health at more than $10,000 per employee household per year. The costs can be staggering when you add up a company’s expenses for absenteeism, treatment of illnesses under the health plan, long-term or permanent loss of employees to catastrophic health conditions, as well as low/productivity caused by chronic pain, fatigue or high stress levels. It’s no wonder companies prefer to prevent health problems through wellness programs.

Given the advantages of keeping employees healthy, you might think wellness programs would have a healthy effect on the bottom line. But that’s not necessarily so. The concept is golden, but most wellness programs are not designed to achieve strong net savings.


A new approach is clearly needed. Use of communications media – whether print, telephone, or computer – can help reach employees and dependents wherever they are located, on every health topic.

“A critical success factor within any program initiative is the appropriate use of communications,” advises George J. Pfeiffer, past president of the Association for Worksite Health Promotion. “Regular communications will build awareness, increase knowledge, teach skills, motivate, and reinforce the desired health action. In reviewing successful programs, especially in the area of demand management, this has been the case. The benefit to the organization is cost-effectiveness and improved program efficacy.”


The classic scenario is of an employer offering occasional health improvement seminars at one or two of its largest locations. These programs are inaccessible to the rest of the employees and dependents, and many such seminars reach only about 1 percent of employees. Rarely do these programs, or the company gym, involve 5 percent of the company population regularly.

Wellness education and consumer medical guidance can be extremely cost-effective. But first, this assistance and information need to reach or be accessible to employee households. Methods that reach only 1 percent to 5 percent of the population are dismally ineffective.

Once is not enough (even during the Super Bowl). Imagine for a moment that you are the director of marketing for a company. Would you propose that sales goals could be reached if three-quarters of the total marketing budget were spent for just one ad during the Super Bowl? Some health promotion programs resemble this approach when they put most of their budget into one event, typically a health fair or health screening. Such once-a-year promotions have a limited impact initially, and an even smaller impact each subsequent year. When it comes to changing health behavior and reducing the number of behavior-related health problems, more frequent reinforcement of healthy lifestyles is more effective.

Greater frequency makes the difference. Employees want to be healthy, and they want their families to be healthy too. Studies show that as frequency of exposure to health-improving information is increased, health-improving behavior increases. Medical researchers attribute most of the recent decrease in the rate of heart attacks to more frequent messages about the disease risks of smoking, high cholesterol and high blood pressure.

Employers can disseminate disease-prevention information more frequently in various printed formats from nonprofit health associations or from their managed-care networks. Health newsletters are a cost-effective way of giving employees information on improving health and preventing disease by covering topics from A to Z in an easy-to-administer monthly format. The most cost-effective newsletters are 4 to 12 pages long, have many short articles, and a wide scope of assistance for disease prevention, health improvement, work and family issues, safety and consumer medical information.


Like changing the oil in your car regularly, many health promotion programs are actions that will pay off as long-term investments. Preventing illnesses such as heart disease, strokes and cancer can save tens of thousands of dollars in treatment costs. Some health education programs, however, yield strong returns on investment in less than 12 months.

Most people use the Self Serve rather than Full Serve gas pump to save money and time. There are parallels in health care. The most frequent health problems are minor – colds, flu, cuts, sprained ankles, burns – and can be appropriately treated with simple actions.

Providing medical self-help communications to employee families significantly reduces unnecessary medical and absenteeism expenses. Strong first-year returns on investment have been repeatedly documented when medical self-care guides and/or telephone decision counseling are provided to employee households. More than 10 million American households have received these resources and found guidance and greater understanding when symptoms arise. Dozens of minor conditions can be appropriately treated with simple actions and the assistance of a medical self-care guide and/or a nurse on a telephone decision counseling service.


An estimated 20 percent to 40 percent of doctor office visits are for minor problems that could be appropriately treated by self-care. These visits represent another significant opportunity to reduce unnecessary absenteeism expenses. About 55 percent of emergency room visits are for conditions that are not true emergencies and could be more appropriately and affordably treated in a doctor’s office or by self-care. Research studies have repeatedly found that medical self-care guides and/or telephone decision counseling reduced use of outpatient medical services by 15 percent to 24 percent.

“Without question, communications-based strategies are highly effective in reducing inappropriate use of medical services,” says James Otis, vice president of research and development at The Center for Corporate Health. The center recently completed a large-scale, insurance claims-based study on the impact of health decision counseling and self-care programs. A self-care book combined with a monthly health newsletter reduced outpatient utilization, saving $2.40 for each dollar spent in the first year. An even more powerful effect was observed when the same self-care book was paired with a 24-hour nurse telephone counseling service. This program reduced health-care expenses by saving $4.75 for each dollar invested over the same period.

Employee surveys consistently show that a high percentage of employee households use and appreciate understandable health-improvement and consumer medical information. People want relief from their medical symptoms as soon as possible. Medical self-care guides and telephone health-counseling services provide help to all employee households, whenever symptoms occur, and guide people to appropriate treatment and quicker recovery. Excess medical utilization is reduced, and employees feel more confident in their health decisions. These approaches to cost management are much more popular than shifting increased costs to the employees or restricting their health benefits.

Rubbermaid Cleaning Products was concerned that its wellness program and managed-care network were missing opportunities to help employees when symptoms arose at home. Leon Wright, manager of benefits and services, proposed an inexpensive program of self-care education. Employees received a brief orientation on how to use their self-care books at home.

“The self-help book was positively received and showed that we cared,” said Wright. “We reinforce wellness and self-care messages every month with an inexpensive health newsletter. Not only have our medical expenses decreased significantly, but the number of doctor office visits has declined. We are convinced of the cost-effectiveness and the wisdom of educating our associates.”


Preventing disease among employees requires a company to provide education over the long term. Printed information, presented in an engaging format, provides households with help every month on a full range of health topics. Newsletters, medical self-care guides and telephone counseling have repeatedly been shown to reduce unnecessary medical utilization and absenteeism with strong net savings in considerably less than 12 months. In fact, such approaches usually achieve net savings within a matter of months.

Not caring enough to sustain health-promotion efforts will cost your company thousands of dollars per employee per year. Some observers say U.S. businesses are fixated on the short term. Are we smart enough to do a little each month to prevent catastrophic problems?

RELATED ARTICLE: Comparative Effectiveness of Health Education Approaches

Company Gym or Health Club Memberships

* Inaccessible to or not used by most employees or dependents.

* Address narrow scope of health issues.

* Very expensive.

* No documented evidence of net savings.

Health Seminars, Classes or Luncheon Presentations

* Inaccessible to or not attended by most employees or dependents.

* Address only one health issue at a time.

* Nominal to significant expense.

* Documented evidence of net savings virtually nonexistent.

Print or Telephone Communications Approach

* Accessible to all employees and to all dependent households.

* Accessible many time, 24 hours a day, when need or interest arises.

* Greater frequency increases effectiveness.

* Free to nominal expense.

* Provides help on full range of health and safety issues.

* More than 90 percent of employee households report using the information.

* More than 90 percent of employee households say they appreciate the information.

* Many studies have documented net savings in less than 12 months.

Scott Campbell is president of Cost-Effective Wellness in Reston, Va., and a consultant to employers and managed-care organizations on consumer health and medical education programs. In 1985 he served as SHRM’s national committee chairman for employee wellness.

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