What does the face of rising health care costs look like at your company? Is it a line worker whose high blood pressure requires immediate attention? A carpenter who drinks two 2-liter bottles of soda a day, not realizing that diabetes is driving his thirst? Or a pregnant office worker who misses routine prenatal checkups? High blood pressure, cholesterol, obesity, heart disease, diabetes, smoking, poor nutrition, a lack of exercise, and inattention to preventive care are costing employers billions in high medical claims and lost productivity. For example, a 2002 report in the journal Managed Care Interface found that inadequate blood pressure control for those with hypertension cost $964 million nationally in direct medical costs. Smokers account for between 7 percent and 14 percent of annual medical spending and obesity for about 9 percent, according to a report by Scott Leitz, director for Minnesota’s health economics program, a division of the state’s Department of Health.

In the ’80s and ’90s, companies tried to curb medical expenses by controlling access to care and shifting more costs to employees in the form of higher deductibles, co-payments, co-insurances, and premiums. But they found that gains from managed-care fixes didn’t last long, says Nico Pronk, executive director for Minneapolis-based HealthPartners Health Behavior group, which provides analytical services and wellness programs for the insurer’s members and other customers. “The underlying cost driver is really the absence of health,” Pronk says.

At the same time, companies realized that such wellness resources as newsletters or on-site fitness centers were mostly reaching the already healthy, and not really influencing employees who needed them. “The average high-risk person has multiple health risks, and people with six or more have health care costs in the range of two to three times that of people the same age and gender who are low risk,” says David Anderson, vice president of program strategy and development at StayWell Health Management in St. Paul, a division of the European-owned health care information and communication company MediMedia USA. StayWell offers wellness programs for large employers.

“The ‘build it and they will come’ approach only takes you so far,” says Ronnie Bragen, product manager for Bloomington-based human resources firm Ceridian. So companies began to explore how to identify the high-risk employees and how to intervene, he says.

Within the past two years, these experts say, companies have begun to actively reach out to employees with increasingly sophisticated health assessment and promotion tools. The result is a burgeoning wellness movement that is already returning $3 for every $1 spent on programs. In the long term, employers hope wellness programs will encourage development of a healthier, more productive work force. “More and more companies recognize that if you have a healthy employee, it’s a good idea to keep them healthy, because you don’t spend as much money on them as you do if they contract a disease,” Pronk says. At the same time, companies are also interested in reaching “that 20 percent of the population that accounts for 80 percent of the health care expense,” says Deidre Serum, director of benefits for hospitality firm Carlson Companies, based in Minnetonka.

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