Wellness: A Choice!
A St. Thomas Health Services Wellness Program Case Study:
Return on Investment

The Beginning Years

1994

Wellness: A Choice! was proposed and began in 1994 upon recognition of the need for educating and directing employees regarding their personal health status. The premise was based on research demonstrating those with the most to gain are those moving from poor health status to average health levels. The program included incentives for participants, with larger incentives given to those who began in the poor health status category, rather than those moving from average to excellent health levels. Participants received both personal health knowledge and certain financial incentives applied to insurance flex credits.

Screening included completion of a personal Health Risk Appraisal (HRA) – including a health history – and uncovered such items as: the use of tobacco, biometric measures like height and weight, body fat composition (%), waist circumference, and resting blood pressure. A blood screening was also performed to determine lipid profiles for Total Cholesterol, HDL, LDL, Triglycerides, and Glucose levels.

Growth & Changes

1997

As the program become more popular, the first FTE was dedicated with the primary responsibility of managing the Wellness: A Choice! program. This included oversight of the first “Wellness Budget”, expanding the reach of the program to include screening for spouses (no financial incentive for spouses at this point) and the addition of Flu Shots, which counted toward the accumulation of program incentive points.

The arrival of HIPAA lead to modifications in the management of incentives available to employees, as discounts or rebates could no longer be applied to health care plans based on individual health status. Participants were still screened, but points were only given for certain behaviors with Flex Credits applied toward health care coverage.

1999

1999 Points were translated into actual dollar amounts rather than Flex Credits to further comply with HIPAA. A separate award check was mailed in December to those who achieved certain goals and earned enough incentive points throughout the year. This “holiday benefit” was well received by those who worked hard following the health screening to improve their individual health status.

2001

As the program gained momentum, Wellness: A Choice! became a “year ‘round program” in 2001, and saw the addition of a second FTE to assist with administration, data collection, and program support.

Enrollment and screening at the employee level was re-aligned to coincide with each participants “birth month.” The program began to partner with Employee Health and a nurse was dedicated to perform blood draws. These enhancements permitted the program to reach an “economy of scale” – especially from a financial perspective.

2002

2002 The incorporation of an Internet based Personal Health Assessment (PHA) provided by ActivHealth of Nashville, TN and their interactive health education modules (“The PHD Network” developed by experts at Duke University Medical Center’s Center for Living) were added in 2002. Each participant, upon completion of the health assessment and personal/family health history questionnaire, receives a personalized health and wellness program based on individual risks and health concerns identified at the time of screening.

The incentive point program was also modified in 2002 to include points awarded for completion of the PHA and individual health education modules.

Participation and Recognition

In 2002, 57% of those eligible participated in the health screening process – and 46% completed both the health screening and their health education modules.

Participation in 2003 remains strong with 57% of those eligible continuing with the health screening – an increase to 52% for those screened and completing the required health education modules.

Leadership at St. Thomas has also helped lead the way – an important factor in most workplace wellness programs. Management Council participation is up to 66% of those eligible participating in Wellness: A Choice since the programs inception, with 49% participating in the past year!

Success has been so well received, the St. Thomas Wellness: A Choice! program was recently accepted as a “Best Practice” by Ascension Health.