Parkway School District recognized for wellness programs

July 29--The Parkway School District's health care costs have remained flat, thanks to the success of its wellness program. Such programs, which encourage employees to adopt healthier lifestyles, have proliferated. But they don't typically result in significant savings for employers.

The school district is one of 10 organizations across the country being honored by UnitedHealthcare, the nation's largest health insurer, for its work in implementing a successful workplace wellness program.

Employee Jim Akers has seen continued success under the wellness program, which has helped him maintain a 63-pound weight loss. Akers, who now serves as the wellness leader for his building, is now off all the medications he was taking to address issues such as high cholesterol.

"I feel so much better, and my wallet is happier," said Akers, a safety specialist for the district.

The assumption is that if employers encourage and reward employees who lead healthier lives, particularly those with chronic conditions, employers will be able to lower their overall health care costs, but that may not be the case.

"Despite the proliferation of wellness programs, drawing reliable conclusions about their financial returns on investment is difficult," according to a 2013 report that appeared in Health Affairs.

What sets Parkway apart from other employers is empowering employees to be leaders in wellness among their peers and tailoring programs to each of the district's 27 buildings, according to Leah Gonzalez, the on-site wellness coordinator for Parkway.

"Big-picture goal is that we're trying to maintain a culture of health," Gonzalez said.

One main goal is prevention and catching problems early to avoid serious illness.

For example, the school district has seen screenings in a mobile mammography unit quadruple since making it available on site.

"We want women to have that done because we know that if there's a problem and we know that if it's caught earlier, that's easily treatable," Gonzalez said.

Parkway tries to cater to the needs of each of its more than two dozen buildings. One building, McKelvey Elementary School in Maryland Heights, is predominantly composed of female teachers, and what they want to see in wellness programming is different from the operations building that employs primarily middle-aged men, Gonzalez said.

At McKelvey, a morning workout class has been popular and well attended. For the operations building, health fairs have proved successful by bringing health screenings to the employees and teaching them healthier ways to cook with the ingredients they already have at home.

Another study suggests that group learning, like those cooking lessons at Parkway, may increase the effectiveness of promoting behavioral changes, which can lead to lower health care costs.

But changing behaviors can lead to unintended consequences. Employers may use incentives to change unhealthy habits, such as smoking. However, one smoking cessation study found "an average weight increase of 21.3 pounds for those who were induced to quit," according to a 2013 in Health Affairs.

And a popular mechanism to get employees to buy into wellness programs is to offer them discounts on premiums or other financial incentives. But "evidence is sparse that financial incentives induce behavior that improves health," according to the 2013 study in Health Affairs.

Parkway does not offer financial discounts for participation in its wellness programs.

A study that analyzed BJC HealthCare's wellness plan found that while the program led to a significant drop in hospitalizations, it did not reduce overall health care costs.

About 82 percent of eligible employees and beneficiaries were enrolled in the wellness program in 2005. Any employee who enrolled in BJC's most generous health insurance plan was required to enroll in the wellness program.

And while the program resulted in a 41 percent decrease in hospitalizations for certain conditions targeted under the program, there was no change in hospitalizations for those with no health conditions.

While hospitalization went down, overall medication use increased.

"Despite these substantial reductions in hospitalizations, we do not believe the program saved money for the employer in the short run," the report said.

A separate study showed that medical costs fall about $3.27 for every dollar spent on wellness programs. While that seems like significant savings, the authors note that they analyzed large employers, those with economies of scale to implement such programs, raising questions about whether small employers could achieve similar savings.

The study also does not take into account the cost to initially start the wellness programs and the time it takes to maintain them. "This is important because wellness program costs are likely to be front-loaded -- that is, more costly at the start -- while health benefits are likely to accumulate gradually. Therefore, to the extent that program costs decrease over time and benefits increase over time, we may be understating the true return on investment," the 2010 study said.

Next year, Gonzalez said Parkway plans to expand its financial literacy offerings. The school district found financial stress was a top issue among employees. Stress can lead to or exacerbate existing health issues.

"The wellness program is working for us, and I think that it can work for a lot of organizations, but it needs to be planned well," she said.

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