For the most part, reducing workplace weight gain and obesity has been a losing battle, but a new report advises employers that there may be a way to help employees improve their weight loss. The secret to success? Targeted, personalized programs for employee subgroups, combined with nutrition and fitness activities that apply to broad employee populations. The Northeast Business Group on Health (NEBGH) report, “Tipping the Scales on Weight Control: New Strategies for Employers,” says the first step is to differentiate employees by body mass index (BMI), a key weight metric, and focus programs and benefits most appropriate for each segment as a way to help increase the effectiveness in reversing the obesity epidemic.
From serving healthier cafeteria fare to building up an arsenal of digital tools, hospitals and other large employers are trying a wide range of approaches to get employees to lose weight. Now, a new report from the Northeast Business Group on Health, an employer-led coalition that examines health costs and delivery, concludes that employers are most successful in addressing employee weight issues with a customized approach that takes body mass index and personal needs into account. Obesity costs U.S. employers about $73 billion per year, according to a widely cited Duke University study, and health care is among the industries where it is most prevalent, according to a separate study published in the American Journal of Preventive Medicine. As benefits managers shop for solutions to help their employees, they should look at programs that offer personalization, whether it's provided onsite, near-site or online, said Dr. Jeremy Nobel, medical director at the business group and a co-author of the report released Wednesday. "Personalization is fundamental but it can be delivered in lots of ways," Nobel said. "It means really understanding the challenges in weight management a person has." Personalization starts with segmenting employees into groups by body mass index, including those under 30 BMI, and reaching out to them with the appropriate behavioral or medical resources, the report says. Once a person reaches a certain BMI, it's harder to lose weight and easier to gain, Dr. Louis Aronne, director of Weill Cornell Medicine's Comprehensive Weight Control Program, notes in the report. The Centers for Disease Control and Prevention considers someone with a BMI of 25 to 30 to be overweight and someone whose BMI exceeds 30 to be obese. But offering custom interventions may be easier said than done. At Montefiore Health System, it's difficult to truly personalize employee weight loss plans by pairing workers with individual health coaches, said Nicole Hollingsworth, assistant vice president of community and population health at Montefiore. A case study on Montefiore in the report adds, "With more than 28,000 employees, multiple locations and communication guidelines that limit outreach and promotion, continual awareness and high-touch engagement are challenges." In order to accommodate employees' diverse needs, Montefiore aims to offer a wide range of options for weight loss and incorporate those approaches into a broader wellness program, said Hollingsworth. More than 800 employees have seen a registered dietitian since the launch of the health system's Associate Wellness program in 2012, according to the report, and participants in a recent six-week weight-loss program at the health system lost an average of 2.6 pounds. These targeted weight-loss initiatives complement public health approaches, such as keeping sugary drinks out of the cafeteria and adding new onsite exercise facilities, said Hollingsworth. In addition, Montefiore offers employees access to digital nutrition and wellness tools provided through the Cerner Corporation. "What's emerging from our findings is that the convergence of all these things might lead to higher effectiveness and more sustained benefits," said Nobel. —C.L.
Worried about lack of progress on employee obesity? Look to targeted, personalized programs for small groups of employees, coupled with more general nutrition and fitness activities encompassing a broader range of people.
"Critical considerations for increasing engagement include greater personalization to capture and respond to individualized clinical factors such as BMI and blood sugar, attention to behavioral factors like attitudes and beliefs, and establishing relationships that could serve as in-person or digital support networks. Using behavioral economics lessons to understand the roles that intellect and emotion play in behavior change is similarly important in designing rewards and incentives."
Independently of the UNC analysis, the Northeast Business Group on Health (NEBGH), a nonprofit health care consumer advocacy led by employer groups and health care providers, shows cancer treatment costs are top-of-mind for group health plan sponsors. Cancer treatments rank at the top of employer expenses, despite cancer’s lower prevalence relative to diabetes, hypertension and musculoskeletal disorders, said NEBGH. But plan sponsors are concerned by more than just premium costs. Beyond containing runaway expenses that push group premiums ever higher, employers are “equally concerned” about ensuring that employees and their families receive top-quality cancer care. “Employers are invested in the well-being of their employees, and they want to be confident they’re steering people to trusted providers and institutions based on reliable information about outcomes and adherence to quality measures,” said Laurel Pickering, CEO of NEBGH.
On May 2, 2016, National Alliance on Mental Illness of New York City (NAMI-NYC Metro) and Northeast Business Group on Health (NEBGH) co-sponsored their Workplace Mental Health Summit VIII with a measurement theme. The Summit focused on how employers can quantify employees’ mental health and its relationship to diminished workplace productivity, as well as evaluate interventions to track improvement. Research shows that poor mental health not only severely diminishes employee well-being and quality of life; it also decreases productivity at work.
The fact that cancer costs are higher than ever is reason enough for employers to be concerned, but new research is giving them another reason to worry: They may not be doing enough for employees suffering from the disease. Employers are concerned about the high cost of cancer care, but they’re equally concerned about making sure employees and family members diagnosed with cancer are receiving top-quality care, says a new report from Northeast Business Group on Health.
While employers are concerned about the high cost of cancer care, they want workers diagnosed with cancer to receive top-quality care. Nevertheless, employees or their dependents with cancer often go without second opinions on their diagnosis and treatment, aren’t directed to a high-quality network of oncology providers, and lack access to nonclinical support services, a new report from Northeast Business Group on Health (NEBGH), an employer-led coalition, shows. The report, Employers and Cancer Care Quality: A Closer Look, also found that employers want to make sure the dollars they invest in cancer care are well-spent, and that they have a strong desire to support the best possible outcomes and quality of life possible for those living with cancer.
Many employers are at a loss when it comes to determining the best and most cost-effective treatment plans for their workers who are diagnosed with cancer. A recent report from the Northeast Business Group on Health said employers cited cancer as the most complex employee health condition they encounter, because of the dual challenge of supporting workers during a difficult time as well as paying for their treatment. Insurers were not much help. "My plans always respond with information about activities instead of outcomes," one employer told NEBGH. Nationally, cancer treatment accounts for 12% of total medical costs for employers but only 1% of medical claims, according to the report. Employers spent $125 billion on cancer treatment in 2010 and incurred $139 billion in indirect costs related to employee productivity. Costs rise as new specialty drugs and treatments for cancer become available, the report noted. NEBGH recommends that employers offer workers who are diagnosed with cancer comprehensive educational resources that help them select the best treatment options at each stage of their disease.
NEBGH found that employers leading the way in quality cancer care have hired cancer nurse managers dedicated to their employees; implemented paid time off for approved family medical leave; developed a cancer-specific portal and guide for benefits, programs and policies; and trained managers and workers in appropriate behavior and human resource policies related to cases where an employee discloses a cancer diagnosis. The survey of 19 self-insured employers representing about 1.2 million workers showed that 58% of those surveyed provide employees with access to oncology centers of excellence, 48% offer critical illness insurance, and 42% provide a network of high-performing oncology doctors.