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Road to wellness paved with cost savings

Like the rest of the faculty and staff at Springside School in Chestnut Hill, Frank V. Aloise Jr. totally buys into the idea of good health as an important employee value.

Like the rest of the faculty and staff at Springside School in Chestnut Hill, Frank V. Aloise Jr. totally buys into the idea of good health as an important employee value.

But Aloise brings another perspective.

As director of finance at the private girls' elementary and secondary school, Aloise writes the premium checks to cover health insurance for the school's employees.

"Our costs were going up, our utilization was going up, our meds were going up," he said. "We had 10 to 12 percent increases."

Something had to be done. That is when Aloise heard about a wellness program that claimed to reduce long-term health risks while paying for itself in a year as some participants no longer needed blood-pressure and cholesterol medicine.

Aloise became a disciple.

So what if it involved drinking up to 64 ounces of orange-juice-flavored water a day? More on that later.

"It has changed the way I live my life," said Aloise, whose tire around his waistline has shrunk from mountain-bike to racing-bike size.

As health insurance costs rise, employers are scrambling to reduce premiums, especially now that they average $10,073 per employee, according to a survey by Mercer L.L.C., a benefits-consulting firm.

One plan of attack? Wellness programs, with companies offering employees incentives to participate. Locally, 35 percent of companies employing 500 or more are doing that, according to Mercer.

Springside's 10-week program, which began in September, is not too complicated. There are 10 hour-long videos delivered via the Web. Participants learn when and how to eat. The orange-juice-flavored water is an all-day drink to keep energy and blood-sugar constant and reduce cravings.

The most startling change? Participants skip breakfast, drinking 32 ounces of the liquid to start the day and counter dehydration from the previous night.

When Aloise says "our costs," he is not just talking about Springside School.

Aloise sits on the board of the Philadelphia Area Independent Schools Business Officers Association, an association of financial officers such as Aloise from 133 private schools and universities, among them most of the Quaker schools and a handful of colleges, including Gwynedd-Mercy, St. Joseph's, and La Salle.

Of the $150 million the association spends on group purchasing for supplies such as fuel oil and copy paper, $120 million funds health benefits for 23,000 employees and family members.

It sounds simple - just make people healthier, and insurance claims will go down.

More easily said than done. Human resources managers debate how much they can impose health-related requirements on employees amid concerns of privacy, overreaching, and discrimination.

Also, there is that pesky return-on-investment question: Does health improve quickly enough to justify the expense, especially if turnover is high?

That is where Aloise's group has an advantage - not much churn in private schools.

"We're not going in for a quick fix, but for a systemic overhaul," said John Manion, the association's account representative at Armstrong, Doyle & Carroll Inc., a Wayne health insurance broker. "We're not just trying to get a decrease in our health insurance for next year. We're looking for multiple years of flatlining and then decreasing."

Manion helped the group investigate Naturally Slim Inc., a health program developed by a nurse in Dallas.

The idea is to find people who have "metabolic syndrome," defined as the presence of three out of five indicators of bad health: heightened cholesterol, insufficient "good" cholesterol, high blood sugar, high blood pressure, and an out-of-whack height-to-weight ratio known as the body-mass index.

The chance of developing metabolic syndrome increases with age. People who have it are more likely to have serious - and expensive - health conditions, such as diabetes or heart attacks, according to some studies.

As the indicators improve, risk should decrease.

The association decided to run a pilot program with 150 employees. Because Aloise was such an evangelist, the biggest group, 25, is at Springside.

To qualify for the pilot, people completed a simple online survey on height, weight, age, and medications. Those chosen had blood tests at the program's start. They will take another at the end, with results back Dec. 15.

Aloise can hardly wait. Neither can calculus teacher Kathleen Tkac, 62.

Tkac's doctor was going to put her on cholesterol medications the same day she was accepted into the program. But, when he learned about the program, he decided to hold off.

"My guess is that you won't need it," she said he told her.

During a break between classes Tuesday, Tkac talked about the program: "I have a thousand times more energy," she said. "I've lost weight [10 pounds], but my real goal is to be healthy. I fit into my clothes, and because I have all this energy, I'm a happy-go-lucky camper."

Whether Aloise will be a happy-go-lucky camper at check-writing time remains to be seen, but if his results match those reported by Steven Johnson, Aloise will be celebrating.

"Most wellness programs make human resources feel good, but they don't work," said Johnson, director of compensation at the Genesis Health System in Davenport, Iowa.

This one, though, does, Johnson said, and he knows because he is now writing a smaller premium check than he did four years ago when Genesis began the program.

About 4,000 of Genesis' 4,800 employees and spouses are enrolled or have been enrolled in the program, encouraged by a "huge discount" in the amount they contribute toward their health care.

Prescription savings plus a 33 percent decline in hospital admissions over four years have dropped Genesis' overall premium cost, now 2.5 percent less than Genesis was paying in 2006.

If Genesis' costs followed national trends, Johnson said, he'd be paying $6.8 million more this year for insurance. The employees' share would be up $1.2 million.

"We're not trying to cure someone who is already a patient," he said. "We're helping others identify risk before it is too late."