Members of the executive suite rarely have much time to spare, making it critical that you make your point fast.

Here’s a three-step strategy you can use to consistently grab execs’ attention quickly and garner a budgetary thumbs up:

Step 1: Stress the big-picture strategy

It’s essential to begin by showing the top brass that you’re thinking strategically about adding to the company’s bottom line.

One way: Research wellness programs companies similar to yours have used, and provide actual figures on how much they’ve saved on health care as a result of their wellness initiatives.

Step 2: Focus on the quick returns

The bottom-line concern of the top brass is just that: the bottom line.

So make sure you have solid numbers on when your new program will start to see a return on the company’s investment.

Example: If you’re proposing an investment in smoking cessation, provide research showing how companies with similar programs are seeing fewer medical claims in year one.

Step 3: Keep their attention

C-level execs usually aren’t all that interested in the small details of the program — plan design, administration issues, etc.

To keep their interest, only tell them the highlights of your plans.

Example: Tell them that you’ll reward wellness participants — but leave out details like who’ll keep track of those who participate.

Here are some common species:

Bottom-liners

These no-nonsense employees don’t like fluff. So the most effective way to present info to — or answer questions from — this group is to be direct.

Concrete examples with tangible facts and figures work well with these workers.

Attackers

These employees tend to be more negative — they have no problem criticizing company initiatives and programs in public.

If an “attacker” comes to you with a gripe about changes you’re making to one of their benefits, show you care about the person’s concerns by listening. Then, if necessary, explain how the changes are meant to help them — or the company — long term.

Avoiders

These are the employees who want to do only the bare minimum.

They present a challenge to benefits pros who are trying to boost participation in company-wide initiatives — wellness programs, health risk assessments, 401(k), etc.

The key to success with this group is making things as simple as possible.

Example: Adding automatic enrollment to your 401(k) may be all it takes to boost participation among these workers.

The vast majority of HR managers say missing open enrollment has a big impact on employees’ wallets, according to a recent CareerBuilder.com survey.

How big of an impact?

• 34% of HR managers say missing open enrollment costs employees at least $500 a year in out-of-pocket expenses (for things like medical care and school tuition, which could’ve been covered by their employer)
• 20% say it costs employees more than $1,000, and
• 10% say it costs workers more than $2,500.

That’s distressing news when you consider that half of hiring managers say more than 10% of their workforce misses annual open enrollment deadlines.

In addition, 25% of workers admit they don’t pay attention to benefits changes, figuring their benefits will roll over — or because they feel the whole process is too confusing.

Employees don’t realize what they’re missing

Another big reason employees don’t participate: They don’t realize everything their employer is offering.

When asked which benefits employees aren’t taking advantage of, HR managers said:

• Wellness benefits (45%)
• Flexible healthcare spending (43%)
• Tuition Reimbursement (38)
• Banking programs (25%), and
• Discounts on personal entertainment (24%) and technology (22%).

One option: Consider a flu prevention rewards program.

Incentives can take the form of:

• Contests. One company doubled participation by putting everyone who signed up for a flu shot into a drawing for an iPod.
• Merchandise. A school district in Minnesota got more teachers to get vaccinated by giving away winter hats with sports teams’ logos on them.
• Healthy rewards. Many companies tie flu shots into promoting overall wellness by giving away pedometers, yoga kits, workout videos or electronic scales.
• Gift cards. There’s always the popular standby of providing small gift cards (worth $20 or so) for department stores, restaurants or movie theaters.

Benchmark participation

Not sure if offering incentives will make enough of a difference to justify the added cost? Try this:

Benchmark your past sign-up rate for flu shots against a new drive using an incentive. Compare both the change in participation and the number of sick days taken during flu season by all employees.

People are trading nutritional eats for processed and fast foods. They’re also spending less time exercising.

That means now’s a great time to refocus on preventive health care. If your company already has a wellness program, it’s a good idea to make sure these proven features are included:

3 areas to check

Referrals from claims and on-site screenings. Most wellness programs pinpoint at-risk employees by relying solely on the employees’ honesty in responding to health assessments.

Certain wellness program providers use a combination of data to determine those at-risk for chronic conditions.

Example: OptumHealth uses on-site health screenings, claims and referrals to assess if an employee is at-risk.

This approach can help to identify up to 10 times more at-risk employees.

Wellness consultants. These individuals are assigned to a company to help develop a wellness strategy, plan promotions, interpret reports and gauge the overall success of the company’s wellness program.

Benefit: By keeping a close eye on a company’s wellness program, consultants can tweak and fix problems on the spot.

Cross-trained coaches. These coaches take a big-picture approach to helping employees with various lifestyle-related health issues.

Example: Smoking. There are a significant number of people who won’t try to quit smoking simply because they’re concerned about gaining weight in the process — a common problem.

A cross-trained coach will help an employee quit smoking, while also ensuring that he or she makes smart nutritional choices to avoid the common weight gain.

His story:

Almost out of desperation over ballooning healthcare costs, we started thinking about a wellness program for our employees.

The drawbacks? There were several. For instance:

• There was a chance few or no employees would take advantage of the program. So to speak, you’d throw a party that no one attends.

• Only healthy employees would take advantage. The people who really needed the benefits would opt for the doughnuts in the break room instead.

• The program might be too scattershot. We could end up offering remedies for health problems that didn’t exist in our organization.

Well, at least we understood the obstacles. Here’s how we finally cleared them:

Privacy rules get in the way
First, we wanted to understand the health problems we were dealing with.To do that, we contracted with a local hospital to do an employee health screening. This is where things really got sticky for us.

You’ve probably heard about all the new privacy rules, particularly regarding medical records. Because of those rules, we couldn’t just pull individual screenings and find out that, say, Bob needed help controlling his weight or Susie had smoking-related ailments.

Plus, we were pretty sure that even if the law allowed us to look at individual records, our employees wouldn’t be too thrilled about it.

We talked to the screening people about it and came up with a solution to the problem. While they couldn’t give us individual records, they could give us a composite record.

So, for instance, we’d know what percentage of our employees were overweight, had high blood pressure, were near danger levels of cholesterol, and so on.

They come to the party
With that information, the hospital that did the screening worked with us to design a wellness program that met the needs of most of our employees.

We announced the opening of the program and its details, and waited to see if we got any participation. The signup rate: 75%. Pretty good.

The results: After several consecutive years of double-digit increases in our health premiums, our rate increase dipped under 10% this year because our employees needed less medical care.

When we look around and see what’s happening with other organizations’ premiums, we feel confident we took the right approach to a wellness program.

(W.D. Glisson, VP for HR, Frederick, MD)

The more clinically important the treatment relative to the employee’s health risks, the less an employee pays out of pocket for it. 

Example: Women over 40 and younger employees with a family history of breast cancer pay less for a yearly mammogram than employees for whom the test isn’t as necessary.

Supporters of value-based plans say the plan design can work better than high-deductible plans when used in combination with standard wellness program features such as health risk assessments.

Four criteria for measuring quality

According to Simply Well, there are four criteria that have emerged as key benchmarks of measuring the effectiveness of a value-based plan:

1. health care management guidelines
2. preventive screenings and treatments
3. quality of member service, and
4. easy access to care.

Clinical areas of particular concern in many value-based plan designs:

• Employees’ dependents receiving appropriate and timely childhood and adolescent immunizations
• Breast cancer screenings for female health plan enrollees, ages 52 to 64
• Diabetic employees receiving hemoglobin A1C and LDL-C testing
• Members receiving proper referrals and treatment for mental health issues (e.g., primary care physician refers a patient to a specialist to ensure proper prescription and management of an anti-depressant medication), and
• Pregnant employees receivig time and appropriate prenatal and postpartum care, and avoidance of antibiotic treatment in adults with acute bronchitis.

The quality and continuity of care for the aforementioned issues can suffer when employees foot too much of the bill out of their own pockets.

Proponents of  value-based plans say the plans are a way to provide cost relief to employees in need while increasing the chance they’ll seek out treatments that will reduce plan sponsor costs in the long run.

There’s more to come, too. Fifteen percent of respondents that didn’t currently have a disease management component to their health plan hope to add one by 2011. Surprisingly, many firms consider the still-struggling economy to be an incentive to offer disease management. Reason: greater control over long-term health costs.

According to the survey, the highest-demand disease management programs are for diabetes, asthma and heart disease.

Source: Small Employer 2009 Benefits Survey, PDR Consulting Group.

A three-year study of 372 small, medium and large companies by the Institute for Health and Productivity Management shows they’re investing in wellness and oftentimes getting a good return on the investment.

Some of the findings:

• The per-employee amount invested in wellness rose from $204 to $329 in the last year. About two-thirds of the companies said they’d at least broken even on their investment — measured by such factors as decreased sick days,  fewer claims for major illnesses and slowed increases in insurance premiums.
• The most commonly used incentive is premium reductions, followed by merchandise/tokens and gift cards.
• More than half of the companies surveyed offer health and wellness or disease-management programs to spouses,  and a third extend the programs to other family members.
• Two out of three employers — large, midsize and small — offer a health-risk assessment questionnaire to employees, and nearly three out of four of those offer incentives to take it. Incentives to take the questionnaire mostly range up to $300 annually, with about 10% to 15% exceeding $300.
• Smoking-cessation programs are the most popular health and wellness program offered. More than half of employers surveyed (53%) offer smoking cessation to employees, but weight management and physical activity programs are not far behind.
• Diabetes programs are the most popular disease-management program offered. Among those employers that offer disease management programs,
  92% offer diabetes programs, making them the most common disease-management program offered in 2009.
• Some organizations with as few as 210 employees are offering incentives valued at $1,450 per year to keep employees healthy, well above the average.
• The percentage of companies successfully measuring return on investment for health and wellness programs has sharply increased over the years, from 14% in 2007 to 73% in 2009. Some 83% of those who have measured say the programs return better than 1:1 on their investment. In growing numbers, employers are rewarding goal achievement during and after health and wellness program completion.

To order the  full study, go here and look for the link on the right side of the page.

Restricting employees’ off-duty conduct can be pretty tricky business. Do employers have the right to decide what workers can — and can’t — do after hours? 

Here’s a real-life example of how trying to control off-the-clock behavior can leave employers on shaky legal grounds:

The Scotts Company in Massachusetts adopted a policy that required employees to stay tobacco-free — both on and off the job. For monitoring and enforcement purposes, employees would be required to submit to nicotine testing. The company said the policy had two key benefits:

• The policy would lower medical costs significantly, and
• The ban would promote healthier lifestyles.

New hire Scott Rodrigues was a smoker, but he never smoked at work or on company property. However, Rodrigues was given a mandatory nicotine urinalysis. The test showed nicotine was in his system. He was fired immediately.

Rodrigues sued, claiming mandatory nicotine testing violated Massachusetts’ Privacy Act. He argued that he had a reasonable right to privacy outside of work. He also pointed out that smoking was legal and had no bearing on his job performance.

Scotts asked the court to dismiss Rodrigues’ claim.

The state’s Privacy Act protects citizens’ rights to “unreasonable, substantial or serious interference,” so the court had to examine whether Scotts had a legitimate business reason to enforce the policy and require the testing. The court agreed Rodrigues might have a case under the Privacy Act and denied the company’s motion to dismiss.

Now, the company faces a costly trial — or an expensive settlement.

The lesson: If your company’s considering a wellness program with rules about what employees can do on their own time, make sure you check your state’s laws. Many have rules against firing someone because of legal activities they do outside of work.

Other jurisdictions, such as Connecticut, expressly forbid firing or discipline based on tobacco use away from the workplace.

What do you think? Should employers be able to create policies like the Scotts Company’s? Give us your opinion in the comments section below.

Cite: Rodrigues v. The Scotts Company