3) Offer self-help programs

Self-help interventions for tobacco cessation, weight control, stress management, etc., have become more popular as the field of health promotion has become more sophisticated in helping people help themselves. An advantage of self-help programs is employees can change their behavior on their own time and in the privacy of their own homes. Examples of self-help materials include interactive videos, DVDs, computer programs, audiotapes and booklets.

4) Provide health coaching

Many employees would like to change their lifestyle behaviors, but need professional assistance in doing so. This is where health coaching plays an important role. Each employee is assigned a health coach who guides them through the behavior-change process, whether it be to quit smoking, lose weight, manage stress, exercise more, or manage one's time more effectively.

5) Teach medical self-care

Medical self-care represents one of the most promising ways to reduce health care costs. It consists of teaching employees to become wiser consumers of the health care system. They learn when to seek professional assistance for health conditions that warrant it and when to use self-care for those symptoms that can be treated at home. This is important because 55 percent of all ER visits and 25 percent of all doctor visits are unnecessary. The five elements of an effective self-care program are:

• Self-care book
• Self-care instructional workshop
• Nurse advice line
• Self-care software
• Promotional materials

6) Address high-risk employees

Employees who have chronic conditions, such as diabetes and asthma, are considered to be high-risk employees. They tend to have health care costs that are anywhere from 100 to 500 times greater than the costs for healthy employees. Providing a disease management program can moderate these costs.

7) Address low-risk employees

Research conducted at the University of Michigan Health Management Research Center has shown that healthy employees will not stay that way unless wellness programming is provided for them. In fact, up to 20 percent of low-risk employees will move to a higher risk category within one year. Research at the center also has shown that when an employee loses low-risk status, there is an additional cost of $350 per year. When employees regain low-risk status, there is a decrease in costs of $150 per year.

8) Offer incentives

The use of incentives to encourage people to participate in wellness activities and change their lifestyles has become very popular. Incentives may take the form of paying less for health plan contributions, offering lower coverage levels, providing reimbursement for wellness programs, giving insurance premium discounts, and providing awards, such as cash, gift cards, t-shirts, water bottles, golf equipment, etc. to those who participate in wellness programs. The incentives can be used to reward a variety of behaviors, including completing an HRA, participating in a health screening, attending a health fair, quitting smoking, joining a fitness club, using a self-care guide, or accessing an e-health portal.

9) Use e-health as an adjunct

Many companies are putting up an e-health portal and calling it their wellness program. They rationalize that "everybody" uses the Internet and it is a low-cost way to reach all their employees. Unfortunately, this view has many flaws. Not only will the organization reach less than a quarter of its employees, but it may not save any money. An e-health portal should only be an adjunct to the more traditional wellness strategies, not a replacement for them.

10) Evaluate your program

In order to justify continuance of a wellness program, data must be gathered to satisfy upper level management. There are a variety of measures that can be obtained. They include the number of employees who participate, changes in specific risk factors among the employee population, changes in absenteeism rates, changes in productivity and/or presenteeism and employee satisfaction surveys. Perhaps the most important variable is financial data to determine if reductions in health care costs took place.