Log 10,000 steps a day to stay fit.

But, is 10,000 steps the best target for everyone? And can fewer steps lead to better health?

According to our research, people who take just 5,000 steps a day have better health, lower health care costs, and fewer hospital stays and emergency room visits than people who do not exercise.

After reviewing aggregate reports from annual wellness screenings, a large employer in the Southeast found that more than 50 percent of its employees were obese and an additional 28 percent were overweight.

Employees classified as obese based on body mass index (BMI) measurements had medical costs that were 35 percent higher than members who fell within the normal BMI range.

Something needed to change in order to reduce health care costs and improve the health of all employees.

In teaming up with this employer to design a multidimensional strategy, one of the components of the program involved getting people moving by engaging, measuring, and incentivizing employees for practicing a simple healthy behavior—regular physical activity measured by the number of steps taken per day.

The employer provided fitness trackers to participants and set up an incentive plan that rewarded step goal achievements.

To understand how wearable fitness technology, voluntary health coaching, and incentives could positively affect health and wellness in the workplace, we analyzed data over a three-year period to understand how employees who exercised in moderation compared with those who did not exercise, and how or if activity levels affected claims costs for employees based on their BMI classifications.

Capturing verifiable data through fitness trackers

We knew we had to get verifiable, real-time data to track program results, which is why we used a fitness tracker to measure physical activity.

The devices automatically logged daily steps so employees didn't have to manually input the data.

Over the course of the three-year period, more than 60 percent of employees were tracking and verifying steps with the aid of wearable fitness devices.

Monitoring activity levels, including steps per day

We compared physical activity by three exercise levels:

• None: 0 steps or 0 minutes of activity per day

• Minimal: Less than 5,000 steps or less than 38 minutes of activity per day on average

• Moderate/High: More than 5,000 steps or more than 38 minutes of activity per day on average

Through annual biometrics screenings, data were gathered on employees who were within a normal weight range, those who were overweight, and those who were considered obese based on BMI standards published by the U.S. Centers for Disease Control and Prevention.

Encouragement through health coaches

Employees also had opportunities to work with health coaches, part of a team of clinical specialists who are experts in fields such as nutrition, smoking cessation, physical activity, stress management, etc.

Coaches helped employees identify health issues, set realistic goals, and lend encouragement. Over 80 percent of employees over the three-year period worked with a health coach.

An activity-based incentive plan for ongoing engagement

Employees were encouraged to challenge themselves and their co-workers.

An activity-based incentive plan increased ongoing engagement with the program, and those who met specific goals were able to earn up to $200 per quarter.

Having this easily measurable, ongoing program created more buy-in than previous efforts, which usually centered on a specific time period and a one-time reward.

Participants also benefitted from the social engagement aspect of the program, which resulted in teams being formed across departments and beyond.

Employees' accountability to their teams resulted in higher participation over time as many employees who were slow to initially engage came on board in order to not miss out.

The findings: moderate exercise, or 5,000 steps per day, can have a big impact

When comparing people who didn't exercise to those who did, we found that those who did a moderate amount of exercise had the following:

• Annual health care costs nearly 20 percent lower than employees who did not exercise. The hard numbers: $2,038 per member per year (PMPY) for non-exercisers compared to $1,646 PMPY for moderate exercisers.

• Emergency room visits 50 percent lower than employees who did not exercise (comparison was made between employees who were overweight and moderate exercisers, and employees who were overweight and non-exercisers). The hard numbers: 219.6 ER visits per 1,000 for overweight non-exercisers compared to 73.6 ER visits per 1,000 for overweight moderate exercisers.

• Inpatient hospital stays more than 50 percent lower than employees who did not exercise. The hard numbers: 59.9 IP stays per 1,000 for overweight non-exercisers compared to 30.1 IP stays per 1,000 for overweight moderate exercisers.

Across all BMI levels, the effect of regular exercise is impactful.

Even among obese members, evidence showed those who did not exercise continued to have health care costs 23 percent to 39 percent higher than obese members who exercised at least a moderate amount.

Over several years, the company's health care costs inflation trend flattened to 1 percent annually. The wellness program has been a key part of this success.

Considerations:

Whether a company is considering a wellness program, or starting a company-wide challenge, here are some tips to help motivate employees to become active participants in their health.

1. Start small. It is important to set realistic goals that people can achieve. Start with a small goal, and then move your employees to larger goals over time.

2. Create smart incentives to increase participation. Create an ongoing program with incentives along the way, rather than a one-time reward.

3. Create (friendly) competition at the workplace. We saw that many teams formed across the organization, resulting in higher participation as many employees who were slow to initially engage came on board in order to not miss out on activities and competition.

4. Incorporate devices that people want to use. Engagement increases when people can use a fitness tracking device or app that fits seamlessly into their daily routine. If you want employees to track their health and fitness for a campaign, let them use a device or app they are likely to use on a daily basis.

5. Gain buy-in from leadership. Creating a culture of health in the workplace takes more than just a few employees participating in a program. It takes visible buy-in from the senior leadership to demonstrate a true commitment to better health.