264918 Rural Healthy Community coalition links worksite wellness and health reform for smallest employers: A simulated work-site wellness add-on for insurance exchanges

Monday, October 29, 2012 : 1:10 PM - 1:30 PM

Kala E. Ladenheim, PhD, MSPH , Division of Health Improvement, Medical Care Development, Augusta, ME
Philip DiRusso Jr., MS , Cardiovascular Health Program, MCD Public Health, Augusta, ME
Background: In wellness as in coverage, the smallest employers are neglected. Can this be addressed under health reform? A community-based coalition in rural Maine, Somerset Microwellness (SMW), addressed administrative and market barriers to workplace wellness for very small businesses (<10) by designing and simulating a wellness add-on for insurance sold through Exchanges. SMW offers a tailored mix of worksite and community activities, with some services pooled to lower fixed costs and protect confidentiality. Financial incentives simulate tax credits and insurance rebates. Method: The project (1) defined a micro-worksite wellness add-on to insurance, (2) developed metrics for evaluating employee participation in a hybrid employer-community program, adapting an evidence-based large business scorecard --Health Enhancement Research Organization (HERO)/Mercer and (3) enrolled microbusinesses. Maine Health Access Foundation funding simulated financial incentives, which were paid to employers that met the targets. Results: With a 100 employee target, SMW enrolled 19 businesses, comprising 73 employees and 11 family members, in the first 6 months. 90% of employees reported no previous wellness activity; 80% were contemplating health changes or considering more. By the six month point 2/3 of the worksites had developed written work plan for wellness and all had participated in at least one activity. One unexpected opportunity: employers needed help with environmental/ policy activities -- posting smoking policies (13% at start) and annual fire drill (27% at start). Conclusion: Community-based worksite wellness, including metrics-based incentives, is feasible and acceptable to microbusinesses and is ready for testing as an insurance add-on.

Learning Areas:
Administer health education strategies, interventions and programs
Implementation of health education strategies, interventions and programs
Occupational health and safety
Public health or related organizational policy, standards, or other guidelines

Learning Objectives:
Identify new opportunities under health reform for community coalitions to improve their own sustainability by offering community-workplace wellness to very small businesses. Compare obstacles and opportunities for providing workplace wellness faced by mid-sized (100+) and very small (<10) employers. List features of worksite wellness of particular interest to very small employers.

Keywords: Health Reform, Worksite

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I developed this project proposal and am the principal investigator for this project.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.