Employee obesity.

Thinking about an obesity-related disease management program for your organization? Here’s what you need to know.

In order to be effective, the program must meet participants’ individual medical and psychological needs, not to mention your own organization’s need to control long-term health costs.

How wide-reaching should the program be? After all, it doesn’t make sense to pay for services your workers don’t want or can’t use.

Mary Beth Chalk of Resources for Living suggests that obesity programs may be broken down into four tiers of worker need, from which your organization’s return on investment (ROI) can also be measured.

Tier 1 –  Education

Tier I staff members struggle with weight control problems but don’t need a health coach.  Instead, they could benefit from a self-directed program that provides weight-management related materials online, targeted mailing, and/or access to nurse call line.

How to measure ROI –  utilization. Do staff members click on the Web site? Do they return to the site regularly? Do people  use the nurse line? Your program vendor ought to provide you detailed use stats.

Tier 2 –  Clinical supervision

If the worker has been diagnosed as obese – a BMI  score over 30 is obese, over 35 is clinically obese – he or she would do better working with a health coach in a clinically supervised program.

Three keys to getting maximum results –

1. Periodically have participants rate their relationship with their health coaches. Not everyone clicks, so a change might  be in order.

2. Coordinate your disease management care with your staff member assistance program (EAP)services. Reason –  Inability to control weight is often closely tied with mental health issues – and one can adversely affect the other. the more closely your employee assistance program and obesity program managers work together, the higher the chance for success.

3. Beware of the fade-out effect. A lot of staff members in weight-loss programs get off to a excellent begin and then fall back into old habits. People  should re-commit to the program after three sessions, four months and nine months.

To measure ROI, look at utlization, goal achievement and decreased presenteeism. of course, presenteeism is notoriously challenging to measure with reliable dollar figures. So how can you overcome that problem?

• Begin with employees’ salaries. Let’s suppose one participant earns $40,000 per year.

• Ask employees to self-report how energetic and productive they feel on the job, on a percentage scale. Then have supervisors estimate the employee’s productivity and split the difference. for this example, let’s assume it averaged to 50 percent.

• Collect scores again six months and one year into the program and then multiply the difference by salary. the result is your estimated productivity ROI.

In the example above, when the worker earning $40,000 improves from 50 percent to 75 percent after one year, the productivity related ROI is $10,000.  

Tier 3 –  Medical management

At this level, the obese staff member needs a higher level of care than a health coach can offer. the staff member has chronic health conditions related to obesity – such as diabetes, high blood pressure, and/or sleep apnea – and needs a doctor case manager. In particular, the staff member needs to set up regular visits with the doctor and create a treatment plan.

To measure ROI, start with the lower-tier criteria, then track quarterly and year differences in FMLA or compensated absences, and prescription drug costs. Then compare it to the per-participant cost of the obesity program.

Tier 4 –  Morbid obesity

At this level, the worker has been diagnosed as morbidly obese – Body Mass Index (BMI) over 40 – and is considered a potential candidate for gastric bypass surgery.

ROI is measured through ongoing health claims in addition to the previous criteria.