Employees at Nabholz Construction Corp., headquartered in Conway, Arkansas, keep getting healthier, while company leaders continue to see declines in health insurance premiums. And, it’s all thanks to the Wellness Program the company implemented in 2007.
The program has even garnered some national attention, earning Nabholz a No. 58 ranking among the 100 Healthiest Workplaces in America for 2016. The program was also featured in an HBO documentary.
Jayme Mayo, Nabholz wellness director, says the program’s success is rooted in a genuine care about employees’ health and well-being.
“A construction company, a blue-collar institution, really lends itself to a lot of opportunity... They are people who wanted to make a change but didn’t know where to start.”
“We really work with each person and educate, encourage, and motivate them to have better health,” she explains. “Sometimes money is the kick in the behind that will get them moving in that direction.”
Nabholz’s Wellness Program is an outcomes-based approach, where employees and their spouses can earn a fully covered insurance premium and extra cash for improved health.
Health screenings are offered twice a year, in the spring and fall. The company pays 100 percent of the monthly health insurance premium for each employee and their spouse who get screened at least once per year. Employees who choose not to get screened must contribute 20 percent to the monthly premium.
In addition, employees have the potential to earn up to $400 per year for improvements in five areas — obesity, cholesterol, blood glucose, blood pressure, and tobacco use. Spouses have the potential to earn another $100 for improvements in these areas, Mayo says.
At the end of the year, employees receive a Wal-Mart giftcard with their incentive awards.
Nabholz, which was founded in 1949, has about 1,100 employees across five states. Mayo says there is nearly 100 percent engagement in the program.
However, the handful of employees who are wary of participating in the company-sanctioned screenings can have a form completed by their physician and receive the 100-percent company-paid insurance, but they are not eligible for the incentives payments.
In addition to the health screenings, the company has an on-site clinic at its Conway headquarters, with a full-time physician and medical assistant on staff. The wellness team also includes a personal trainer and bilingual dietitian, along with Mayo, who is a registered physician assistant.
Mayo says her team delivers the screening results in person to establish a valuable relationship with employees. If something critical pops up in a screening, the employee gets an immediate phone call, she says.
Employees are also encouraged to get physicals in addition to the company screenings. “We’re just hitting the treetops. There are so many other things that need to be addressed,” Mayo insists.
Nabholz launched the Wellness Program after shifting from a fully funded health insurance plan to a self-funded plan in 2007, Mayo explains.
When insurance premiums increased, company leaders didn’t want to pass the costs onto employees, nor did they want to absorb the costs. Transitioning to a self-funded plan meant access to more data, which allowed them to identify what was driving health insurance costs.
Initially, employees were skeptical about the program, Mayo says, and it took the company a little time to find a plan that worked best. But, once the outcomes-based setup was implemented, employees have had major health improvements.
From when the program began until now, the number of employees reporting high blood pressure declined from 40 percent to 15 percent. Those with high cholesterol declined from 46 percent to 16 percent. Smokers initially accounted for 49 percent of employees, and now 30 percent.
“It was incredible the change we saw from two perspectives,” Mayo says. “One was the engagement of our employees was huge, and the second was we started seeing a shift in our health insurance.”
For the past five years, Nabholz has saved about $1 million a year in health insurance premiums, she says. There have also been no premium increases for the past two years, and last year, the company saw a 4.5 percent decrease.
“Once we paired the employee and the spouse, and we had a design that made sense — it met the needs of our people and it met the needs of our health insurance plan — that’s when the big payoff started happening for us,” Mayo says.
Creating a Successful Program
Because of its success, the Nabholz Wellness Program was featured on the HBO documentary, “The Weight of the Nation,” in 2012. The film examined initiatives across the country aimed at reducing obesity.
Since word has gotten out about the program, Mayo says she has received calls from companies all over the country, including insurance companies, large healthcare organizations and government agencies, asking for advice in setting up a similar program.
She says what has made the program so successful is the support of Nabholz’s executive leadership and a solid program design — both are an essential first step in creating a wellness program.
Mayo also emphasizes that Nabholz’s program is not a part of the human resources department, and she believes this is how it should be with any similar program. Human resources, she says, are often too busy to take on such a program and usually do not have staff with backgrounds in health and wellness.
Screening is another essential component to a successful wellness program. “You have to know where your problems are before you can know what to do to fix them,” she says, explaining that claims data only tell part of the story because it accounts for only employees who have visited a doctor.
While programs like Nabholz’s can be successful in any industry, Mayo says it worked especially well at the construction company.
“A construction company, a blue-collar institution, really lends itself to a lot of opportunity,” she says. “These [workers] don’t sit at a computer all day. They’re not on WebMD. This stuff is not at their fingertips. This is a group of folks who probably haven’t had health high on their priority lists. They are people who wanted to make a change but didn’t know where to start.”