National health care expenses are projected to reach over $2.8 trillion and be over 16 percent of the gross domestic product (GDP) by 2011 according to the Centers for Medicare & Medicaid Services (CMS) (Kaiser Family Foundation [KFF], 2007). Chronic disease and preventable illnesses account for approximately 72 percent of annual health care costs (Centers for Disease Control and Prevention [CDC], 2003). The primary chronic diseases and preventable illnesses that contribute to health care costs are cardiovascular disease and stroke, obesity, cancer, diabetes, and arthritis.
According to the CDC, there are three “modifiable health-damaging behaviors” that impact health care costs (Armstrong, 2007). These behaviors are smoking, physical inactivity, and poor nutrition (Becker, 1975). One explanation for the high cost of health care for chronic disease is the aging population. While the life expectancy of Americans has risen from an average of 59 years in 1950 to a current age of 77, there has also been a parallel rise in health care costs (Conners, 1992). The increase in health care costs has become a significant issue for businesses.
The objective of the study
The study will examine the worksite wellness programs of the top 50 employers. It will specifically address the differences in the number and type of health promotion programs and services offered. In addition, employer costs for the services offered within the programs will be reported.
Justification and motivation
Employers have experienced a two-fold increase in health costs per employee from 1997 to 2005 (Blau & Blau, 1987). According to a study by the Kaiser Foundation, “companies may be spending as much on health benefits as it earns in profits” (American Institute for Preventive Medicine [AIPM], 2008). Employers are struggling to find alternatives to contain or control the rising costs. Approaches include increased co-pays, decreased benefits, and higher deductibles. Another approach to address the costs of health care is the implementation of health promotion or worksite wellness programs.
Employers have looked toward incorporating these programs to avoid cutting benefits or shifting costs to employees (Center for Health Improvement [CHI], 2008). Worksite wellness and health promotion programs are programs designed for employee participation to lead to healthier lifestyles and to prevent the onset of a disease or worsening of the disease. According to the Institute of Health and Productivity, the recommended health and productivity management model “directly relates health investment to a company’s overall gain in productivity and profitability” (Reynolds, 2003).
Although the benefits of worksite wellness programs have been extensively documented, some are more successful than others. One particularly complex issue is how to motivate employees to participate in the available programs at their worksite (Csikszentmihalyi, 1992). Other contributing issues include employer costs and perceived employer benefits. The central motivation that justifies in-depth study on this topic is that better knowledge of worksite programs will motivate employers to participate in the available programs while at the same time yield the highest return on investment.
Scope of the study
This paper will try to examine the benefits to be accrued from the successful implementation of wellness programs and services in organizations. To identify the current worksite wellness programs, determine the types of activities available, and identify perceived barriers to the successful implementation of worksite wellness programs, a survey of the organizations based in California will be carried out. The target population will be all the leading top fifty employers in the state of California as registered with the chamber of commerce and industry. Over 60% percent of businesses are small businesses with less than 50 employees. With a total estimated population of more than 5 million residents, it is a populous state with larger employers is located within metropolitan areas.
A large proportion of the employers are hence classified as small businesses. The classification of small businesses has been advanced as businesses having under 200 employees, with assets under $200m’ ABS (Cat. No. 8140, 2001). The total number of employers in this state shall constitute the population of the study. However, due to time constraints, only the top fifty employers shall be included in the study. The quantitative methodology shall be adopted in the research, where the non-experimental design of the survey research design shall be used. The data collection tool shall be a questionnaire document prepared as presented by (Saunders, 2000). Data will then be analyzed qualitatively before the use of one-way analysis of variance (ANOVA) to determine whether there were any significant differences between the size of the organizations and the number and type of wellness programs and services. The presentation of the results shall be presented using tabular, semi tabular, and text presentation methods.
The information identified in this study will be a resource for employers that have not implemented worksite wellness programs. The most frequently offered worksite wellness programs and employer costs of the programs will be available to employers.
Preliminary Work breakdown Structure and work plan
|Month||Activities||Monitoring indicators||Expected outcomes||Resources|
|June|| || || || |
|July|| || || || |
|August|| || || || |
|September|| || || || |
|October|| || || || |
|November|| || || || |
|December|| || || || |
The study was conducted by surveying the 50 largest employers in California. Although the largest employers have an employee population of over 800, this could impact the results of this study as over 90 percent of California businesses are small businesses with less than 50 employees (Drucker, 2003) (Blum, 1988). With a total estimated population of more than 5 million residents, it is a populous state. The larger employers are located within metropolitan areas of the state and do not represent the rural and frontier nature of the state.
Based on the small sample size, a low response rate may not provide sufficient power to find statistical significance for the variety of services offered and paid by employers. To effectively address the risks associated with this project, a research study design that encompasses all the aspects of this study will be adopted. Given the contextual framework of the research, a case study research design will be employed. Case study research design will be mainly qualitative (or more specifically interpretive qualitative) in nature. In the process of designing the research, the four-dimensional framework suggested by Mouton (2001) (De costs, & Summers,1990) will be used. Within this framework, it will be possible to classify the research into; empirical research, using predominantly primary data, where data is predominantly textual, and with, relatively low control.
The project is expected to run for seven consecutive months; from the beginning of June to the end of December. As indicated in the work breakdown structure, several activities will be carried out every month so that the project is completed within the time frame and specific objectives for every activity achieved.
Ball park figure costs
Appendix 2: budget
In underlining the objectives of this study that seek to identify employer costs associated with worksite wellness programs and with the knowledge that this study makes the following assumptions that primarily relate to availability and variety of services included in worksite wellness programs:
- Health care costs continue to rise. Employers continue to search for a means of containing costs or shifting costs to employees. Research indicates the implementation of worksite wellness programs is an effective tool to control health care costs.
- There are a variety of worksite wellness programs potentially available to employees. It has been shown that they work best when multiple approaches are combined. A combination of several of the offered activities may have cumulative benefits. One specific activity will not provide significant benefits to employees.
- Evaluation of success for worksite wellness programs is conducted in a variety of ways. Many organizations evaluate success based on employee participation. Other organizations measure reductions in health care costs or employee lifestyle changes such as smoking cessation.
This project seeks to open a lid on a noble cause that will enhance the employee well being as well as reward the employer with the highest returns on investment. It therefore my humble plea for support towards the successful completion of this project within its time frames.
American Institute for Preventive Medicine, 2008, The Health & Economic Implications of Worksite Wellness Programs. Web.
Armstrong, M, 2007, Human resources management practice. Kogan Page Publishers: London
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Center for Disease Control and Prevention, 2003, The Power of Prevention.. Web.
Center for Health Improvement, 2008, Controlling Health Care Costs with Strategic Worksite Wellness Programs. Web.
Conners, K, 1992, Be your own boss. Journal of Employment Counseling, 67, 45-56. Colombia University Press: Colombia.
Csikszentmihalyi, M, 1992, Flow: The psychology of happiness. Random House: Sydney.
De cotis, T. A. and Summers, T. P, 1990, A path analysis of a model of the antecedents and consequences of organizational commitment. Journal of human relations, 34: 23-56. Van Nostrand Reihold: New Yolk.
Drucker, P, 2003, They are not employees, they are people. Journal of human relations, 13: 28-36. Colombia University Press: Colombia.
Kaiser Family Foundation, 2007, Trends in Health Care Costs and Spending. Web.
Mouton, S, 2001, implementing team responsiveness and user evaluation of customer relationships management: A Quasi experimental design study of social exchange theory. Journal of management information system (1), 19. Prentice Hall: USA
Reynolds, C, 2003, The health and productivity management. Health and Productivity Management, (3), 2: 6-8. John Wiley & Sons Publishers: New York.
Saunders, E, 2000, Case study research designs and methods. Applied social research methods series, 5, Newbury Park: London. wellnesswhitepaper.pdf.