With overwhelming increases to the health insurance premiums in 2003, the City of Chattanooga realized a need to build a culture of health and wellness among the employee population and their families. The City developed a wellness strategy which included making healthcare accessible and affordable, creating environments that support wellness, and incentivizing employees for improvements to their health. The WellAdvantage Program, the City's employee wellness program, began in 2006 with the opening of an on-site health center. City of Chattanooga employees, dependents and retirees, which is a total population of 7,100, can utilize the services of the program. The WellAdvantage program has grown to also include an on-site fitness center, on-site pharmacy, disease and lifestyle management programs, and employee incentive program. When the WellAdvantage Fitness Center opened in 2007, Jennifer Lowry joined the City as the wellness professional. Throughout her 7 years of employment as the Wellness and Occupational Health Manager, she has lead the organization’s charge to change the culture by managing the on-site wellness services to ensure the City’s vision is achieved, implementing innovative lifestyle management programs to reduce health risks, and administering a successful outcomes based incentive program that effectively leads participants through the continuum of health management and improvement.
I received my bachelor’s degree in Kinesiology from Mississippi University for Women as I have always been interested in a field that I could help others struggling with their health. During my time at MUW, I interned as a worksite wellness specialist at OCH Medical Center’s Healthplex, an on-site fitness center for hospital employees. Through my experience at the Healthplex, I learned the corporate wellness industry was one in which I could add value. Eager to learn more about health and fitness and how to apply my skills to help others, I attended University of West Florida to receive my Master’s in Exercise Science. I am also a certified ACSM Personal Trainer, SPIN instructor, and ALA Smoking Cessation Facilitator.
In 2007, the City of Chattanooga’s population, a total of 7,100 that includes active employees, dependents and retirees, had a long journey ahead. As evidenced by data analysis, a key WELCOA Benchmark, our historical and current data concluded that prevalence rates for diabetes, hypertension and obesity were extremely high. With Mayor’s support, one of my first tasks to tackle our population’s high risk factors was to shift our thinking from reactive to proactive healthcare.
The fitness center is a free benefit that our entire population can access. In August 2007, I began offering group fitness such as Pilates, Body Sculpting and Core Class. I developed and implemented “FitStart”, a free personal training program that gives individualized program design and guidance. Over the years, our fitness center has flourished. Our membership has grown from 250 members to over 1,800 members today. The fitness center now offers more fitness classes including Indoor Cycling, Zumba, and Yoga. With the fitness offerings, we have seen body fat percentage, cholesterol, and blood glucose decrease and we also have a healthier workforce evidenced by fitness testing and biometric screenings results.
Our employee incentive program has also evolved. In 2007, only 15% of the employee population was participating in the incentive program as it was geared more towards the healthier population. I wanted an outcomes based program in which we could reward those for not only maintaining their good health but we could also incentivize those who made improvements. In 2009, I launched the City’s current incentive program called ChipRewards, an outcomes and behavioral science based incentive program. Since 2009, we have improved our engagement rates to 63% of the employee population. Since the program’s inception, our employee participation rates of those completing a biometric screening has risen from 46% to 73%, mammogram screenings has increased from 39% to 65%, and colonoscopy screenings have increased from 9% to 30%.
Another key to our success in accomplishing our proactive approach was building our wellness team, which includes an on-site registered dietitian (RD), fitness manager, and medical providers trained as health coaches. In 2010, I hired a RD to provide face to face health coaching. Today, our RD provides one-on-one consultations to more than 55 unique patients per month and demonstrates healthy cooking during our monthly cooking classes. I also implemented lifestyle management programs such as weight management and tobacco cessation. We also changed our health center vendor to one that provides holistic care. By incorporating a holistic model, our population is making strides in improving their health in several areas including BMI (23%), blood pressure (64%), and cholesterol (35%). Also, 48% of our total population is completing their annual biometric screenings at our health center and our medical staff provides health coaching to a 532 unique patients/month.
By taking a proactive approach to healthcare, implementing key lifestyle management programs, incorporating the right wellness team, and communicating our commitment to health and wellness to our population, we have experienced significant savings. A May 2014 actuarial analysis shows an overall savings of over 10 million dollars and the trend for our healthcare premium costs has almost flat-lined having only a 3% increase for fiscal year 2015.
In 2010, I developed and implemented the “Take Control” Diabetes Management program. Of those diagnosed as diabetic, 43% are enrolled in our program and making progress towards reduces risk factors.
I, with the assistance of our fitness manager, implemented Genesis and Thrive. Genesis is a 10 week beginner programs that features a comprehensive support approach, which includes weekly meetings led by dietitians, therapist and exercise specialists. Thrive is a 10 week intermediate-advance program comprised of five key elements including exercise, nutrition, social support, life-balance and maintenance. With these programs, participants have had significant changes to their BMI, cholesterol and blood glucose levels.
Changing our incentive program from participation to outcomes focused also contributed to our success. Our program concentrates on health maintenance or improvements in blood pressure, cholesterol, blood glucose and weight. We also reward employees for completing preventive screenings such as colonoscopies and mammograms, which can generate huge claims savings.
The best way to inspire those to live a healthier lifestyle is to lead one yourself. As the City’s wellness professional, I have always strived to lead by example and take responsibility for my own actions and decisions. Whether that be by participating in fitness classes with the employees, listening to and supporting an employee’s efforts in accomplishing their goals, or simply choosing healthier options at the annual Christmas party, it is my responsibility as the City’s wellness professional to demonstrate a commitment to health and wellness to our employees. I also have focused on aligning my own wellness goals with the City’s vision and initiatives and I have communicated my dedication to helping employees achieve better health.
The biggest threat to the health promotion industry is the increasing cost to healthcare and the barriers between healthcare providers and wellness programs. In the next 5 years, I believe more collaboration between insurance companies, hospitals, private physicians, specialists, and worksite wellness programs should occur. Insurance companies should be willing to share data with on-site wellness vendors to coordinate care and close gaps; pharmacists should be working more closely with a patient’s medical provider to map out an effective, affordable plan for the patient. Our focus should be on providing accessible, affordable, quality care to our population and helping them to identify their health issues in order put the right strategies in place that prevent or slow progression of a costly disease. My vision for the future of this industry is to propose a more collaborative, holistic effect between worksite wellness programs and healthcare providers to improve the health of our employees and their families.