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Mon 4 Feb 2008 04:00 AM

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Fit for purpose

Offices are set to become training grounds, as firms realise that healthy employees add up to a healthy bottom line, writes Joanne Bladd.

Offices are set to become training grounds, as firms realise that healthy employees add up to a healthy bottom line, writes Joanne Bladd.

Visitors to the Axa Insurance office in Dubai recently would have been surprised at the scene. Rather than fielding claims from customers, rapt employees were instead receiving tips on stress-relief from a yoga teacher.

Financial incentives are a little strong. Do I have the right as an employer to take that approach? I think a softer line is better.

Few professions can claim good health as part of the job description, but companies are fast realising that it's key to a more industrious workforce. And wellness programmes - initiatives that actively promote a healthy lifestyle among staff - are on the rise in the Middle East.

Their critics argue they simply add an unnecessary cost to the balance sheet.

Their champions maintain there is a direct link between health programmes and reduced absenteeism, fewer stress-related illnesses, improved retention rates and better staff performance.

Andrea Rossi was an early convert. As CEO of Axa Insurance Gulf and Middle East, employee health became a strategic aim for him after a tour of the office opened his eyes to the state of his staff's health.

"I saw people eating chocolate for lunch or drinking the wrong drinks, people that are predominately sedentary," he explains. "It has an impact on their health, and therefore their health insurance.

The promise of more productive workers gave Rossi the impetus to develop in-house health schemes. Alongside yoga sessions, employees are encouraged to participate in training sessions for company-wide sporting tournaments and are set to benefit from a free purpose-built gym in their new office.

The firm is also looking into hiring a company dietician to steer employees' eating habits back on track. For Rossi - a man at the business end of the health insurance equation - the compensation is clear-cut.

If people feel better, I'll see the benefits on the office floor - not only the lower costs of health insurance, but in less absenteeism, higher productivity rates and happier staff," he explains.

For many managers, the idea of pushing staff to lose weight or exercise crosses the line into Big Brother territory. But wellness programmes are typically driven by more mercenary factors than paternalistic concern.

The trend has sprung out of Corporate America, where out-of-control health costs have prompted companies to analyse their value in minute detail.

Studies, such as that from the Wellness Council of America, have found that for every US$1 invested in a staff health plan, employers save $3 on insurance fees.

As a result, more than 25% of American companies now have some type of employee-wellness scheme. And as these firms have set up round the world, their health plans have gone with them.

Rossi admits that, on a local scale, Axa's programmes are unusual.

But he's confident that the recent decision by the UAE government to force employers to foot health bills will see more regional companies follow suit.

We'll see more local companies following suit with these plans because they make business sense. It just takes time to filter down,' he says.

All work and no play

Martyn Anthony is the head of Wellness Specialist Services for BUPA. As micro populations, he says, offices typically reflect the same disease trends seen across the nation, so most wellness programmes target similar areas.

"There are some core elements to these plans...support for psychological issues at work, for stress or stress-related ailments, health assessments, particularly looking at weight, preventive care for an older population; I think these are well used elements across most sectors.

Anthony consults with firms to tackle specific health issues; whether an explosion in absenteeism, or improving ‘presenteeism' - the level at which an employee functions at work.

He believes more companies are working - and investing - to keep their staff's health on track, rather than risk profits slipping.

It makes business sense to take care of not just the financial performance of your business, but the people behind it. I think it's a realisation of a long-used saying that ‘my people are my most important asset'."

IBM is one firm taking the subject seriously. The company made headlines for offering staff in US offices financial incentives to enrol in health plans to lose weight and exercise.

Workers can choose one of four programmes targeting healthy eating, physical activity, preventative care or children's health, and use an online record to track their progress.

Each rebate is worth $150 in cash, and employees can choose any two rebates to notch up $300 in cash per year. The results are plain. As a direct result of the firm's smoking cessation plan, IBM's smoking rate in the US is less than 10%, compared to a national average of more than 20%.

The plan has been deemed so successful, it's now only offered to new recruits. Last year, more than half the firm's US employees earned the rebate from the preventive care plan.

So how does the firm benefit? Patric Traut, wellbeing specialist for IBM, is frank.

The company wants employees that are productive and healthy," he says matter-of-factly. "The healthier they are, the more revenue they can produce. We are all facing demographic battles.

It's getting harder and harder to source a workforce that can fulfil what the company needs. When people get older, they are sicker. It's why companies install these programmes.

IBM employees in Egypt, Dubai and Turkey have the option of enrolling in smoking cessation programmes, flu vaccination schemes, and nutrition lectures. These fall short of the more extravagant schemes in place in the US, admits Patric, but still garner around a 33% attendance rate among Middle Eastern staff.

IBM has ploughed more than $30 million into its wellness schemes to date, but it is reaping the rewards. Head to head, Traut claims, the firm's insurance costs are rising far more slowly than the industry average. "And it's due to our wellness programmes," he says firmly.

Toeing the company line

Aside from the financial arguments in their favour, wellness programmes make for good PR. Even minor changes can boost a company's image, which, in the current recruitment climate of the GCC, is an attractive perk that doesn't demand a doubling of salaries.

"It's the best way of retaining your employees and, in the GCC, that's the biggest problem we face," Rossi says matter-of-factly. "These programmes build loyalty and encourage retention. It's a genuine investment in your company's human resources.

"Employees see that the company is supporting them," adds Traut. "You are promoting job satisfaction.

Among smaller companies, the prospect of forking out for healthcare plans - even those that deliver to the bottom line - will more than raise an eyebrow.
Yet research shows that such projects are not just for large organisations. For each Dubai Holdings (a firm that has recently announced a company-wide set of health initiatives) there are effective low-cost alternatives for companies with smaller balance sheets. Programmes, argues Axa's Rossi, can be as modest or extravagant as the budget permits.

"Any company - whatever size - can implement measures," he stresses. "It's very easy - you don't need to have a gym. If you're a small company, organise team sports on the beach.

In the short term there are slightly raised costs, but new activities feed through into reducing costs over a five to 10 year timeline.

According to Bupa's Anthony, e-health schemes are one strategy helping to level the corporate playing field. Companies with less to spend can pay a flat fee per employee, to provide access to online portals with self-scoring health appraisals and patient education.

"At £5 a head, it's very cost-effective," Anthony explains, "and because it is web-enabled, employees can access it through work or from home.

"These appraisals can be taken periodically, so if you're following a health programme you can track the benefits that you personally are accruing. For small companies, this really works.

Online solutions are set to get even cheaper as bigger players move into the market. US firm WebMD, the company behind leading CME site Medscape, already offers bespoke solutions to American corporations, built to their insurance policies, and has plans to bring its services to the Middle East.

"More and more of the major companies signing up with us want us to provide the necessary information and coaching in order to keep staff out of the major disease categories," says CEO Wayne Gattinella.

Many of the companies that we cater for today, like IBM and Microsoft, have large workforces outside of the US. So we see this as an opportunity to bring our brand of health information to the global employees of corporations that we serve."

Small firms can also take comfort in new research that shows employers can earn back the cost of their programmes over the course of five years, if they can whittle down risk factors by a mere 0.2%.

In a study funded by the US Centers for Disease Control, Dr Ron Goetzel of Cornell University created an ROI calculator to identify the minimum improvement needed to break even on wellness investments.

Looking at specific firms, Goetzel found that Dow Chemical could reap a stunning 300% return on investment if it managed a 1% risk-factor improvement. With 26,000 employees, even a minimally effective wellness programme would work to the tune of $50 million over five years.

"In the short term there are slightly raised costs, but new activities feed through into reducing costs over a five to 10 year timeline," Anthony agrees. "With the right information or framework, wellness schemes can have a huge impact.

Cash under question

It's not all plain sailing for firms hoping to even out staff's work/life balance. Critics of wellness schemes have argued that the plans have the potential to become employers' carrot - or stick - of choice. Certainly in the US, wellness plans have teeth.

The more sinister side of these schemes include cutting insurance benefits, assigning workers to risk categories, and levying fees for non-participation in schemes. It's a hardline approach that recognises the most unfit and ill employees are the ones least likely to sign up for lifestyle changes.

Many GCC employers, Rossi believes, would feel uncomfortable with the prospect of dangling cash incentives, IBM-style, in front of workers who submit to losing weight.

There is a fine line, he warns, between support and discrimination and mandatory health schemes cross it. "You can't force people, but you can offer these services for free," he says carefully. "Financial incentives are a little strong. Do I have the right as an employer to take that approach? I think a softer line is better.

Flipping the equation to pay for healthcare, rather than sick care means a fundamental change in workplace culture. Encouraging employees to take charge of their own wellness programmes is one way of respecting personal boundaries, Rossi suggests.

"If these programmes come from the top, it helps, but they should be driven by employees. That's the idea. It creates team building, and it can be very motivational. It's just a question of someone taking ownership and executing the programme confidently.

Connecting your staff to a supportive wellness programme can radically change the office environment, claims Rossi; and happier staff are more effective staff.

"In my company, I want to be the preferred employer by choice," he concludes. "I want my employees to come to work by choice, not purely because they need the salary, but because they enjoy working in this environment. And I'm happy to invest to help that happen.

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