Helping employees improve their health status and reduce the probability of preventable risks is the single most significant approach to reducing the number and severity of health problems. Health promotion and disease prevention activities such as smoking cessation, high blood pressure detection and control, nutrition counseling, weight management, exercise, back injury prevention, and stress management can all be instrumental in managing health care costs.
Although promotion of healthful employee habits does not necessarily require extensive company resources for the program to be effective, it does require the commitment and encouragement of top management. Some low-cost yet potentially effective activities include such efforts as encouraging exercise and weight control by establishing company running or walking teams, providing space for before or after work aerobics classes, providing low-fat, low-salt foods in the company cafeteria and vending machines, and holding periodic health education and screening programs to teach about and detect serious illnesses. Savings associated with health promotion activities are not often immediate and are smaller the higher the employee turnover rate. Many researchers are convinced, however, that such activities should facilitate a healthier work force and lower total health care expenditures.
Employee assistance programs (EAPs) provide a broad range of services including counseling for marital and family problems, job-related problems, and emotional disturbances as well as alcohol and drug abuse problems. To implement such programs, larger employers frequently employ full- or part-time personnel for in-house counseling and referral of employees to local services. Smaller employers may establish such programs by contracting with an outside consulting service. In lieu of a formal employee assistance program, employers can also encourage self-referral by providing a community resource guide to employees.
Maternal and Well-Baby Care Programs
As an increasing number of women of childbearing age have entered the work force, greater emphasis has been given to maternity and children assistance programs as part of corporate health insurance plans. This interest was enhanced by the 1978 Pregnancy Disability Amendments to the 1964 Civil Rights Act requiring that health care benefits for maternity be the same as health care benefits for other conditions. Corporate prenatal programs include expense associated with prenatal/obstetrical, “well-baby” and “well-child” care. Medical costs for low birth-weight and preterm babies can range from $15,000 to over $100,000, compared with roughly $3,000 for the birth of a normal weight baby. In view of the costs involved, corporate prenatal programs can be cost-effective. In addition, sick babies may also delay or prevent a female employee from returning to work. Such services include physical visits, immunizations, well-newborn care, health education, developing screening, clinical, laboratory, and radiological testing.
Maternity care is one of the most frequent reasons for hospitalization. The birthing center concept (or hospital short-stay program for maternity) is an effective means of minimizing costs associated with routine maternity care. Birthing centers are usually freestanding facilities separate from a hospital. These facilities, intended for low-risk pregnancies, provide midwifery or maternity services generally delivered by a physician. The mother and child are discharged within 24 hours of delivery in most cases.