Engaging Employees in Health and Wellness: the Healthy Pfizer Program

Although Pfizer is in the healthcare industry, itscorporate leadership struggles with the samechallenges that face other large and small businessesin keeping employees and family membershealthy and productive. While managing tremendousinvestments in health, Pfizer sought to inform, motivate,and empower its employees to take the steps towardhealth improvement, sickness prevention, and diseasereduction that have been proven to positively affect thewell-being of employees and their families.

Healthy

Pfizer

Healthy Pfizer

Living Healthy

Care Counseling

By managing engagement and outcomes, has succeeded in influencing employee understandingand action. In year 2 of this new employeedirectedhealth management initiative that began in2005, has exceeded initial benchmarksfor participation. Year 1 (June 2005 through June 2006)saw an 83% health questionnaire completion rate amongcolleagues, with 28% and 17% of those identified as beingeligible for and programs,respectively, enrolling in these coaching programs.Measurable changes in employee health areevident, and indications point to improvements inhealthcare utilization, claims, cost, productivity, absenteeism,and presenteeism (the degree to which individualsare fully present and functioning while they are atwork).

Healthy Pfizer

was launched with defined goals forthe first 3 years. Year 1 included employee engagementthrough healthcare awareness and understanding. Year2 comprised behavior change, including exercise frequency,smoking reduction, medication adherence, andpreventive care. Year 3 involves utilization changes,such as patterns of hospital and emergency departmentuse and physician visits.

DEMOGRAPHICS AND COMPONENTSOF HEALTHY PFIZER

Healthy Pfizer

Pfizer's target demographic group for was its US employee base of 41 223 members and theirdependents, for a total of 105 479 covered lives.¹ Theemployee demographics are 54.6% men and 45.6%women, with a mean age of 40 years and just over 9years of Pfizer service. Factoring in dependents, themean age of the covered lives is 28.6 years, and themean family size is 2.56 members.

Healthy Pfizer

Healthy Pfizer

The population includes employeesworking at all Pfizer sites, its sales force, as well asdependents. Major sites include the company's headquartersin New York City and Brooklyn, New York, aswell as sites with more than 500 employees inConnecticut, Michigan, Missouri, New Jersey, andCalifornia. When was launched in June2005, Pfizer offered 5 medical plan options, with mostcovered lives enrolling in self-insured plans.

Healthy Pfizer

The program is multifaceted. Componentsinclude a health questionnaire, a Web portalwith access to health information, health coaching, andassistance with disease management. The program alsoprovides access to online health advisors, workplace-basedservices, and an electronic data warehouse torecord and benchmark progress.

Healthy Pfizer

All US Pfizer employees are considered participants. The level of involvement that an employeepursues is his or her choice. The first step is completing the120-item health questionnaire–a risk assessment tool.The questions address family disease history, exercise frequencyand fitness, results of recent disease screenings,habits related to eating and drinking, and biometric data,including body mass index, cholesterol and glucose levels,and questions that assess emotional health status.

Healthy Pfizer

The online questionnaire can be completed in lessthan 15 minutes by registering at a customized site poweredby partner WebMD.² The site offersa variety of resources on healthy lifestyles, behaviormodification, disease management, stress reduction,child-rearing, and other topics. A personalized datatrackingfeature lets participants benchmark their status. Participants can record the results of periodic biometricscreening to create a powerful, ongoing record oftheir progress over time.

Healthy Pfizer

To help colleagues complete the questionnaire, Pfizerheld health screenings at each location at the time theprogram was launched. At the screenings,employees obtained their blood pressure, bodymass index, and cholesterol and glucose levels, whichthey could then use when responding to the questionnaire.The combination of responses to the health questionnaireand the biometric data from screenings yieldsa powerful snapshot of current health status.

Healthy Pfizer

Healthy Pfizer

Living Healthy

Care Counseling

Automatic data analysis scans the responses to thehealth risk assessment, including biometric data, toidentify participants for risk modification and diseasemanagement programs. These programs are offered bypartners Gordian Health Solutions³ andMatria Healthcare.⁴ Gordian Health Solutions provideslifestyle management programs primarily focused onreducing health risk factors, such as tobacco use, obesity,elevated stress, elevated blood pressure, and cholesterollevels. Matria Healthcare provides care counselingand disease management for persons diagnosed withtype 2 diabetes, asthma, coronary artery disease, andother chronic conditions. Employees participating inwho are identified for the coaching programsreceive a letter from Gordian Health Solutions() or Matria Healthcare (),depending on which coaching partner is mostappropriate, informing them about their eligibility forthe program, providing self-enrollment information ifthey choose to enroll immediately, and letting themknow that they will also be receiving a telephone callregarding enrollment (Table).^5-10

Healthy Pfizer

Healthy Pfizer

Healthy Pfizer

Coaching is provided telephonically by GordianHealth Solutions and Matria Healthcare. Throughout theprogram, no data are identified to Pfizerby individual employee or dependent name. Rather,executives receive only aggregate dataand population-based reports in accordance withhealthcare privacy laws. The entire programis adherent with the Health Insurance Portabilityand Accountability Act of 1996,¹¹ ensuring that personalhealth information is protected.

Participants also have access to a 24/7 telephone linestaffed by nurses. Professional nurses provide answersto healthcare questions and offer expert guidance onnavigating the healthcare system.

From Knowing to Doing

Healthy

Pfizer

Awareness helps change behavior, and acquiringhealth information increases a person's pursuit ofhealthcare services. When a colleague in the program is identified as a candidate for coaching,the individual is invited to telephone a coach for moreinformation about risk factors and about coachingdetails, such as schedules, goals, and assessments. Theparticipant and coach jointly develop and execute acoaching and behavior change plan that might includeweight loss goals, an exercise regimen, suggested menus,and adherence with physician recommendations forglucose testing and other evaluations depending onidentified risks.

For Pfizer, the coaching programs are beginning tocreate a healthier, more productive workforce that isusing the right health resources at the right time. Pfizerbelieves that engagement in these programs will ultimatelylower the company's healthcare costs and resultin a positive return on investment. More than 13 000colleagues and dependents have enrolled in the coachingprograms, which represents about 25% of those identifiedas being eligible for the programs.

Healthy Pfizer

Healthy Pfizer

A strong indicator of future success is a program'sability to tailor its offerings. Questionnaire and screeningdata are used to fine-tune onsite programming.For example, data revealed that overallsmoking is less prevalent among Pfizer employees thanamong the population at large. Site-specific programsdeemphasized smoking cessation initiatives in favor ofother more relevant issues, such as fitness, nutrition,and weight management. At a manufacturing site implementingthe program, a high percentageof participants indicated poor diets and family historiesof heart disease. These factors were studied, and programofferings were adjusted accordingly.

ENCOURAGING ENGAGEMENT

Healthy Pfizer

Patient-centeredness is an important component ininitiatives to drive employee engagement in and responsibilityfor their healthcare, and sustained engagementis a function of culture change over time. During year 1,the primary goal was to encouragehealthcare engagement and understanding. This wasachieved in part by offering $100 gift cards to employeesand dependents who completed the health questionnaireand risk screening. The initial incentive alsoincluded a 20% discount on the employee-pay portion oftheir health insurance coverage. An expected target goalof 50% participation was exceeded by almost 30%.For the coaching programs, the initial target was a 20%enrollment rate for colleagues identified for coaching bythe end of year 1 and a 40% enrollment rate by the endof year 2. The number of participants who signed on forcoaching exceeded the year 1 expectations.

Healthy Pfizer

America on the

Move

During year 2, more engagement was required. Toachieve the maximum incentive (a $100 gift card and a20% health insurance discount), participants had toretake the health questionnaire, begin to compile theirelectronic personal health record, take an annual physical,enroll in the coaching program, participate in atleast 2 coaching sessions, and join a walking programoffered by partner .¹² As of November 20, 2006, 14 000 employeeshave registered in the walking program.

HEALTHY PFIZER

CASE STUDIES

Healthy Pfizer

Although years 1 and 2 of the programhave been primarily devoted to increasing engagementrates and to promoting healthcare awareness, multipleindividual and family successes are evident. The following3 case studies are indicative of the programresults.

A Research Scientist

Healthy Pfizer

A research scientist had never given much thoughtto her health risk factors until she participated in ascreening. Despite a healthy lifestyle,genetics proved to be a contributor to her dangerouslyhigh blood pressure. Informed actions helped lower herblood pressure to acceptable levels. Now taking medication,exercising daily, and several pounds lighter, sheis convinced of the value of healthcare knowledge andvigilance.

A Paralegal

Healthy Pfizer

A paralegal met the challenges head-on,dropping 40 lb after identifying her risk factors anda family history of type 2 diabetes. She began taking thesmall steps that had eluded her in the past. In additionto healthy eating, she added moderate exercise to herlifestyle and found ways to remain active throughout herbusy day. Behavioral change has helped her find moreenergy for her son and for graduate school, in addition toher duties at work.

A Logistics Manager

A senior manager of logistics is a 200-lb athlete over6 ft tall who was surprised to learn that his cholesterollevel was climbing silently but steadily. He likens hisGordian Health Solutions coach to a teacher or counselor.Almost a year after his health screening, hischolesterol level is below 200 mg/dL (<5.18 mmol/L). Hewatches his sugar intake, stays away from cheese, andcontinues to exercise regularly.

REACHING BEYOND

Healthy Pfizer

Company officials drew on the decade-long experienceof Pfizer Health Solutions (PHS), Pfizer's care managementprojects subsidiary, in creating .PHS is dedicated to improving health and healthcaredelivery through innovative programs that demonstratethe value of personalized, coordinated, and accessiblehealthcare services. Working in partnership with government,payers, and providers, PHS develops andimplements health improvement projects that focus onhelping individuals and populations living with, or whoare at risk for developing, chronic diseases. PHS programshave demonstrated that investments in healthcan result in better outcomes at lower costs.

Florida: A Healthy State

Among those programs is , acollaboration between PHS and Florida's Agency forHealth Care Administration that emphasizes healthunderstanding and subsequent behavior change.Beginning in 2001, the program provides innovativepatient education and nursing care to high-riskMedicaid patients with asthma, high blood pressure,type 2 diabetes, and heart failure. The delivery vehicleis a statewide network of community hospitals, civicorganizations, and patient advocacy groups. During thefirst 3 years, the program helped the state save $97.4million through investments and medical cost reductions(as validated by Medical Scientists, Inc, Boston,Mass, an independent third-party evaluator and leaderin the use of predictive modeling software). In additionto improvements in clinical indicators, the program hasaffected utilization rates. Patients across all populationsare spending more time in their physicians' offices andless time in emergency departments and hospitals.

Amigos en Salud

Friends in Health

Healthy Pfizer

Amigos en Salud

The () program,another PHS community initiative, is designed to helppatients with type 2 diabetes understand their condition,to promote self-management skills, to encourage andsustain behavior change, and to provide ongoing communitysupport in the context of individual cultures. Theprogram operates in Savannah, Georgia, to provide culturallyrelevant education, outreach, and access tools inHispanic and African American communities with highrates of type 2 diabetes, hypertension, hyperlipidemia,and associated modifiable cardiovascular risk factors,including obesity, physical inactivity, and poor nutrition.Like , aims to increasethe desire and ability of participants to achieve healthgoals. Documented successes include lower glycosylatedhemoglobin and low-density lipoprotein cholesterol levels,better adherence to diabetes process measures,reduced body mass index, and improved behaviorchange, such as eating healthy and exercising.

Healthy Pfizer

Healthy Pfizer

The time has come for new approaches to USemployee healthcare, away from a sick care system toone emphasizing disease prevention. As the initialresults of are assessed and conveyed,company executives anticipate that willresonate beyond a healthier workforce at Pfizer. Otherbusiness leaders are encouraged to build on the modeldescribed herein to offer their own innovations andapproaches to drive better employee health and to lowerhealthcare costs.

From Pfizer Health Solutions, 235 East 42nd St, New York, NY 10017

Address correspondence to: Susan Denelsbeck, MA, Pfizer Health Solutions, 235 East42nd St, New York, NY 10017. E-mail: susan.denelsbeck@pfizer.com.

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2. WebMD. Available at: http://www.webmd.com/. Accessed October 28, 2006.

3. Gordian Health Solutions. Available at: http://www.gordian-health.com/. AccessedOctober 28, 2006.

4. Matria Healthcare. Available at: http://www.matria.com/. Accessed October 28,2006.

5. Centers for Disease Control and Prevention, National Center for HealthStatistics, National Health and Nutrition Examination Survey. 1999-2002.

Vital Health Stat.

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Diabetes

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7. Benjamin SM, Valdez R, Geiss LS, Rolka DB, Narayan KM. Estimated number ofadults with prediabetes in the US in 2000: opportunities for prevention. 2003;26:645-649.

8. Families and Work Institute. Available at: http://www.familiesandwork.org/.Accessed October 28, 2006.

MMWR Morb Mortal Wkly Rep.

9. Centers for Disease Control and Prevention (CDC). Cigarette smoking amongadults: United States, 2003. 2005;54:509-513.

Behavioral Risk Factor

Surveillance System Survey Data.

10. Centers for Disease Control and Prevention (CDC). Atlanta, Ga: U.S. Department of Health andHuman Services, Centers for Disease Control and Prevention, 2004.

11. Health Insurance Portability and Accountability Act of 1996, 18 USC §264(West 1994).

12. America on the Move. Available at: http://aom.americaonthemove.org/site/c.krLXJ3PJKuG/b.1524889/k.BFFA/Home.htm. Accessed October 28, 2006.

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