David Kasper, VP of employee benefits for Waste Management Inc. in Houston told a group meeting about business health recently that benefits programs need to be integrated in order to keep healthy people at work and to get injured or ill people back to work as soon as possible. Waste Management switched from a benefit-centric model to an employee-centric model to improve profitability and employee relations while reducing turnover, absenteeism, and presenteeism.

Before the switch, Waste Management had as many as 25% of its workforce absent at any given time, leading to contract labor costs that were almost as high as its group health costs. Now the company uses onsite health advisers who talk to health care providers and company managers to make arrangements for an injured employee to return to work in some capacity, including putting them in jobs that match their physical capabilities.

The new program has trimmed costs significantly. In 2003-04, the average health care spending per employee was rising at a 21.4% rate. With the new plan, the costs are kept to a 2.4% increase.

In a similar vein, Public Services Enterprise Group (PSEG) integrated its benefit programs to minimize costs and loss of productivity. The company evaluated its greatest cost drivers and identified these conditions on which to base its program: cardiovascular, musculoskeletal, and mental health conditions.

PSEG is also working on sending consistent messages about good health practices. It is working on making its facilities smoke-free, and is also considering a policy that would stipulate that employees using company money to buy lunches must buy healthy food. PSEG feels that the food message is important because 70% of its workforce is overweight to obese.

Efforts to control costs that are aimed at injured or ill employees are a good step, but employers also need to consider the large segment of their employee base that is healthy. Preventative care and targeted wellness programs are also an important part of this integrated approach.