St. Louis County goes lean with fitness programExercise grant from Blue Cross has employees healthier, insurance costs down
By: John Myers, Duluth News Tribune
St. Louis County officials realized they had issues with older and generally less-healthy employees — read overweight with chronic health problems — than the average work force in Minnesota.
In 2006, the county’s self-insurance pool of money was being gobbled up so fast, it dipped to less than a three-month reserve because claims by employees were so high.
“The rule is to have a three- to six-month reserve on hand to cover costs, so there was some worrying going on,” said Jim Gottschald, county human resources director.
County officials took a long look at the problem, and instead of raising premiums or deductibles to cover the gap, they decided to try getting employees and their families healthier.
At first that involved “medical school” classes for all employees, to teach them how their benefits really worked. Then it was mandatory class time to learn that smoking and being fat and sedentary was a likely ticket to chronic health problems and an early death.
Employees and their families started getting regular physicals and taking advantage of free diagnostic care to spot health problems before they became crises. Now, county employees have among the highest preventive-care usage rates in the Blue Cross system.
St. Louis County still didn’t have a program to address the biggest problems its work face faced: obesity and generally being out of shape, which led to ailments such as heart disease, diabetes and depression that piled up lost work days as well as medical costs.
The county began promoting friendly biking and walking competitions among employees. And late in 2011, as the county asked for bids from companies for the coming year’s health-insurance management contract, county officials included a request for cash back to help employees get into shape.
Blue Cross responded — and was again chosen as the county’s insurance manager — by offering a $150,000 grant to the county to be used directly for personal fitness. The grant was, in essence, a rebate from Blue Cross for part of the money they get to run the county’s health insurance money from premiums employees pay.
In January, county officials worked with health-care and fitness experts to develop a program that would do more than offer the usual $20 monthly rebate for occasionally showing up at a fitness center. Instead, county officials wanted employees to work out in groups, and do it under the direction of professional fitness trainers.
The Blue Cross grant paid the full cost of the small-group training sessions at more than a dozen fitness centers with 25 trainers across the Twin Ports.
Big losses, big gains
The results surprised even the people who organized the effort.
Based on physicals before and after the challenge, participants’ blood pressure dropped. Their heart rates fell. They lost weight — an average of more than 6 pounds, but some lost more than 25. Their body fat index declined. Their flexibility increased. The average number of push-ups each participant could do doubled from 15 to 30.
All of this happened after just 82 days.
About 75 percent of the 230 participants said it was the first time they had ever seriously worked out. And they came from across the county’s work force — from snowplow drivers and social workers to department heads — even County Attorney Mark Rubin and County Commissioners Steve O’Neil and Peg Sweeney — as organizers encouraged those at the top to lead by example.
“There’s also an added benefit we never thought of. It’s building camaraderie among employees,” Gottschald said. “Up in Virginia, we had county road maintenance guys exercising in groups with social workers, two groups that likely would never have seen each other on their jobs.”
The key, organizers said, was that participants didn’t just exercise on their own. Instead, they worked out in a group of four. And they had the help of a professional fitness trainer at each session.
“I’d never done anything like this before. I’d worked out a little, but never in a group or with a trainer. It makes a huge difference to do it regularly and do it right,” said Jim Gaylord, a child protection officer for the county.
Gaylord lost 16 pounds over the 12 weeks. His blood pressure dropped. His heart rate dropped. His body fat plummeted. And, at 38, feels better than he has in years.
“We learned other things from the trainer, about eating right and being active. It was more than just the one-hour sessions,” Gaylord said. “It helps change how active you are.”
Sweeney, 68, who has had two shoulder surgeries, agreed.
“I couldn’t squat to pick things off the floor before. Now I can bend down. I’ve felt my muscle strength coming back. And I’ve lost 17 pounds since I started this,” she said. “Having the small groups and the professional training really helped. Now I’ve taken what I learned and I’m doing it at home on my own.”
Gaylord was so happy with the results that, even when the Blue Cross grant stopped paying for his group sessions, he opted to stay in the program. So did 90 percent of the other participants.
Gottschald said the county’s health committee saw the results and decided to use leftover money in the grant to pay part of the monthly fee for employees who continue to work out. In addition to the usual $20 Blue Cross rebate everyone gets for a fitness membership, participants still in the county program get another $50 to help cover the cost of the personal trainer. That’s amounted to about half the cost, Gaylord and others noted. No county tax money has gone to the program — it’s all part of the Blue Cross grant.
“I think they might have had the same results working out alone with a trainer, but being in group, they helped each other. There was a group goal and their personal goals. … They really built a bond,” said Jessica Currey, a professional trainer at Evolve Duluth, where Gaylord and several other county employees trained, usually in groups of four.
“This took away all the excuses for not doing it,” said Wendy Stenberg, of Cloquet, who works in the county’s information technology department and lost 12 pounds during the 12-week challenge while training with Currey in evening sessions after work.
After the original program ended, Stenberg tried to work out on her own, but she skipped a whole month and is now back in the group.
“The group holds each other accountable, so you show up and you work hard,” she said. “Having a trainer is incredibly helpful in keeping you going and doing it right.”
Kari Perrine, account manager for Blue Cross, said the program worked because employees counted on each other to show up and work hard at each training session, much as they do at work. Now, Blue Cross is trying to sell the program to its other customers, private and public insurers.
Healthier employees spend less on health care, she noted. And because the county is self-insured, the savings go right back to taxpayers.
“I don’t know of any other employer, public or private, that has gone this far to get people moving toward being fit,” Perrine said. “The combination of the small group and the personal trainer brought out people, most of whom had never done anything like this before. It really reached the target population.”