1946 - California State University, Northridgealliance/Wellness_Coreteam/Absolute Advantage M… ·...

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1946—Forty years after 11-year-old Raphael Cianchette boarded a passenger ship alone in Naples, Italy, bound for America, four

of his sons—Carl, Ken, Bud, and Chuck—locked arms to build a construction empire.

With Ken and Bud’s Army savings for seed money and Chuck’s 1934 pickup truck as the company vehicle, Carl launched the family enterprise. Incorporated in 1949, Cianbro, now an employee-owned company, is one of the East Coast’s largest civil and heavy industrial construction and construction services companies.

Carl, Ken, Bud, and Chuck Cianchette were raised to be hardworking, self-reliant entrepreneurs. Instilled with their parents’ philosophy – treat people with dignity and respect, your word is your bond, and give back from which you take – the boys delivered newspapers, worked odd jobs, and learned early the value of a positive, can-do attitude and the rewards of an honest day’s work.

They believed in themselves and they believed they could succeed by working together. They also believed they could achieve the impossible regardless of the obstacles. This same confidence and can-do spirit lives on in our people today. It is what allows Cianbro to successfully complete some of the most complex projects in the construction industry.

The Cianchette brothers—each unique and different individuals—provided our company with tremendous depth in its early years. Their mutual respect and trust in one another allowed them to focus on growing the company. They initiated the teamwork that Cianbro thrives on today. And, they believed that the people who worked beside them should be the future owners of the company. Their legacy lives on.

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Cianbro’s Vision, Mission And ValuesVision: Tobetheconstructorofchoice.

Mission: Cianbrowillsafelyconstructqualityfacilitiesontimeandatacompetitiveprice.Throughinnovation,efficiency,andacan-dospirit,wewilldevelopourpeople,satisfyourcustomers,andgrowprofitably.

Services And Traits Of The OrganizationCianbro,anemployee-ownedopenshopgeneralcontractor,servicesfromtheNortheastthroughtheMid-Atlanticstates.Servicesinclude:commercialandinstitutional,heavyindustrial,energysystems,pulp,paperandforest,marine,hightech,transportation,fabricationandcoating,dataservices,andelectrical.Oursuccesscanbeattributeddirectlytoourteam’sspiritofworkingsafe,cooperation,

Organizational Chart

Cianbro’s Business Context And Background

BUSINESS DEVELOPMENT DATA SERVICES/INFO-TECH

Scott MorrisonVice President

Business Development

PEOPLE

Alan BurtonVice President

HR, Safety and Health

FINANCIAL

Tom StoneChief Financial Officer,

Treasurer, Secretary, Clerk

FABRICATION/COATING

Dave LeavittGeneral Manager

Fabrication & Coating

CIANBRO DEVELOPMENT CORPORATION

Charlie CianchetteGeneral Manager

Operation Support Services

Ernie KilbrideVice President

Estimating

Peter ViguePresident & CEO

Mac CianchetteSr. Vice President

Linc DenisonVice President &

General Manager SNE

Mike HartVice President &

General Manager MAR

Frank SusiVice President &

General Manager NNE

Amy WebberWorkers Comp Adjuster

Becky WalkerSafety Administrator

Scott KnowlenManager of Health &

Environmental Hazards

Laura HenryInjury Management

Meghann SmithSafety/SICA Assistant

Sarah GraySafety Assistant

Kristi ConnellClaims Administrator

Megan DodgeSICA Support

Andrea PelletierCarol OuelletteDiana HartelyHR Admin Assistant

Peggy LagasseSwitchboard Operator

Katie NoilesLeah Finnemore

HR Support

Sue MorrisonHR Administrator

Amy ChuteAssistant HR Manager

Lauren BenttinenPension Benefits Supervisor

Stephanie RushtonDisability Case Manager

Dr. Larry CatlettMedical Director

Rita BubarHR Manager

S A F E T Y H R & H E A L T H

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enthusiasmandgenuineconcernforcustomers–onethatisunmatchedintheindustry.Thecompanyisrecognizednationallyforitssafetyprogram.CianbromeetsandexceedssafetycompliancewiththeOccupationalSafetyandHealthAdministrationandworkswithmanyregulatoryagenciesonemployeehealthandsafetyandhazardousmaterials.Offeringconstructionservicesfromtheconceptualstagesofdesignthroughstartup,ourTQMapproachbringscontinualimprovement,partneringandqualityprocessestoconstructionmarketplace.ThroughouttheEasternUnitedStates,Cianbrooffersawiderangeofservicesinourareasofexpertise.

PeoplearethefoundationofCianbro’ssuccessandourmostvaluableresource.Continuingsuccessdependsonourabilitytoattract,select,andretainthehighestqualitypeoplewhocansuccessfullymeetthediversechallengesofCianbro’sinvolvementandgrowthintheconstructionindustry.Toaccomplishthis,wemustmaintainanenvironmentthatcontinuallyandvisiblyreinforcesandcelebratestheconceptsoftreatingpeoplewithtrustandrespect,workingtogether,multi-skilledemployee,can-dospiritandsafety.

Present Competitive Position Within The IndustryCianbrohasitscorporateofficeinPittsfield,MaineandregionalofficesinPittsfieldandPortland,Maine;Bloomfield,Connecticut;andBaltimore,Maryland.ItisoneoftheEastCoast’slargestcivilandheavyindustrialconstructionandconstructionservicescompanieswithgrossannualsalesinexcessof$360millionandover2,000teammembers.Cianbrooperatesin13statesasaprimecontractorandundertheguidelinesofa“federalcontractor.”

Listedinthetop100ofEngineering News Record’sTop400Contractors,Cianbroisrankedasaleaderinthemarketareasofhydropower,pulpandpaper,industrialprocess,andmanufacturing.Bestknownforhands-onconstruction,Cianbroalsoprovidesconstructionmanagementservices.

Throughoutitshistory,Cianbrohascompletedmanytechnicallycomplexandenvironmentallysensitiveprojectsforawidevarietyofpublicandprivateclients.Forover50years,Cianbrohassatisfiedclientsinautomateddistributioncenters,chemicalsandpharmaceuticals,fabricationandcoating,foodandbeverageprocessing,fossilfuel,hydropower,nuclearpowerplants,hospitals,largebuildingcomplexes,parkinggarages,pulpandpaper,semiconductors,transportation,marineinfrastructure,andwaterandwastewater.

Core Values Of The OrganizationWevaluepeoplewhoexercisejudgmentandtakeaction;acceptaccountabilityfortheiractions;learnfromexperienceandcontinuouslyimprove;treatotherswithhonesty,fairness,dignity,andrespect.Wevalueourwordasourbond,meetingcommitmentsandexpectingotherstomeettheirs.Wevalueourfaithinothersandassumetherisktoestablishmutualtrustandrespect.Wevaluerelationshipswithotherswillingtoworktowardmutualgoalsandmutualprosperity.Wevalueacceptingresponsibility,earningrights,andsharingopportunities.Wevalueourreputationasameasureofourintegrity;weaspiretobeindustryleaders.Wevalueourroleasresponsiblecorporatecitizens,beingapartofthesociety,notjusttheeconomy.

PeterVigue,PresidentandCEOofCianbro,believesthatpeoplearethecompany’smostvaluableresource,andthatasanemployeeownedcompany,safetyandhealthshouldbeapriorityineveryworkactivity.Management’scommitmenttoestablishinganinjury-freeworkplacestartsatthetopandinvolveseveryteammember.Inordertomaintainasuccessfulsafetyprogram,allmanagersmustfeelpersonallyresponsiblefor,andbeheldaccountablefor,thehealthandwellbeingofourteammembers.Infact,thecompanyhasseta“zeroinjury”goalthatallmanagersandsupervisorsareexpectedtoadoptandliveby.Alongwithprovidingtheleadershipandvision,managementalsoprovidestheresourcestoensureasuccessfulprogram.Over50safetyrelatedtrainingcoursesareofferedtoteammemberstogivethemtheknowledgenecessaryforsuccessfulsafetyperformance.

Cianbroappliesthesamephilosophytoteammemberhealthasitdoestosafety.Takingapageoutofitssuccessfulsafetyprogram,Cianbroisworkingwithteammemberstoeliminateat-riskhealthbehavior.Exercising,eatingright,losingandcontrollingweight,beingtobaccofree,loweringbloodpressureandcholesterol,managingstressanddiseasesistheorderofthedayatCianbro.Withits“Behavior-Based”HealthyLifestyleProgram,Cianbrogivesteammembers(andtheirdependents)ongoingaccesstopersonalhealthcoachesanda15%discountofftheirmedicalplancost.

Challenges To The OrganizationCianbrohasmanystrengths.Onthepeoplefront–expertise,flexibility,leadership,integrity,depth,experience,culture,skills,attitude,approach,safety,innovation,creativity,entrepreneurial,compassion,caring,andefficient.

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Otherassetsincludeourrelationshipswithcustomers,financialinstitutions,vendors,subcontractors,policymakersandourbusinessstrengthsinreputation,diversification,riskmanagement,buyingpower,andasanopenshop.

Thatbeingsaid,westillfacemanychallenges.Wefacetheeconomicchallengesthatallcompaniesface.Wemustmaintainandgrowourmarketshare,particularlyintheMid-AtlanticandSouthernNewEnglandregionswherewearelessknown.Wemustcultivatenewandexistingrelationships,solvecustomerproblemsandbethecontractorofchoice.ManycustomersonlymakeafewsizablecapitalinvestmentsinconstructiontoneedacontractorlikeCianbro.Weworkourselvesoutofajobeachtimewecompleteaproject.Therefore,wemustalwaysbebiddingnewworkandlookingfornewopportunities.Wemustcontinuetobediversifiedinordertoprovidegrowthforthecompanyaswellascareergrowthforteammemberswithinthecompany.Asanemployeeownedcompany,itisextremelyimportanttobeprofitabletoretainteammemberequityintheirretirementplan.

Anotherbigchallengewefaceisretainingourcultureastimepasses.Ourcultureisgroundedinourrootsfromourfounders,theCianchettebrothers.Wearecommittedtokeepingthevaluestheyinstilledinuswhilegrowingthecompanyandremainingopenshopandmeritbased.InthepastwehavefacedchallengesfromUnionorganizers.Ourphilosophyhasalwaysbeentopayandtreatpeoplewell.Ourchallengeistocreateanenvironmentwhereteammembersfeeltheyhaveavoiceinthecompany,thattheiractionsmatterandthattheycanmakeadifference.

Wefaceimmediatechallengesasourworkforceages.27%ofourworkforcewillretireinthenextfivetotenyears.Successionplanningiskey.

Healthcarecostsremainachallengeforusasacompanyandtoourteammembers.Healthcareis11%ofourburdenrate,thesinglelargestbenefitcost,farexceedingretirementbenefits.Weaskourselveshowwecanstayinbusinessandcontinuetoseethesecostsgrowattheratetheyhavebeenoverthelastfewyears.Manycompanieswillnotbeabletostayinbusinessandcontinuetoprovidehealthcarefortheiremployeesunlessthingschange.

Present Approach To Corporate HealthThe Genesis Of Our Wellness ProgramTheimportanceofsafetyandhealthatCianbroisbestrepresentedandchampionedbyPeteVigue,PresidentandCEO.Inthe80’s,hestartedapushtocreateaculturefocusedonthesafetyandhealthofourteammembers.Cianbro’sinnovativeandcreativesafetyprogram,includingthebehavioralsafetyprogram,CAPP(CianbroAccidentPreventionProgram),beganbecausePetebecameconvincedthatitwastherightthingtodo.Cianbro’scommitmenttosafetybecamenumberoneand“safetyfirst”becameitsmindset.

In1988weimplementedapre-placementphysicalandadrugtestforallnewhires.WepartneredwithDr.LarryCatlett,whonotifiedeachapplicant,inwriting,theresultsoftheirphysicalandincludednotesabouttheirnon-workrelatedhealthissues.Webecamepartofaprocessthatencouragedemployeestotakebettercareoftheirhealth.WhentheAmericanswithDisabilitiesActtookeffect,wetookpainstoidentifyworkmodifications,whichallowedustoemployapplicantswiththeirrestrictionsandnotaskthemtodoanyworktheyweren’tphysicallycapableofperforming.Ourincidentratesandworker’scompensationcostsbegantodeclinewhileourmedicalcostsincreased.

Demographic Overview—AsofJune2005,Cianbroemploys1,839teammembersdistributedasfollows:

Gender Age Ethnic Origin

Male90%

Female10%

25 andunder11%

26-3521%

36-4529%

46-5528%

56-6510%

Over 651%

Caucasian

90%

Afro-American

3%

Asian/Pacific Islander

1%Indian/Alaska Native

1%Hispanic

5%

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Intheearly90’s,PetevisitedtheCooperClinicforphysicalproblems.Throughthisexperience,helearnedtodealwithhisillnessthroughdiet,exerciseandhealthyliving.Frustratedwithmanagedcare,therisingcostofmedicalcoverageandtheravagesofpreventabledisease,PetebroughtthisconceptofhealthylivingtoCianbro.ThesameculturechangePetebroughtaboutwithsafety,carriedoverintowellness.Drivenbyastrongbeliefofdoingtherightthingforteammembersandthe“health”ofthecompany,Peteempoweredthehumanresourcesteamtocreateawellnessprogram.Improvingteammember’squalityoflifeandreducingat-riskhealthbehaviorwasthecompany’sanswertoaddressincreasinghealthissuesandhighmedicalpremiumcosts.Wecan’tfocusonaclaimsbasedsystembutratheraclaimspreventionprogram.Wemustfocusonpreventinglifestylebehaviorillnessesandmitigatingtheeffectofotherillnesses.

How Long The Program Has Been In PlaceOurWellnessProgramgrewnaturallyasaresultofinitiativesthatbeganinthe90’ssuchas24-hourcoverageforteammembersandcoordinatinglikecoverageandprocessesacrossourbenefitsprogram.PetethendirectedthehumanresourcesteamtocreateaformalWellnessProgram.Atthisstage,theprogramincludedenhancingthemedicalplantoincludecoverageforwellcare,physicals,immunizations,birthcontrol,andotherpreventiveservices,creatinglikesystemsandcoordinatingdisabilitybenefitsbetweenworkrelatedandnonworkrelated,relatingthesafetyatworkexperiencetosafetyathome,aseatbeltprogram,andatobacco-freeprograminoffices,trailersandvehiclesandawellnessnewsletter.

In1997,withthehelpofourmedicaldirector,Dr.LarryCatlett,westartedasix-monthpilotprogram.ParticipantswereaskedtocompleteashortHealthRiskAppraisal(HRA),workonidentifiedcontrollableat-riskbehaviorsandperiodicallymeetwithanursehealthcoach.Outcomesindicatedthatone-on-onehealthcoachingencounterscouldsignificantlyreduceat-riskhealthbehaviorsandphysicalmeasurementsacrossthestudiedpopulation(seepilotresultsbelow).Culturalsupportsof

wellnesssuchasnewsletters,wellnesspoints,lunchandlearnsandonlinewellnessinformationsetthestagefortheinterventionstocome.In1998,thepilotprogramwentcompanywideasapurelytelephonicprogramwithnoincentivesandexistedwithonlyasmallenrollmentthrough2000.In2001,weimplementedarevampedprogrambasedonaone-on-oneinterventionsandanincentiveforparticipationtiedtoourmedicalplancalledtheHealthyLifeStyleProgram(HLP).

Wellness Vision And Mission StatementsVision: TobetheHealthiestCompanyinAmerica.

Mission: TocontinuouslyprovideandpromoteprogramsthroughoutCianbrothatencourage,educate,andsupportteammembersandtheirdependentstomakehealthy,mental,physicalandfinanciallifestylechoicesonadailybasis.

Wellness And Strategic Priorities Of The Organization Asearlyas1993,Cianbro’sstrategicplanshaveinvolvedemployeehealth.Ourobjectivesweretoeliminateat-riskbehavioratworkandhome,improvequalityoflife,increaseproductivity,andreducemedicalcostsforlifestyle-relatedaccidentsandillness.

PetehasdirectlychargedhisseniormanagerstosupporttheeffortsofboththeSafetyandWellnessPrograms.In2001,Cianbro’sseniormanagerspledgedtheirsupporttowellnessandtheconceptofeliminatingat-riskbehavior.Leadingbyexample,theyhavemadethiscommitmentbyincorporatinghealthandwellnessgoalsintoCianbro’sannualstrategicplan.Peteisdirectlyinvolvedwiththe“marketing”ofbothsafetyandwellnessascorporateculturalvalues.Youcan’thaveahealthycompanywithouthealthyemployees!

Ourcurrentstrategicplanfor2005hasanoverallgoalto“createawellnesscultureforourteammembersandfamilies.”Underthisgoal,specificobjectivesaresetwithmeasuresofachievingandtargeteddates,andmanagersarenamedresponsibletomakesuretheobjectivesarereached.

The Operating Model And Theoretical Underpinnings Of The Wellness InitiativeCianbro’soperatingmodelforwellnessispatternedafteroursafetyprogram.Ourgoalinsafetyistoeliminateat-riskbehaviorandachievezeroincidents.Thisgoalcaneasilybeappliedtowellnessbyeliminatingcontrollableat-riskhealthbehaviorandpreventingillnessandinjurybeforeithappens.

Wellness Pilot Results (77 Participants)Initial Risk Status Final Risk Status (after 6 months)

High 8 0

Medium 45 19

Low 24 47

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Cianbroisthefirstconstructioncompanytoimplementabehavior-basedsafetyprocessthroughoutitsorganization.Cianbro’sAccidentPreventionProcess(CAPP)empowersteammemberstoparticipateinsafetyimprovementsbyidentifyingbothsafeandat-riskbehaviorsineverydaywork.Ratherthanfocusingoncomplianceorwhatworkersaredoing“wrong”,observationsofteammembersopensthedoortodiscussat-riskbehaviorsandbarrierstosafebehavior.Thisleadstoproblemsolvingbothonthespotandlaterincommitteemeetingswheredataisanalyzedandactedon.Cianbroacceptsresponsibilityforestablishingandmaintainingasafeworkenvironment.“Ourteammembershavetherighttogohomeeachdaywithoutinjury”hasbeentheobjectiveformanyyears.

Usingsafetyasthefoundationofwellness,weunderstandthatcaringaboutourteammembersdoesn’tjusthappenduringtheworkday.Wewanttosendteammembershomeattheendofthedayinthesameconditioninwhichtheycametowork.Wealsowantteammemberstocomebacktoworkthenextdayinthesamehealthyandsafeconditiontheywereinwhentheywenthome.

Toassureteammember’shealthyreturn,CianbrohasadoptedabehaviorbasedhealthcoachingprogramthatincorporatesthetechniquesofMotivationalInterviewing(MI),aprovenmethodofenhancingbehaviorchange.Beforeproceedingtothedevelopmentofshortandlongtermgoalstowardhealthbehaviorchange,thecoachandclientmustinvestigatethemanyissuesthatmaybetheunderpinningsoftheat-riskhealthbehaviors.Ourbasicassumptionisthatreductioninat-riskhealthbehaviorandconsumereducation,leadstodecreasedshortandlongtermhealthcareconsumptionandthusadecreaseinoverallhealthrelatedcostsincludingthosenotedbelow.

Wellnessinitiativesaredesignedandimplementedbythecorporatehumanresourcesdepartment.ThehumanresourcesdepartmentworkswithSHARE(Safety&HealthAwarenessRaisesExcellence)Committeeswithintheorganization.PartofthemissionofthesecommitteesistosupporttheutilizationofourcurrentSafetyProgram,Cianbro’sAccidentPreventionProcess(CAPP)andtheWellnessonWorksitesProgram(WOW).TheSHAREcommitteesactasaconduitfordisseminatinghealthandsafetyinformationandareempoweredtobringaboutchange.

Health Behaviors Within The OrganizationTheWellnessProgrampromoteshealthybehaviorsthroughitsemphasisonsafetyandwellnessinterventions.Theone-on-onehealthcoachinginterventionassessesteammembersriskstatusbyusingourHealthRiskAppraisal(HRA)andrecordingtheirphysicalmeasurements(height,weight,bloodpressure,cholesterol,etc).OurWellnessTrackingSoftware(WTS)identifiesandtracksindividualriskssuchasbloodpressure,weight,tobaccouse,inactivity,stressanddepression,hypertension,cholesterolandnutrition.Thesebehavioralrisksareassignedanumberedweightaccordingtopotentialseverityortheimpactoftheriskandriskmutability.Theweightforeachriskisaddeduptogivetheparticipantanoverallbehavioral“riskscore”.At-riskbehaviorsincludenotonlythosementionedabove,butalsofrequencyofmammogramsandPAPsmears,prostateevaluations,STDrisk,drugandalcoholuse,children’sactivity,nutritionstatusandBMI.

Currentlywearemodifyingourstressriskidentificationandinterventionstrategyincludingthecultural

WELLNESSAT HOME

SAFETYAT WORK

HEALTH AND SAFETY24 HOURS/DAY

Health CareCosts

$

FMLA Costs

$

EAP Costs

$

TurnoverCosts

$

PresenteeismCosts

$

AbsenteeismCosts

$

Workers’Compensation/Restricted Work

Costs

$

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adaptations,coachinginterventionsandexternalresourcestoaddressparticipantrisk.Thisfurtherintegrationofasupportstructureforwork-lifebalanceissueswillallowustomovebeyondthe“wall”ofresistancetheseissuespresentandallowustoaddresstherootcausesthatareoftenresponsibleforthemaintenanceandpracticeofat-riskhealthbehaviors.

Cianbro’s Most Innovative ApproachPerhapsthemostnovelpartofourapproachhasbeenthedevelopmentofaprogramthatmeetstheparticularneedsandconditionsofourconstructionenvironment.Ratherthanimposeastructuredapproachfrom“outside”,wecreatedonefromthegrounduptakingintoconsiderationtherealitiesofourbusinessstrategyandenvironment.

TheHealthyLifeStyleProgram(HLP)isthecenterofCianbro’sWellnessProgram.UsingthetechniquesofMotivationalInterviewing(MI),whicharedesignedtoprovidetheparticipantwithanopportunitytoexaminetheirat-riskhealthbehaviorinanenvironmentfreeofjudgmentsandstandardsolutions,wehavebeenabletobothenhancemotivationtowardchangeand

helpparticipantsunderstandthereasonsbehindtheircontinuedhealthriskpractices.

TeammembersmeetwithahealtheducatortocompleteaHealthRiskAppraisal(HRA).Healtheducatorsencouragetheparticipanttoidentifyat-riskhealthbehaviorsthattheyfeelareimportanttochange.Participantssetachievablelongtermgoalsandshorttermbenchmarks(alternatebehaviors)thatarereasonable,attainableandsustainable.Healtheducatorsevaluateandenhancetheimportanceofat-riskbehaviorchangeandhelpbuildtheconfidencerequiredtoreachgoals.Theyprovideongoingcounselingatfollow-upinterviewsandtrackprogressovertime.Theultimategoaloftheinterventionistoimprovetheoverallhealthstatusoftheparticipants,theirqualityoflife,andproductivityatworkwhilereducingtheneedfor,useandcostofhealthcarebothinthelongandshortterm.Throughtheirpersonalhealthcoach,teammembersareconnectedtothecompany’sstrategicwellnessplanaswellastheirproviders’expectationsfortheirhealth.Thishasresultedinsignificantbehaviorchangesandcostreductions,themostrecentofwhicharedisplayedinthefollowinggraph:

Cianbro Behavior Change (1/1/2003 to 3/4/2005)

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Dr.LarryCatlett,Cianbro’smedicaldirector,managestheprogramforCianbro,withhiscompanyOccupationalMedicalConsulting(OMC).OMChiresandtrainshealtheducatorsthattravelthroughouttheEastCoasttoCianbrojobsitesasrequired.AllrecordsarekeptconfidentialandareonlyaccessedbyOMC.OnlyaggregateriskinformationisreleasedtoCianbro.

Participationintheprogramisvoluntaryandanincentiveisofferedtoencourageparticipation.Whenateammemberjoinstheprogram,hisorherspousemustparticipatetoqualifyfortheincentive.Teammembersthatparticipatereceivea15percentcredittowardstheirhealthcarecostinadditiontothe65percentcontributionthecompanymakesforteammembersafter6monthsofservice.

In2004,weintroducedaccountabilitywithrightsandresponsibilities.Itistheparticipantsrighttoreceivea15percentdiscountontheirmedicalplanpremium;inexchange,itistheirresponsibilitytomakebehaviorchange.Participantsareaccountableformakingprogresstowardtheirgoals.Weareconcernedwiththehonestywithwhichteammembersandspousesinteractwiththehealtheducators.Whenahealtheducatorsays,“Areyoustillexercisingthreetimesaweek?Doyoustillweigh180?”thetendencyistosayyesbeforeweevenadmittoourselvesthatwehavenotexercisedforthreeweeksandhavegainedtenpounds.Withaprogramthatistiedtoamonetaryincentiveitiseasytogetparticipation,butatwhatcost?Wearecommittedtotheprincipalofeliminatingat-riskbehavior.Whiletherearestillchallengesfacingusinourprogram,theoutcomeweseekisclear–feelingbetterphysically,avoidingandpreventingdisease,livinglonger–itistherightthingtodo!

Newfor2005,allteammembersmustcompleteaHealthRiskAppraisalwithOMCinordertoremaineligibleformedicalbenefits.Sofar,thiseffortatdevelopingamorerepresentativepictureofthecompany’soverallhealthriskburdenhasresultedina10%participationincreaseintheHealthyLifeStyleProgram.TeammemberswhodonotjointheprogramarestillrequiredtocompleteanannualHRA.

WhileourHealthyLifeStyleProgramwillhelpusdealwiththecostofheathcare,someelementsarebeyondourcontrol.Changingbehaviorisveryhardworkforindividualsandmaintainingabehaviorchangeforthelongtermisevenmorechallenging.Currentlywehavemovedalargeportionofthecoachingprocesstothetelephone.Thisisasaresultofinternalpressurefrommanagerswhobelievetheinteractionofthehealtheducatorwithteammembersduringworktimeisa

determenttoproductivityand/orteammembersneedtoshowmoreresponsibilitytowardtheirhealthbymeetingwithhealtheducatorsontheirowntime.Educationandreturnoninvestmentdiscussionshavesoftenedthisposition,however,theabilitytomotivatewithoutfacetofaceinteractionwillbeseverelytested,particularlyinnewandrecalcitrantparticipants.Lessovertisthemessagethissendourteamthatperhapswearelesscommittedtothiseffortbecausewearenolongerallowinginterviewstotakeplaceduringworkhours.Asaresult,healtheducatorsareavailableforextendedhoursduringtheweekandOMChaspartneredwithaSpanishtranslatortocommunicatewithparticipantswhoprefertospeakinSpanish.Althoughtheseobstaclesmaymakeitharderforparticipantstomeettheirrequirements,ourcommitmenttowellnessstillstands.

Making Strategic Health DecisionsOMC’sWellnessTrackingSystem(WTS),developedjointlybyOMCandCianbroandcurrentlyundergoingarevisionupdatebyOMC,istheprimarysourceofprogramdatausedintheevaluationandplanningforstrategichealthdecisions.WTSstoresallparticipantrisksandriskscores(costandbehavior)andtrackschangeinat-riskhealthbehaviorsandpopulation/individualscoresovertime.Currentlyweareintegratingactualaveragecostsincurredbyindividualswithinthelow,mediumandhigh“cost”riskcategories.Wewilltrackchangesovertimeofbothoverallcosts,levelsofcostswithinriskcategoriesandthechangeincostsassociatedwithpopulationincrease/decreasewithintheriskcategories.DisabilityandclaimsdataaswellasnewdataonabsenteeismwillbeincorporatedintoWTSandexaminedinlikemanner.

Cianbroalsousesvarioussourcesofexternaldata.WeutilizeCDCandlikeorganizationsfordataongeneralhealthriskanddisease,andnationalmedicaltrenddatapublishedbyMercerandothergroups.OurcompanyinformationprovidedbyCigna,ourthirdpartyadministrator,providesuswithinformationonourannualclaimcostsandhowwecomparetootherbusinesses.Cianbro’smedicalplanisselfinsuredandtrackstheexpectedteammembercostsannually,theactualteammemberannualcostandannualchangesinthatcost,andthenbenchmarksourchangesagainstnationaltrend.

Addressing At-risk PopulationsCianbrohasdesigneditsHealthyLifeStyleProgramtoaddressat-riskpopulationswithincentivestoparticipate,environmentalandculturalsupportswithinthecompany

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andaccountabilitywithintheprogramforprogresstowardchangeovertime.Motivationalinterviewingisusedtoinformandeducatetheparticipantabouttheirat-riskbehavioranditsconsequences,butallowsthemtosettheirownagendatomakechange.Oncethatagendaisset,thehealtheducator’sjobistoenhancetheimportanceandconfidenceoftheirchosenhealthbehaviorchangesandassisttheindividualinsettingrealistic,sustainablegoalstowardthosechanges.

Frequencyofinterventionandfollow-up,educationalmaterial,positivereinforcement,comprehensivehealthcare,andCianbro’senvironmentandincentiveskeepwellnessinfrontofparticipants.Providingfreetobaccoreplacementtherapytoteammembersandspousesgiveparticipantsthatadditionalsupporttomakepositivechange.

Cianbroalsosupportstheeffortsofteammembersandtheirfamilies,togetandstayhealthythroughthemedicalplandesign.Alllab,x-ray,anddiagnostictestingarecoveredinoroutofnetworkat100percentwithnodeductiblesorco-pays.Allpreventionrelatedtestslikemammograms,colonoscopies,PSA,physicalexams,immunizations,flushots,etc.arecoveredat100percentorwithasmallco-pay.Themedicalplanevenprovidescoverageforhearingaids.In2005,Cianbroaddedcoverageforvisitstothedoctorregardingweightmanagementeveniftherewerenounderlyingmedicaldiagnosis.Ourgoalistosupportthebehaviorwearetryingtoencourage.

Keeping Low Risk Populations At Low RiskItisclearbothfromourownexperienceandotherstudiesthatitisimperativetomaintainandincreasethelowriskpopulation.Participantsthatmaintainalowriskstatusthroughouttheirlivesincurmarkedlylesshealthrelatedcostsacrossavarietyofbenefitcategoriesincludinghealthcare,disabilityandworker’scompensation.Productivityissubstantiallyenhancedaswell.Alowriskparticipantthatmovestoahigherriskstatusandbackmayincursubstantiallyhighhealthcostsovertimethanonewhoremainsatalowriskstatus.

TheHealthyLifeStyleProgram(HLP)isdesignedtorewardparticipantswhoaredoing“therightthing.”CianbrorewardsallparticipantsintheHLPequallywitha15%healthcarepremiumreductionregardlessofrisklevelaslongastheymaintainprogresstowardtheirstatedhealthcaregoals.Overtwohundredparticipantsintheprogramhavelowornorisks.Forthoseindividuals,weemphasizemaintainingtheirhealthylifestyleoridentifybehaviorstheywillmaintaintokeeptheirlowriskstatusovertime.

Ensuring The Functionality Of Wellness Initiatives In The FutureIncorporating“sustainability”intoawellnessprogramisessentialandmustbeginintheinitialstagesofplanning.OccupationalMedicalConsulting(OMC)hasdevelopedaHealthReadinessAppraisaltobeadministered,muchliketheparticipant’sHealthRiskAppraisal,priortoprogramstartupandatintervalsthroughouttheprogram’sdelivery.Thistoolisdesignedtofirsteducateregardingtheimportanceofandthenevaluatecompanyprogresstowardtheculturaladaptationsrequiredtosupport,sustainandgrowthewellnesseffortovertime.

Bothsuccessandsustainabilityaredirectlytiedtomanagementbuy-inandmodelingofthewellnessprogram.Cianbro’ssupportbeginswithitsCEO,avocalandadamantsupporteratworkandontheroadofboththerationaleandday-to-dayactivitiesofwellness.Peteadvisesthat“ourcontinuedfocusonimprovingourindividuallifestylebehaviorswillimproveourhealthandthelongtermqualityofourlives.Atatimewhenmanyotherbusinessesarereducingoreliminatingtheiremployee’shealthcarebenefits,IcannotoverstatetheimportanceofyouractiveparticipationinCianbro’sWellnessProgram.”Throughhisleadership,Cianbrohascompletedoneofthemostimportantstepsinassuringsustainabilityofanyworkplaceprogrambymakingwellnessamajorpartofthecompany’sstrategicbusinessplan.Infact,thefirstofthesevenpillarsofthecompany’slongrangestrategicplanis“HealthandSafety.”Thispillarissupportedbyanimplementationplanandmanagementisassignedaccountabilityforitssuccess.Withinthisframework,humanresourceshasbeeninstructedtocreateafiveyearStrategicHealthandSafetyPlan.

Cianbrobecame100percentemployeeownedattheendof2004andassuchhastiedemployeebehaviortothefinancialsuccessofthecompany.Wecan’thaveahealthycompanywithouthealthyemployees.Wehaveencouragedour“owners”tothinklikeownersandmakehealthydecisions,financiallyandbehaviorally,fortheircompany.PartofthistransitionincludedFidelityInvestments,ourpensionprovider,whoassistedCianbroinamarketingeffortwhichincludedteammembermeetingsatallprojectlocations.Theimportanceofwellness,financialandphysicalhealthtoCianbroasacompanyandtoeachindividualwasstressedaspartofthispresentation.

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AnotheraspectcriticaltosustainabilityistheestablishmentofWellnessTeamstoserveastwo-waycommunicationlinksbetweenthosewhostructureanddelivertheprogramandtheprogramrecipients.Membershipshouldberepresentativeofalllevelswithinthecompany.TheWellnessTeamsshouldbeinfluentialintheformulationofcompanywidehealthgoals.Inclusioninthecontentdevelopmentandprogramdirectionisessentialforemployeebuy-in.CianbroachievesthisthroughitsSHAREcommittees.TheSHAREcommitteesactasaconduitfordisseminatinghealthandsafetyinformationandareempoweredtobringaboutchange.

Producingnewandsupportivewaystoreachoptimumhealthalsohelpsthewellnessinitiativemoveforward.CianbrohascommittedtoauniquemeasureinitsTobaccoFreeStatusinitiatedin2003byprovidingNRT(NicotineReplacementTherapy)coupledwithbehaviorchangesupportthroughtheHealthyLifestyleProgramto

bothemployeesandspouses.CianbrowasthefirstinthenationtorequestthedirectpurchaseofNRTproductsfromGlaxo-Smith-Klinewhonowoffersproductsatadiscounttoemployersacrossthecountry.Actionslikethesearecriticaltoassuresustainability.

Finally,CianbrohasimplementedthemandatorycompletionofaHealthRiskAppraisal(HRA)forallteammembersandtheirspousescoveredbyCianbro’smedicalplanbutnotenrolledintheHealthyLifeStyleProgram.Thisensuresthatallteammembersandspousesenrolledinthemedicalplanunderstandtheirhealthrisksandthebehaviorsthatcouldputtheminjeopardyintheyearstocome.TheHealthyLifeStyleProgramiscompletelyvoluntarybutHRA’smustbecompletedonanannualbasiswithahealthcoach.TheywillreviewrisksandhelptheparticipantwhodoesnotenrollintheHLP,planforimprovementoverthecomingyear.

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OutcomesThe Impact Of Health Promotion Programs On Health Risks86%ofteammembersandspousesenrolledinCianbro’smedicalplanparticipateintheHealthyLifeStyleProgram(HLP).ThesmokingrateintheHLPpopulationisasustained5%.TheoverallHLPpopulationsmokingrateatprogramintroductionexceeded38%.

Inactivity,definedasfailingtoparticipateinatleast30minutesofaerobicexercisemostdaysperweek,hasseenasubstantialreductioninincidenceasevidencedbythegraphtotheleft.Notethatthisdecreasehasoccurredonthebackgroundofpreviousdecreases.CurrentlytheriskincidenceofinactivityinHLPparticipantsis6%.Bycontrast,86%oftheMainepopulationisfelttobeatriskforinactivity.

Significantriskreductionshavebeennotedinothercategoriesincludingthosedepictedinthefollowinggraphs:elevatedtotalcholesterol,pre-hypertension,stressandtheseriouslyoverweight.

Tobacco Use

Inactivity

High Cholesterol

Pre-Hypertension

Stress

Seriously Overweight

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CurrentlyourWellnessTrackingSoftware(WTS)isbeingmodifiedtoincludetheHealthRiskAppraisal(HRA)onlycategoryandwewillbeabletocompareriskincidenceinthisgrouptothatinHLP.Wewillalsohaveanearlyexactestimateofriskincidenceintheoverallpopulationassubscriptionratestothemedicalplanarehigh.

Wellness Efforts And Financial OutcomesIn2000and2001,Cianbroexperiencedaverageincreasesinannualhealthcarecostsperemployeeof21%.Weknewthatifthistrendcontinued,ourhealthcarecostsperemployeewoulddoubleby2005.WeimplementedtheHealthyLifeStyleProgram(HLP)in2001.Todayourtotalhealthcarecosts,(whichincludeclaims,administrationfees,reinsurance,andthecostofallourwellnessprograms)whilestilltrendingupward,areincreasingatanaverageannualrateofabout9-10%ascomparedtothenationalaverageof9-13%.Unlikemostotheremployerswhohavesharplyraiseddeductiblesandcopayments,wehaveonlymademinorcostshiftstoourteammembers,mostparticularlywithasmallincreasein

theprescriptiondrugcopays.Plus,we’veactuallybeenabletoincreaseplanbenefitsatatimewhenothercompaniesarereducingthem.Forexample,forplanyear2005,wehaveaddedcoverageforweightmanagementatthedoctor’sofficewithoutanyunderlyingdiseasediagnosis.

In-depthwellnessinterventionshavebeenshowntoreturnfrom$3-8dollarsinhealth,productivity,worker’scompensation,absenteeismanddisabilityafterapproximately5years.Thegraphonpage18assumesthatCianbro’shealthcarecostshadcontinuedtoincreaseat14%annually(maroonportion).Thedarkbluebarrepresentsthetotalcostofthemedicalplaninyears2001to2004andprojected2005costs.ThelightbluebarrepresentsthetotalcostofwellnessincludingtheHealthyLifeStyleProgram,other“in-house”wellnessinitiativesandthe10%(2002)and15%premiumreductions(2003todate)toitsparticipants.ROIisexpressedannuallyintermsofsavingsonprojectedcosts(atthefixedrateof14%)/totalwellnesscostsindicatinga$2.51ROIin2005onhealthcarecosts.FutureROI’swillbecalculatedtoreflectotherbenefitcostsavingsaswell.

Cianbro % Increase Medical In Costs Per Employee (Actual vs. National)

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Advancing The Business ObjectivesThewaysinwhichourwellnessinitiativehasadvancedourcompany’sbusinessobjectivesarehuge.Asacompanyweseektodifferentiateourselvesfromourcompetitorsintheeyesofourclients,customersandcurrentandprospectiveteammembers.Whilewehavelongbeenaleaderinsafety,nowwearerecognizedasaleaderinwellnessalso.Ourclientsandcustomersarecontactingustolearnhowtheycanbecometobaccofree,dealwithhighmedicalcosts,andimplementawellnessprogram.Atatimewhenmanyotherbusinessesarereducingoreliminatingtheiremployeehealthcarebenefits,oureffortsandconcernaboutwellnessallowustounderstandthevalueofaqualityandcomprehensivehealthcareprogramforourteammembers.OurcontinuedfocusonimprovingourindividuallifestylebehaviorssupportsourCompanyvaluesystemasanemployee-ownedcompany.Itisimportantforus,asownersofCianbro,torememberthatwehavearesponsibilitytoworksafelyandtoensureourpersonalwellnessandwellbeingknowingthatittakeshealthypeopletooperateahealthycompany.

Stressingpersonalaccountabilityinat-riskbehaviorchoicesdoesn’tstopattheendoftheworkday.Teammembershavealotofinfluenceonhowwellourcompanyperforms.Inturn,thecompany’sperformancedeterminesourshareoftheprofits.Weneedtotakeownershipofouractionsandlookforwaystopositivelyinfluencetheactionsofothers.Everydaywehaveopportunitiestodothat:

Whenwewatchoutforeachother,ourworkgetsdonesafely.

Whenwestayhealthyandfit,wearemoreproductiveandthathelpsuscompleteourprojectsontime.

Byparticipatingindecisionsabouthowourworkareasoperate,wehelpourteambemoreefficient.

Bykeepingourskillsuptodate,wecanincreasethequalityoftheworkwedo.

Bottomline,ifwewanttosharetherewardsofownershipweneedtotakeresponsibilityandactlikeowners.Thatincludestakingresponsibilityforourhealthcareandlifestylechoices.

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Cianbro Wellness ROI Actual vs. Project Medical Plan Costs

2001 2002 2003 2004 2005(Est.) Total(2002-2005)Actual Medical Plan Costs (excluding Wellness) $9,233,865 $8,068,089 $8,507,925 $8,202,610 $8,939,728 $33,718,352Wellness Program Costs –– $1,196,454 $1,819,046 $1,765,167 $1,895,246 $6,675,913Projected Medical Plan Costs @ 14% per year $9,233,865 $10,526,606 $12,000,331 $13,680,377 $15,595,630 $51,802,944

Return on Wellness Investment (ROI) Savings –– 105% 92% 210% 251% 171% on Projected Cost/Wellness Cost

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Lessons LearnedSinceCianbrobeganitsfirstWellnesseffortsintheearly90’s,manychangesandimprovementshavebeenmadetoourWellnessProgram.Amongthemostimportantlessonslearnedalongthewayincludetheimportanceofmanagementbuy-inandcommitment,stayingthecoursewithcontinuousimprovement,creatingasupportiveworkenvironment,theimportanceofmeaningfulincentives,andcommunication,communication,communication!TheessenceofaWellnessPrograminvolveschangeandtheseimportantlessonslearnedshowhowdynamictheprocessis.YoucanneverassumeyouarefinishedwithWellness.

Senior Management Buy-in And CommitmentAchievingtopseniormanagementbuy-inwaseasyatCianbrosincewehadtheunwaveringsupportandvisionofourPresidentandCEO,PeteVigue.Althoughthiswasessentialtotheprogram’ssuccess,initiallythisvisiondidnottrickledowntootherseniorandmid-levelmanagers.Itbecameapparentthatweneededto“sell”wellnesstotheothermanagersandsecuretheircommitmenttosupportwellnessatourmultipleworksites.Presentationsneededtobemadetoallmanagementlevelsaboutwhywellnessisimportantandhowitaffectsourbottomlineandthequalityoflifeforourteammember’s.Oncebuy-incamefrommanagement,thenthecommitmenttosupportwellnessandtheculturalchangesrequiredforsustainabilityfollowed.Securingmanagementbuy-inisnotaonetimething,butacontinuousprocess.Managementneedstoreceiveperiodicbutfrequentfeedbackontheprogram’shealthandfinancialgoalsandhowprogressisbeingmadeoneach.

Staying The Course With Continuous ImprovementAlongwithcommitmentfrommanagementcomesthedeterminationtostaythecourse.WhenwellnesswasfirstintroducedatCianbro,theteammember’sperceptionwasthatitwasjustanotherfadthatwouldquietlygoaway.Stayingthecourseinvolvedcreatingmeaningfulobjectives,implementingandupdatingmanyaspectsoftheprogram,collectingandusingdatatoevaluateoutcomesandcommunicatingresultstoallteammembers.AlthoughtheWellnessProgramchangedconsiderablyfromourfirstpilotprojecttoourpresentprogram,ithasnotgoneawaybuthasbecomestronger,moremeaningfulandisdeliveringresults!Atanypointwecouldhavebecomediscouraged,butpersistenceisnecessaryforthesuccessofanyprogram.Ifoneapproachdoesn’twork,tryanother.

Creating A Supportive Work EnvironmentCreatingaworkenvironmentthatissupportiveofwellnesshasproventobequiteachallengeatCianbro.Wearealargeconstructioncompanywithmanyjobsitesandpredominatelymaleblue-collarworkers.Theseworkerscanbeonajobsiteforafewmonthstoafewdays,working10-12hourshifts,4-7daysperweek.Manyofourteammemberstravel1-2hourseachwaytoworkortheymayliveinahotelmanymilesfromhome.Thismakesitdifficulttojoinagymorevenhavehomecookedmeals.Itisahardenvironmenttoencouragedailyexercise,eatingright,andstressreduction.Creatingaworkenvironmentthatissupportiveofwellnessiscrucialtohelpingteammembersovercomebarrierstogoodhealth.Forexample,iftherearenohealthyfoodstochoosefrominthevendingmachines,thenitisimpossibletomakeagoodchoice.Creatingatobacco-freeworkplacewasanotherwaytocreateaworkenvironmentsupportiveofwellness.Thisideaneededalotof“selling”tomanagementduetothefearoflosingvaluableteammemberswhousetobacco.Wearestillworkingonencouragingflexibleworkhours,compressedworkweeksandreducingworkrelatedstress.Youmustcreateahealthenhancingcultureatworksincepeoplespendmoretimeatworkthanathome.Asupportiveworkenvironmentmustbepairedupwiththesupportofindividualeffortsduringoffhours.

Importance Of Meaningful IncentivesForthesupportofteammembers,weneededtolookatincentives.Whatincentivesaremeaningfulandappropriate?Westartedbyoffering$100giftcertificatesforparticipationinourpilotWellnessProgram.Wemovedontoofferingwellnesspointswhichcouldbeturnedinforgiftcertificates.Wellnesspointswereearnedthroughvariouswellnesspromotionssuchasparticipationinwalkathonsorattendinghealthrelatedlunchandlearns.Theproblemwithwellnesspointswasthatmostlypeoplewhoalreadyhadhealthybehaviorsweretheonesusingthepoints.Itwasnotamotivatingtoolforpeopletochangeunhealthybehaviors.Wemovedontoprovidinga15%discountonhealthcoverageforparticipationinourHealthyLifeStyleProgram(HLP).Thisprogramidentifiesat-riskbehaviorsandrequiresgoalsettingandeffortbytheteammemberandspousetoreducerisks.Thisincentivehasbeenthemostsuccessful.Whileitrewardsthoseteammemberswhoalreadyhavehealthybehaviors,italsogivesincentivetothosewhoneedtoimprove.

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Communication, Communication, Communication!Wehaveagreatprogram,supportofourCEO,andourwellnessteamisallonboardwithourobjectives.Communicationoccursthroughcheckstuffers,weeklybulletins,andamonthlyandquarterlypublication.WegotsomefeedbackthatteammemberswereconfusedordidnotknowwehadaWellnessProgram.Nomatterhowwellyouthinkyouaredoing,don’tassumethatyoureffortsatcommunicationareworkingwithoutcarefulassessment.Westeppedupoureffortstocommunicateandissuedinformationaboutwellnessinalmosteverycommunicationsent.Healtheducatorsnowreviewtheprogramanditsoutcomeswithallparticipantsateveryopportunity.Wealsoaskedmanagerstoincludehealthwhentheydiscusssafetyatthejobsite.Westartedtohaveamemberofthewellnessteamparticipateonthecompany-wideSHARE(SafetyandHealthAwarenessRaisesExcellence)Committee.Thiscommitteeprovidessupportanddirectionforsafetyandhealthrelatedefforts.Itcannotbeoverstatedthatcommunicationisthemostvaluabletoolinyourwellnessefforts.Ifemployeesdon’tknoworunderstandthegoals,objectivesanddetailsofyouroverallprogram,youwillnotgettheresultsyouarelookingfor.

In ConclusionTheselessonslearnedcanbevaluabletoanybusinessinitiatingorcurrentlyinvolvedinaworksitewellnessprogram.Ourrecommendationsforotherswouldbe:

Sell the program right from the start.Includealllevelsofmanagementinordertogaincommitment.Explainwhatyourwellnessprogramisandwhyitisimperativetodoit.Moneytalkswhenyouarespeakingtomanagers,somakesuretoincludetheprojectedincreasesinthecostofhealthcoverageandhowthataffectsthebottomline.ROIexamplesarealsohelpful.

Stay the course – don’t start and stop.Committowellnessforthelongterm.Whileyourprogramwillevolveovertime,themessageabouttheimportanceofhealth,howitaffectstheindividualsandthebusiness,shouldremainthesame.

Make sure your workplace is supporting a healthy environment.Youcan’texpectemployeesto“swimupstream”forverylong.Theyneedahealthenhancingcultureatworkwhilereceivingongoingopportunitiesandsupportindividually.

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Evaluate your health coverage.Doesyourplandesignsupportthebehavioryouaretryingtoencourage?Doyouprovidefirstdollarcoverageforpreventiveanddiagnosticservices,etc.?

Provide meaningful incentives.Mostpeopleneedalittlenudgeintherightdirectionintheformofanincentive.Makesureyourincentivesaredesignedtoreachtheaudienceyouaretargeting.

Communicate your message.Gettingwellnessinformationdirectlytoyourtargetedaudiencecanbedoneinamilliondifferentways.Determinewhoyouraudienceisandhowtoreachthem.Theimportantthingtorememberisthatyoucannotcommunicatetoomuch.Communicationshouldbeviewedasanever-endingprocessthatisvitaltoyourwellnessefforts.

Cianbrohasworkedatwellnesssincetheearly90’s.Wecontinuetoevaluateandimproveourwellnesseffortsinordertobringameaningful,sustainableandsuccessfulprogramtoouremployee-owners.Weknowthatnooneisgoingto“fix”thehealthcarecrisisinthiscountry.Weneedtohelpourteammembersandtheirfamiliestakecontroloftheirhealth.Wesincerelyhopeourlessonslearnedhelpothercompaniesbecomesuccessfulintheirwellnessefforts.

Vision For Health In The New MillenniumProtecting Employee Health And Well Being While Advancing Business Objectives Cianbroishealthierandstrongerthanever.Wecontinuetoinvestinourpeopleandfacilitiestoimproveourperformanceandcompetitiveness.Movingforward,wewillcontinuetostayoncourseandfocusedonourstrategicplan.Itisimportantforeachofus,asownersofCianbro,torememberwehavearesponsibilitytoworksafelyandtoensureourpersonalwellnessandwell-beingknowingthatittakeshealthypeopletooperateahealthycompany.Itisallaboutimprovingourpeople’slives.Todayourcountry–andourcompany–areatacrossroadswithhealthcare.Ourchoicesaretwo,acceptwhatthecurrentsystemandsocietyimposesonus,ormotivateourselvestotakecontrolofourhealth.AtCianbro,ourteamistakingcontrolandourgoalistobeoneofthehealthiestcompaniesinAmerica.–PeteVigue,President&CEO

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The BHAGS That Drive Cianbro’s EffortsAswemoveforwardinto2005andbeyond,weareputtinga5-yearstrategicplan(aspartofouroverallbusinessplan)forwellnessinplace.Firstandforemost,istomergeandcompleteanevolutionofourwellnessconceptsintohealthandsafetyconcepts,creatingatrueintegrationbetweentheworkplaceandhome.Wemustcreateaculturethatunderstandswhathappensintheworkplacehasanaffectonthehomeandwhathappensathomeaffectstheworkplace.Longhours,travel,stressfromtheuncertaintyoffuturework,beingawayfromhome,alltheseworkfactorscreatestressathome.Athome,stressaboutmaritalandchildsituations,financialworries,substanceabuse,depression,andhealthproblemscanplayintotheworkplaceandcreateriskofinjury,absenteeism,presenteeismandproductivityissues.

Our5-yearstrategicplanisbrokenintotwoareas:EarlyDetectionandDiseaseManagement,andHealthRiskCostManagement.

Early Detection and Disease Management:Through2005-2006,wewillimplementanimportantqualitytoolaspartofourmedicalprogramforthefollowing14procedures/conditions:

AngioplastyCardiac CatheterizationCoronary Artery Bypass Grafting Heart Valve ReplacementColon Surgery Laparoscopic Gall Bladder RemovalRadical Prostatectomy Total Abdominal HysterectomyTotal Mastectomy Disc SurgerySpinal Fusion Total Hip ReplacementTotal Knee Replacement Chronic Obstructive Pulmonary Disease

Thisqualitytoolwillhelpmedicalparticipantsmakeinformeddecisionsregardingwheretheyreceivetheirhealthcare.CianbroinpartnershipwithCigna,ourthirdpartymedicalcoverageadminister,andintandemwithCigna’spredictivemodelingtoolwhichassignsariskleveltoparticipantsbasedoncurrentclaimsanddiagnosis,willprovideatollfreenumberforparticipantswhoarecontemplatingorscheduledforsurgeryforoneoftheaboveconditions.ACignacasemangerwillthendirectparticipantstothemedicalfacilityclosesttothemthatis

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designatedasa“CenterofExcellence”inqualityandcost.Ifthisfacilityisoutsidetheircommutablegeographicalregion,say100miles,wewillofferanincentivetotheparticipantiftheyelecttotraveltothe“CenterofExcellence”fortheirprocedure.

FurthertoaddressCianbro’sgreatestareaofworkrelatedandnon-workrelatedincidentsandrisk,thecompanywillagainpartnerwithCignatoimplementtwodiseasemanagementprograms:diabetesandmusculoskeletal.Afurtheranalyticalstudywillexistonworker’scompensationandnonworkrelateddisabilityclaimstotargetspecificmusculoskeletalpreventablecategories.Duringthesametimeframe,thecompanywillimplementacustomdesignedergonomicsprogramsupportedbytheHealthyLifeStyleProgram(HLP).

Additionally,intheHLP,wewillbeaddingacustomized“recommendedscreening”reportfortheindividualparticipanttotaketotheirphysicianthatliststherecommendeddiagnosticteststobeperformedbeyondthelevelofsimplehealthpromotionrecommendationsbasedontheirage,gender,etc.Wewillincludeaformtobecompletedbythephysicianortheparticipantwiththeresultsofthosescreeningswhichwillbeenteredintotheparticipant’shealthrecordintheWellnessTrackingSoftware(WTS).Attheendofeachyear,participantswillreceivean“AnnualHealthSummary”oftheirprogressintheprogram.

Health Risk Cost Management:Ourgoalinthisarea,istoadoptaprogrambasedonthewellnesswheelthatcanbedeliveredasatrainingprogramtothejobsites.Thisenhancementisintheearlydesignstages.ThroughtheHLPwewillidentifycorecostandriskdriversinareasoflifesatisfaction,healthperception,stress,etc.Ourwellnesswheelmaylooksomethinglikethis:

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AnotherpartofthisgoalistoincreaseourEmployeeAssistanceProgram(EAP)utilizationwiththelogicthatifteammembersandfamiliesaregettinghelpfortheirlifestress,healthriskwillgodownandEAPusageup.

WehavealsocomputedouraverageriskscoreforallparticipantsintheHLPandwillbesettingagoaltoreducethatannuallybysomeincrement.Atthebeginningof2005,weimplementedtwonewprograms:amandatoryHRAforallteammembersandspousesenrolledinmedicalbutnotinHLP,andacompanywideattendancetrackingsystem.2005willbecomeourbaselineyearforbothprograms.

Resources Allocated To Systematically Accomplish The Proposed ObjectivesThroughtheinitiativeofcreatingatrueintegrationbetweenhealth(wellness)andsafetyintheworkplaceandathome,CianbrowillbringtheentireresourcesoftheCompanyforwardtoaccomplishourgoals.Bytalkingaboutwellnesseverytimewetalkaboutsafety,entrustingtheresponsibilityforwellnessaswellassafetytoourfrontlinemanagers,weavingthewellnesselementsintoexistingsafetyprograms,weintendtopermeatetheorganizationwiththehealthandsafetyculture.Byhavingourfiveyearplan,companygoalsandobjectives,tiedtothecompany’soverallstrategicplan,weareforcingourselvestolookaheadandplaneachyear’sprograms,createthebudgetsandallocatethepersonnelwhocanexecutetheplan.

Achieved Outcomes And Declaring Victory In Worksite Wellness2005and2006willbecomebaselineyearsformanymeasurements,suchastheprogramsdescribedintheBHAGS.

ThroughtheHealthyLifeStyleProgram(HLP),wearetrackingourchangesinlifestyleriskfromyeartoyear.Theoutcomeweexpectistoreduceidentifiedriskincrementallyeachyearaswehavedonesincetheprograminceptionin2001.

ByrequiringanannualHRAofeveryoneenrolledinmedicalcoverage,wewillbeabletobenchmarkourriskagainstourpopulationofthoseintheHLPandthosewhoarenot.WeexpecttheoutcomeofrequiringanHRAtoincreaseparticipationintheHLP.In2005enrollmentwentfrom70%ofthoseonthemedicalplanto86%.WealsoexpecttoraisethelevelofhealthawarenessofthosewhocompletetheHRAbutdonotjointheHLP.

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Inthequalityarea,wewillbeabletolookattheeffectofdirectingparticipantstoqualitycentersofexcellence,andmeasureourincidentsandclaimsrelatingtodiabetesandmusculoskeletal.Theexpectedoutcomemultiple,wewillincreasetheawarenessoftheeffectofqualitycareupontheoutcomeofthesurgicalprocedure,anddecreasetheseverityfactorofdiabetesandmusculoskeletaldiseaseorincident.

Afterestablishingourbaselineyearin2005forattendancetracking,wewillextractthoseabsencesrelatedtoillnessandtrackforward.Wewillthensetgoalsforreducingallabsencesbutwithafocusonwellnessformedicallyrelatedabsences.

Wewillcontinuetobenchmarkourmedicalincreasesagainsttrendandlookforcontinuousimprovement.Ourdesiredoutcomewillbetokeepourincreasesbelownationaltrend.

Ourvisionistocreateawellnessculture.Wewillneverdeclare“victory”becauseweareonacontinuouslearningpathandeachquestionthatweanswerandeachgoalthatweaccomplishsimplyleadsustothenextone.Whilethereisnooverallvictory,wedohavemanywinners.Everydaythatwestayhealthyasacompany,asteammembers,asfamilies,meansthatweareallwinners.Everydaywecanofferouremployeeownersaffordablequalityhealthcare,ahealthyandsafeenvironment,steadyemploymentandagoodpaycheck…weallwin.

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All information ©Wellness Councils of America (WELCOA) 2006. WELCOA provides worksite wellness products, services, and information to thousands of organizations nationwide. For more information visit www.welcoa.org.

Suggested Citation: Cianbro. (2006). WELCOA’s Absolute Advantage Magazine.

Cianbro % Change In Costs Per Team Member

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