People come up with a million reasons not to see the doctor. There’s no time, it’s too hard to schedule an appointment, they hate waiting in the doctor’s office, they can tough it out on their own, and the list goes on. Even when employers bring workplace health services to the jobsite or nearby, some find difficulty in engaging employees to take advantage of their primary care health benefits.

Admittedly, it’s easier said than done. Employers who offer dedicated worksite medical clinics provide access to world-class healthcare teams who can help employees and their families make positive health improvements — and, as a result, employers realize financial savings. But employees won’t get healthier if they don’t use the services, while employers won’t see a positive return on their investment.

For instance, some employees with access to an onsite primary care team incorrectly fear their employers peeping on their most private health records or clinical staff discussing their health issues with others at the company (both are illegal due to HIPAA).

For Sheetz, a convenience store chain with 2,000 employees in six states, its fleet of truck drivers worried most about passing a physical exam required by the Department of Transportation, says Travis (TJ) Eckels, Sheetz Senior Manager of Employee Benefits and Wellness.

“That was the group, initially, that we were worried the most about,” says Eckels, adding that Sheetz partnered with Marathon Health to open its first onsite health center in 2012.

“The drivers may not be the first ones in line to sign up for regular health coaching, because they’re afraid you’re going to uncover something that restricts their license. But it’s turned into one of our most engaged groups,” Eckels says.

What helped win the group over? A dedicated clinician attended regular driver meetings to establish good communication with the team, and she even went on a 12-hour ride-along with the drivers so she could experience the stress and physicality of their jobs firsthand.

“The big message at these driver meetings is, ‘Listen, we’re always going to uncover things. People have conditions. Our goal is to keep you on the road safely. It’s not to take away your license,’” Eckels says.

Attending meetings, doing ride-alongs, and direct communication with employees are just a few of the strategies companies can use to build trust and increase engagement with onsite health services. For the ultimate patient engagement strategy to really work, says Amy Lefevre, Marathon Health Senior Director of Patient Engagement, companies must take a 4-pronged approach:

  • Buy-in and promotion from senior leaders
  • Strong incentive programs that reward employees for taking healthy actions
  • Strategic marketing and communications strategy from the healthcare provider
  • An amazing care team that proactively engages patients

1. Obtain Leadership Buy-in and Promotion for Better Workplace Health

Employee engagement begins with your leadership team, including chief executives, managers, and supervisors, Lefevre says.

In addition to strong promotion and buy-in from the top, she says companies typically see better engagement when they allow the Marathon Health clinical team to communicate directly with members — without needing to jump through hoops. “We’re marketers,” Lefevre says. “We’re trying to get people to take action. We need to have the freedom and flexibility to communicate to patients.”

When a company partners with Marathon Health to open dedicated health centers, the Marathon team conducts a communications and culture audit to understand the company’s demographics, their communication preferences, and any big changes happening with their healthcare coverage, Lefevre says.

New Balance Athletics, a sports footwear and apparel company, partnered with Marathon Health 12 years ago. Today, 75 to 80 percent of the Boston-based company’s nearly 1,000  manufacturing employees actively engage with the onsite health services on a regular basis, says Benefits Director Glenn Haskell.

“Marathon is a high-end, high-intervention wellness program. It’s not a check-the-box solution,” Haskell says. “If you’re doing Marathon, you’re an employer who is fully engaged and really committed to a wellness program.

“We believe that wellness is in our DNA,” he adds. “For us to be all-in on wellness makes total sense. That’s why we’ve got such buy-in from ownership and senior leadership, because they recognize from a cultural perspective, this is something we almost have to do, given who we are.”

2. Offer Workplace Incentives to Reward Employees for Taking Health Actions

How do you reach the gold standard in member engagement? Offer employees incentives to use the health services, Lefevre says.

Most incentive programs focus on participation or outcomes. For example, attend a smoking-cessation or weight-loss program, and you’ll receive a grocery gift card. Make healthy changes to reduce your cholesterol, blood pressure or A1c levels, and earn a monetary reward once you lower the numbers. One company even paid for a 3-day trip to hike a Colorado mountain for engaged employees who improved their numbers, Lefevre says.

Cold, hard cash works best, followed by a large HSA contribution, or premium reductions on what employees pay for health insurance. If you go the cash route, the “sweet spot” falls somewhere between $250 and $500, she says, although some companies will contribute up to $3,000 to their employees’ HSA account.

The full fitness center, wellness center and health center at Sheetz, built separately from its distribution center, is free for all employees and their spouses to use, Eckels says. It’s the employee incentive that really paid off for the company, as nearly 70 percent of patients with chronic conditions now engage with the service.

“We made it a destination,” Eckels says. “We have a registered dietitian, personal trainer, individual exercise classes, Peloton bikes for spin classes, yoga, and more.”

Incentive programs of any kind often spark that first touchpoint with a new patient, and after they have a wonderful experience, they’re more likely to return again and again, boosting engagement further and leading to better health outcomes.

3. Develop a Strategic Communication Strategy for Better Workplace Health

Spread the word about your workplace health center benefits by getting the clinical team involved with face-to-face employee events, from eating lunch together to attending company-wide events. Send emails, create home mailings, and put up digital signage or bulletin boards in common areas or main entrances.

That’s how New Balance grew its engagement numbers, Haskell says.

“We give Marathon Health free rein to reach out to the employees,” he explains. “That’s part of the beauty of the onsite clinic. If you do it right, the clinician begins to be part of the culture.”

Lefevre stresses the importance of segmenting communications to different patient demographics, and not settling for a one-size-fits-all messaging strategy.

“If you’ve used our services, we’re going to talk to you differently than someone who’s never engaged,” Lefevre says. “We can’t send the same email to everyone, because it’s not necessarily relevant.”

4. Proactively Engage Employees to Improve Health with an Amazing Care Team

While targeted communications play an integral role in driving engagement, Lefevre says proactive engagement by Marathon Health providers proves highly effective.

“Even something as simple as having the provider, at the end of the visit, say, ‘Hey, if you had a great experience, go tell your coworkers,’” she says. “Or any events where we can get our clinicians out — like setting up a table in a cafeteria or a common high-traffic area — those face-to-face events really help to get people to come in, because they’re meeting that clinical team and provider outside of the walls of the health center, so it’s less intimidating.”

To be engaged, a member must schedule an appointment with a provider, whether it’s a doctor, nurse practitioner, physician assistant, health coach, behavioral health specialist, physical therapist, registered dietitian, or certified diabetes educator.

“Ultimately, we want the right people utilizing the health center at the right time for the right reason,” Lefevre says.

The Marathon Health model allows providers to spend quality time with each patient, which helps them build trust and form long-lasting relationships. Many of the providers serving on amazing care teams also live in the communities they serve, which companies like family-owned Sheetz and New Balance appreciate.

“These are the people who employees will see at the general store or around the neighborhood,” Haskell says. “And I think that buys the program a lot of credibility.”

About the Author: Kristy Esch

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