Pitney Bowes: Obesity Initiative

If you have questions, please contact:
J. Brent Pawlecki, MD
Associate Medical Director
Pitney Bowes Inc.
Phone 203-351-6934
E-mail: brent.pawlecki@pb.com

Introduction
Goal
Proposed Strategy

2003—Phase 1
2004–2005—Phase 2
2005–2006—Phase 3

Introduction

Pitney Bowes, particularly with its aging workforce, has not escaped the epidemic of obesity in the United States. The company’s medical expenses directly attributed to obesity are estimated at $5.6 million in 2002. And obesity is likely to be a significant indirect factor in Pitney Bowes’ medical expenses (for both fully insured and self-insured employees).

The reality is that preventing obesity is considerably cheaper than treating people once they become obese. But despite a track record at Pitney Bowes of successful wellness initiatives that address obesity and other health-related problems, cases of obesity continue to rise. Clearly, obesity must be addressed as a business imperative, focusing on how the epidemic affects the company’s fiscal and shareholder value.
(See “Obesity Epidemic: Background,” final section, for more information.)

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Goal

Decrease or hold steady the number of people at Pitney Bowes who become obese by increasing prevention efforts. Use a multidimensional approach of developing a supportive corporation and a healthy work environment; and also foster personal responsibility to ultimately hold down medical costs and promote healthy, engaged and productive employees.

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Proposed Strategy
2003—Phase 1

Supportive Corporation

• WebMD tool (e-health platform) is implemented to expand personal health information access via the Internet.
• Preventive services such as cardiovascular and diabetes screening included in health plan design.
• Behavioral health and disease management programs in place.
• Weight loss, fitness and nutrition education is included in wellness initiatives (i.e., cardiovascular, mental health, diabetes) and through the medical clinics.
• A registered dietitian serves as a valuable team member in the medical and wellness programs.

Healthy Work Environment

• Health professionals offer teaching and counseling in the 7 on-site medical clinics.
• A dietitian works with local food services to provide regular healthy choices on the menu.

Personal Responsibility

• Numerous well-attended and well-received health and fitness seminars conducted.
• Weight Watchers programs available at some worksite locations.
• Fitness centers provided at the WHQ and Shelton locations in Connecticut.
• Activity and exercise fitness programs through worksite initiatives (e.g., walking programs).

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2004-2005—Phase 2

Supportive Corporation

• Senior management makes tackling health and obesity problems a business priority.
  – Become vocal and active proponents from the perspective of growing the business and maximizing shareholder value.
  – Work to transform the internal corporate culture to include health and fitness awareness, which will increase employee effectiveness and productivity, and control some of the rising health care costs.
  – Use inspirational “Power Talks” to address the impact of health costs on the company’s bottom line and its ability to provide affordable health care.
• Top leadership participates in fitness and wellness activities, serving as examples for other employees.
• Aggressively market available tools and programs.
  – Prominently feature health and obesity tools on the PB e-Health platform.
  – Expand promotion of the programs and the WebMD Personal Health Manager.
  – Develop a new incentive to encourage high participation.
  – Increase prominence of “Health and Well-Being News” on the PB Intranet homepage.
• Preventive services are expanded in health plan design.
• Behavioral health and disease management vendors develop and implement solutions supporting corporate goals.
• Use WebMD Health Risk Appraisal to determine employee risk, and develop measurement tools to monitor adverse risk changes (increases/decreases). Measure program results and impact on costs using MedStat (data integration warehouse) tools.
• Minimize conflicting messages about health (e.g., promoting exercise while increasing fitness center dues).
• Develop improved communications methods to encourage effective and targeted messages about wellness programs and corporate resources.
  – Currently unable to send limited e-mail reminders to select locations (e.g., to WHQ employees only).
  – PB workforce is highly diverse, with a significant number of employees lacking intranet access in the workplace.

Healthy Work Environment

• Maximize the use of the teaching power and counseling made available by health professionals in the 7 on-site medical clinics, and supplement this with improved tools (i.e., tools being released in 2004 and 2005 by the National Business Group on Health’s Institute on the Costs and Health Effects of Obesity).
• Vending machines and company stores institute variable pricing according to nutritional values. Limit, when possible, less healthy choices.
• Cafeterias institute variable pricing based on nutritional and caloric values.
• Promote bottled water, diet soda and healthier food options for use during company meetings.
• Promote walking trails and clubs at appropriate facilities.

Personal Responsibility

• Launch a corporate “Know Your BMI” [body mass index] campaign through the wellness initiatives.
• Promote the on-line WebMD Health Risk Appraisal with linkage to PB and based on identified risk factors.
• Develop new wellness incentives and rewards promoting positive health habits to achieve health improvement goals.
• Implement a discount program for fitness center memberships at best corporate rate (i.e., Global Fit).
• Promote activity and exercise through fitness programs and worksite initiatives (e.g., pedometer/walking program) by using incentives.

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2005-2006—Phase 3

Supportive Corporation

• Health plans are held accountable to the goals of Pitney Bowes and the promotion of their developed programs, providing incentives for participation in weight management programs.
• Implement a rating system for health plan obesity programs.
• Behavioral Health and Disease Management vendors are held accountable for support of corporate weight management program goals.
• Structural changes are made in the design of plans for the purpose of promoting healthy lifestyles.

Healthy Work Environment

• Consider tiered structure for fitness center fees based on an employee’s salary, and priced to encourage broad participation.
• Corporate Procurement department to implement single nationwide vending machine contract, mandating healthier available choices with variable pricing based on nutritional/caloric content.

Personal Responsibility

• Launch campaign with “Decrease Your BMI” focus.
  – Develop corporate goal for individuals to decrease BMI by 1 point (or below the recommended 25) during the year.
  – With corporate BMI average likely around 27, implement campaign to measure and then decrease the corporation’s average BMI by 1 point.
  – Consider creating challenges or competitions by departments.

Obesity Epidemic: Background

• In the U.S., 64.5% of adults are overweight (BMI>25), and 30.5% are obese (BMI>30).
• Obesity accounts for 300,000 deaths in the U.S. annually, second only to tobacco usage.
• Prevention of obesity is key, as research reveals that treatment options are rarely successful long-term, with the exception of bariatric surgery for people with BMI>35 (costing roughly $30,000/patient).
• Small changes in lifestyle can yield great results in affecting BMI levels.
• Weight loss of about 10% of body weight for those overweight or obese improves many health conditions, including diabetes, heart disease, hypertension, and back and joint disorders.
• Pitney Bowes is not alone in taking more drastic measures to address obesity. Now recognized as an epidemic, states are considering scores of bills that would, among other things, do the following:
  – get kids exercising;
  – warn restaurant eaters about fat, sugar and cholesterol on the menu; and
  – ban sugary sodas and fattening chips from school vending machines.
• Initial evaluation of the WebMD Health Risk Appraisal completed by Pitney Bowes employees reveals that over 80% of people have a poor diet and 85% are not within their normal weight range. Additionally, 61% are physically inactive. These scores are higher than for all other health risk factors, and are higher than those for the general population.

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