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As a business insurance professional, Dave Dykstra knows that statistically he faces a hefty personal price tag for health care in his retirement years – an average of $250,000 between the ages of 65 and 90.

It’s one of the reasons the 50-year-old and his wife, Louisa, last month enrolled in a personal wellness program through Preventative Health Group (PHG), a prevention-based medical practice based in Clive.

“The biggest incentive for us here is not immediate rewards; it’s rewards we’re going to see 10, 15, 20 years down the road,” Dave Dykstra said prior to a one-hour workout session with the couple’s personal trainer. “It’s sacrificing now, making investments now for something that’s going to pay off down the road by likely having lower health claims.”

Though they could use the wellness program offered by his employer, Principal Financial Group Inc., Dykstra said they chose PHG’s program because it’s more comprehensive than what Principal offers, and one of PHG’s four gyms is located just a few blocks from their home.

Preventative Health Group, which has enrolled more than 500 individuals in its most intensive yearlong program over the past two years, is now preparing to make the same services available to small businesses. It’s among a number of organizations that are seeking to fill an untapped niche in Greater Des Moines and Iowa for wellness programs tailored to smaller employers.

“There’s a huge gap,” said Steve Flood, senior vice president of Holmes Murphy & Associates, which later this month plans to launch a small-business wellness program modeled after a program it developed for its own employees. The insurance broker will offer the product in partnership with Principal Wellness Co.

Strong financial incentives to employees are the key to getting a high participation rate, Flood said, which is critical for identifying workers with often hidden health risks. Holmes Murphy achieved more than a 95 percent participation rate among its employees by giving employees who get annual health screenings a $500 discount off their health insurance premiums each year.

His company’s return on investment has been impressive. “Over the past four years, Holmes Murphy has saved $4 million in health-care costs, and we have not had any premium increases, nor have we had to make any reductions in benefits,” he said.

Iowa’s largest health-care provider also plans more wellness offerings. In February, Wellmark Blue Cross and Blue Shield announced plans for a suite of health and wellness programs called Whole Health Dimensions. Next month, Wellmark will begin offering educational seminars and wellness training programs targeting smaller companies that receive health coverage through Wellmark. As part of the program, the health insurer has hired “community wellness coordinators” who will work with companies on a regional basis throughout the state.

In a similar fashion, the Wellness Council of Iowa is working with Hy-Vee Inc. and Des Moines University to assemble a statewide network of trained wellness coaches. The organization plans to begin providing in-house training of wellness coaches for companies later this year.

More facilities dedicated to wellness are also on the way. The YMCA of Greater Des Moines, which currently offers a number of wellness classes and training at its facilities, in April 2009 will open The Healthy Living Center in Clive, a 65,000-square-foot medical-based fitness center that will also house specialists in areas such as nutrition and physical therapy. Vernon Delpesce, the YMCA’s president and CEO, said he expects about one-third of the facility’s programming will accommodate corporate wellness needs.

Another locally based program, called The Other Health Plan, has piloted a Web-based (www.theotherhealthplan.com) wellness program that combines access to online education resources with tools allowing employees to complete health-risk assessments and personal health records. That program, which began as an initiative of Group Benefits Ltd., an Urbandale health benefits broker, expects to spin off later this year as a separate company. It has partnered with the YMCA of Greater Des Moines and plans to partner with other fitness clubs to provide a comprehensive program.

Small employers in Iowa may receive some help from state government in reducing the cost of offering such programs. In May, Gov. Chet Culver signed a health-care reform bill that includes provisions to create a tax credit for small businesses that provide wellness programs for their employees. The Iowa Department of Public Health (IDPH) has until Dec. 15 to forward a plan for the program to the governor and the Legislature. The bill also requires the Iowa Insurance Division to begin assisting companies with 25 or fewer employees to establish flexible spending accounts to pay for qualified health-care expenses.

Iowans Fit for Life

Iowans Fit for Life, an IDPH program, has begun a pilot project in which the department is assisting 10 small businesses throughout the state, among them an Adel company, in establishing worksite wellness programs. The results of the pilot project will be used to build a statewide program for small businesses.

“One of the things we’ve been trying to do with Iowans Fit for Life is connect the dots between wellness programs,” said Dennis Haney, community health consultant for the program, “so that we at least can all be aware of each other and march in the same general direction, using the same general tactics. We’ve been able to bring several of the major players in the state together … it’s helpful to make sure we’re all on the same page.”

The IDPH will use a portion of an $843,000 federal grant it recently received from the National Center for Chronic Disease Prevention and Health Promotion to develop the worksite wellness program. “We’re specifically targeting small businesses,” Haney said. “That’s where we felt like we might have an opportunity to help the state improve.”

The pilot program, called Investing in Employee Wellness, focuses on nutrition education and physical activity incentives. Partners in the project include Iowa State University Extension Program, Wellmark and the Iowa Farm Bureau Federation.

“An approach we’re taking is to begin by talking about return on investment with businesses,” Haney said. “There is ROI information out there, and we often start with that to catch the ear of business professionals, and then share the information about how you build a worksite wellness program. Typically the more work involved, the greater the return on investment.”

The Other Health Plan

Employees of Group Benefits Ltd. get out to the YMCA on company-paid memberships several times a week to play basketball or work out, get free fruit in the company lunchroom and meet individually with a wellness coach each quarter to review their progress. They also compete for wellness points toward a free lunch each two weeks. The company is among five small businesses participating in a pilot of The Other Health Plan’s program prior to a statewide launch planned later this year; an average of 85 percent of employees at each company are participating.

“When we first started looking at this, we were going to deliver a lot of the online coaching through the YMCA, but it quickly turned into the YMCA really being that incentive piece for the employer groups,” said Chris Haviland, The Other Health Plan’s director of business development. “So it’s much more than saying, ‘Hey, here’s your program.’ We have to put into place activity levels and awards. And one of the incentives to get employees out of their seats and taking action was going to the YMCA.”

In addition to continuing its partnership with the YMCA of Greater Des Moines, The Other Health Plan will contract with other health clubs to pair with its online educational and wellness tools at www.theotherhealthplan.com. An employer or individual will soon be able to search by ZIP code to find nearby participating facilities and programs, Haviland said.

Fees will likely be on a per-member, annual basis, with choices ranging from a la carte to an all-in-one program, he said. Additionally, “if you want it on an individual, one-on-one basis, you can do that. If you want it through your employer, we’ll help you structure that.”

Whole Health Dimensions

Through Wellmark’s Whole Health Dimensions, nine community wellness coordinators in Iowa will work with employers to communicate health information, encourage healthy lifestyles and raise awareness of wellness programs already available throughout the community.

Many of the resources will be available on Wellmark’s Web site, www.wellmark.com, said Heidi Long, a Wellmark health management consultant who’s leading the project.

“The No. 1 priority for the wellness coordinators is to find specific events within their regions, such as Race for the Cure, screening day at Hy-Vee, as well as resources related to wellness,” Long said. Some events have already been placed on the online community resource calendar, which will be further developed into a searchable tool that will enable users to search by community for wellness events, she said.

Each of Wellmark’s approximately 11,000 small-group (companies with two to 100 employees) members in Iowa have access to the full suite of Whole Health Dimensions as a part of the insurance plan at no additional cost, Long said. “We want them to get more involved by meeting with their community wellness coordinators,” she said. Currently, the program is focusing on five topics: smoking cessation, nutrition, weight management, physical activity and stress management

Additionally, Wellmark will begin a series of workshops throughout the state in August designed to show its small-businesses members how to implement a wellness program. Two other seminar series, one on stress management and another on weight management, will also be available for employers to schedule on-site or at central locations.

Preventative Health Group

When Jake Velie launched Preventative Health Group three years ago, he had just one trainer and a medical director. And he knew what it was like to be obese. At 5 feet 10 inches, he weighed 290 pounds in high school but shed 100 pounds before graduating. With the help of a family doctor, he was able to change his lifestyle to keep the weight off.

“I got to the point where I was done with that,” he said. Preventative Health Group (www.phsglobal.com) takes the same holistic approach.

“We started by talking with physicians and letting them know they could refer patients to us,” Velie said. The business took off soon after WHO Radio talk-show host Steve Deace began talking up the program on his show; Deace lost 70 pounds through the program.

As a prevention-based medical practice with two physicians, the clinic focuses on lifestyle education. Last month, the group moved from temporary space to a permanent facility at 2480 Berkshire Parkway in Clive, which includes a full diagnostic laboratory for health screenings and an X-ray laboratory as well as an in-house chiropractor.

A key part of the business is the Snap Fitness centers operated by PHG trainers, who provide personalized programs for clients. The 24-hour facilities, accessible by key cards, are also available on a monthly membership basis.

“We had no idea how successful the fitness side of this clinic was going to be,” said Velie, noting that its fourth fitness center will open this month in Eastwood Village on East 33rd Street. “A lot of people have memberships in gyms outside of ours, but come and see our trainers because of how well trained they are and how successful we’ve been in helping people get results.”

Corporate contracts are the next growth step for the business.

“We’re currently talking with several of the major third party administrators for health insurance, and are looking to talk with any company that either wants to provide incentives for their employees to come through this program, or companies that want on-site education from us,” he said. “The results that we’ve been able to help people achieve clinically sometimes far overshadow what prescriptions can do.”

The Dykstras’ investment in the program, which even includes cooking classes, is already showing personal returns. They’ve both lost weight within the first month.

“The biggest thing from the nutrition side is a schedule of what we should be eating,” Dave Dykstra said. “And from the exercise standpoint, what I like about this is you’re hiring a coach … because she knows what I should be doing, and I don’t have to research it.”

Staying fit when your profession is selling health insurance policies doesn’t hurt, either.

“By coming in here (to the gym), I’m basically putting my money where my mouth is,” he said.