That the cost of health care in the United States is rapidly increasing, along with the average American’s waistline, is no secret.

But rather than raise the white flag, more companies are taking a targeted approach to workplace wellness that uses population health management and preventive health care to address prevalent issues among their employees. In-depth data analysis allows these companies to establish programs and initiatives intended to not only lower health-care risks but insurance premiums as well.

“Having a healthy workforce can really benefit an employer,” said Steve Flood, senior vice president of Holmes Murphy & Associates Inc., a West Des Moines-based insurance broker. “And if nothing is done, and those people stay, you will have issues. The key is to try to take as good of care of people as possible.”

Holmes Murphy approaches the issue with its clients through use of Decision Master Warehouse, a software program that examines companies’ claim data to determine the origins of those claims and which could be affected by lifestyle changes, such as cardiovascular disease.

Employers receive a nameless overview of their workforces that highlights pressing health-care issues and where health-care dollars are being spent, which they can then use to develop and market in-house programs that specifically target those problems.

For years, Greater Des Moines companies such as Pioneer Hi-Bred International Inc. and Wellmark Blue Cross Blue Shield have not only established workplace wellness initiatives, but have also continued to analyze and improve their programs to better address prevalent and costly conditions. Their efforts have earned both companies the Wellness Council of America’s Platinum Well Workplace award.

“In looking at our claims data and injury data, and with an aging population, we knew we needed to focus on helping our employees become more active,” said Jill Norris, manager of preventive health and wellness at Pioneer, which opened a fitness center in 2003 to address the issue. “We have long tenure with employees, so we know investment in their health makes good sense.”

Pioneer, which instituted a wellness program in 1979, examines data to determine which medical conditions are driving health-care costs.

The company has reduced expected medical costs by approximately $2,000 annually per employee, according to the 2005 Health Plan Performance Benchmarking Study conducted by Towers Perrin. The company has also avoided the double-digit health insurance premium increases that have become almost standard and boasts a health insurance plan with an efficiency rate that is 21 percent higher than its peer companies, Norris said.

Cardiovascular disease is one of Pioneer’s top four sources of medical claims, so the company has encouraged employees to change their behavior through strategies such as exercise, healthy dieting and stress management.

The company now requires twice-daily stretch breaks in its field offices as an attempt to reduce the prevalence of back injuries, and offers the Office Athletes computer program to its office staff, which encourages them to take breaks during the workday. Healthy Sprouts promotes healthy prenatal behavior, and Cut Out Tobacco helps about 30 to 40 people a year quit smoking.

For years, the company has offered optional health screenings, which has become increasingly popular among companies.

“It provides us with a good profile of our population and allows us to see where we’re making a positive impact and where we need to focus more resources or information,” Norris said.

Individuals’ screening results remain anonymous to their employers, which receive a broad profile intended to guide their programming efforts. Holmes Murphy’s Flood said some companies have adopted innovative methods of increasing participation rates, such as lower premiums to employees who go through the screening process, regardless of their results.

“Driving people in there is a first step in really trying to change the culture,” Flood said. “If somebody who is going to have a $50,000 claim goes through the screening and reduces that to a $40,000 claim, that’s a win.”

Wellmark has taken an incentive approach to many of its wellness programs, such as Pathways to Wellness, through which employees can earn up to $300 in flexible spending that can be applied to their 401(k) or medical spending accounts. Participants earn points by practicing healthy behavior such as preventive exams and stress management. The program has produced a return on investment of about $3 per dollar invested and $615,369 in annual savings through reduced claims.

Wellmark’s Custom Fit ergonomics program has produced “tremendous results in repetitive motion injuries,” according to Cynde Shepherd, team leader for the company’s population health improvement area. An on-site dietician works closely with the Blues Café staff and has implemented a farmers market where workers can purchase fresh fruits and vegetables. The Nutrition for You program provides employees with individual nutrition assessments and coaching programs. About one-third of employees use an on-site fitness center.

“For the last several years we’ve been focusing on our highest-risk folks,” Shepherd said. “Nurses work with them individually to identify where they’re ready to make a change and what kind of information they need about their condition.”