The Company Doctor

By Lisa Takeuchi Cullen

In hand-to-hand combat, the American worker would lose to a band of sleepy preschoolers. Only 15% of workers exercise enough, and 40% don't attempt so much as a sit-up. More than half blame work, with 8 in 10 grousing that they would hit the treadmill--really they would--if only their employers encouraged it.

Be careful what you whine for. With health-care costs hobbling profits, more employers are saying to employees, Get healthy--or else. After all, insurance premiums and absenteeism by sick workers set businesses back $15 billion a year, says the Centers for Disease Control and Prevention. And yet 70% of health-care costs stem from preventable chronic diseases. Take diabetes, which costs nearly $92 billion a year: 91% of cases could be avoided by better eating. Smoking-related illnesses rack up an additional $75 billion a year.

Employers' whip of choice is the corporate-wellness program. Three-quarters of large employers have one, up from 56% three years ago. And the new wellness program has teeth. It levies fees for not joining, assigns workers to risk categories, rewards them for improving and sics personal coaches on employees to hound them into better habits. Some employers take the mission so seriously they're telling workers to get well or get lost.

Worthington Industries was an early convert. The $3 billion metals manufacturer opened a gym at its Columbus, Ohio, headquarters in 1985, later adding free yoga, step and cardio classes. In 1995, it built an onsite wellness center with three full-time physicians, a lab and pharmacy. But with the company's health-care premiums still soaring, CEO John McConnell decided to get serious. In 2003 Worthington hired an outside vendor to implement a program called Healthy Choices that would track and improve workers' health. Workers who participate get cash credits of up to $50 a month toward their share of health-care premiums. "I thought, 'People respond to money,'" says McConnell. "It's a pretty sweet deal."

The results are plain. Since 2004, the percentage of participating workers in the low-risk category rose from 30% to 41%. Pat McGee, 49, a corporate trainer based in Jackson, Mich., says his days on the road "began with doughnuts and ended with pizza." After a heart attack in January 2006, McGee embraced the wellness program, which has since helped him quit smoking, change his diet and start walking four miles every day. His two daughters quit smoking too. Thanks to success stories like McGee's, Worthington saved $2.5 million in claims over the past two years, more than double what it has spent on the program, says Kay Cooke, director of benefits. That makes McGee proud: "We're a profit-sharing company, so I figure every dollar we save is a dollar in my pocket one way or another."

Wellness programs are wasted efforts unless workers take part, but for now, they remain mostly voluntary. A 2005 study by the Deloitte Center for Health Solutions found that at most companies, less than half of employees participated. That's where the carrots and sticks come in. While employers like Kaiser Permanente dangle cash incentives for workers who submit to health evaluations, others, like AstraZeneca, threaten higher premiums for not taking part. Scotts Miracle-Gro has gone so far as to fire a worker for smoking; he has since filed a federal lawsuit charging discrimination. Worthington CEO McConnell says he would never fire a worker for poor health, maybe because he's no Lance Armstrong himself: 6 ft. and 230 lbs., at 54, he is a lapsed jogger who sneaks a smoke some evenings and whose risk assessment is only moderate. Even for bosses, wellness doesn't always come easy.