Lands' End Takes on Diabetes Prevention and Management
Lands' End is a direct merchant of traditionally styled clothing for the family, soft luggage, and products for the home with retail sales through catalogs, the Internet and stores. Based in Dodgeville, Wisconsin, Lands' End employs 7,151 individuals.
As with many self-insured companies, Lands' End saw its health care costs spiraling out of control and outpacing its sales growth through the 1990s and into 2001. Between 1997 and 2001, its health care costs rose 16.7 percent while sales rose 3.9 percent. Rising health care costs were driven by higher medical care costs, a health plan design that had broad eligibility requirements and open, non-restrictive features, and an aging workforce.
Lands' End knew it needed to contain its health care costs while also helping employees lead healthier lives. The company developed a four-pronged plan to begin addressing the issue:
- Develop a set of guiding principles.
- Revise its health plan design so that employees shared more of the cost and could choose between two different health plan options.
- Educate employees about the problem and empower them to be part of the solution.
- Partner with health care providers to address issues collaboratively.
Company leaders also wanted employees to view the company as an “advocate” for good health. The company promoted prevention and early detection of chronic conditions, discussed the company's rising health care costs, and addressed the need for employees to take part in containing health care expenses using several communication mediums.
The company held discussions at staff meetings and seminars, published articles in the corporate newsletter and posted information on its Intranet. Lands' End also increased its on-site medical services and improved health programs and service such as:
- providing access to on-site nutritionists, physicians and physical therapists;
- offering employees a self-care book and on-line E-medicine support;
- hosting diabetes, colorectal cancer, and bone density screenings; and
- establishing disease management programs for diabetes and weight management.
Diabetes Prevention and Management Program Overview
In February 2003, Lands' End conducted a company-wide diabetes screening. Participating employees received a $50 incentive. Of the 3,329 employees who participated, 689, or 20 percent, had fasting blood sugars (FBS) above 110mb/dl (Normal FBS is between 70 and 110 mb/dl.). With this information, Lands' End senior managers initiated the following health improvement strategies focused on diabetes:
- support groups and talks on general health and diabetes-specific topics
- disease management module, and
- regular A1C testing (measures the average blood glucose level in the body over the past three months).
A health education strategies team – made up of a health educator, fitness specialist, two health assistants and a physician – was charged with implementing several efforts. They conducted regular A1C screenings, organized and ran support groups and diabetes education programs, and referred employees to a physician or to fitness, nutrition, or weight-loss classes. The target audience was employees with FBS above 110mb/dl.
Lesson plans and facts from diabetesatwork.org as well as other diabetes on-line resources were used to lead the support groups and nutrition, fitness and weight loss classes. Experts in dermatology, podiatry, family medicine, diabetes education, dentistry, and ophthalmology were invited to speak to employees.
For those with diabetes, education messages focused on managing the condition and preventing further diabetes-related complications. For those who were at increased risk for diabetes, program messages emphasized healthy lifestyle changes as a key to losing weight and preventing or delaying the onset of Type 2 diabetes.
Lands' End has begun containing its health care costs. In 2002, Lands' End's health care costs rose 3 percent as compared to the national average of approximately 12 percent. In 2003, its health care costs increased just 2 percent as compared to the national average of about 13 percent.
The company-wide screening effort has been successful in identifying employees with, or at increased risk for diabetes. However, convincing employees to participate in free diabetes prevention and management programs is a challenge because:
- Some employees do not want to accept the fact that they are at-risk for diabetes or diabetes complications.
- Many employees work on their feet all day or have second jobs. These individuals often feel too tired to come to the on-site activity center to exercise.
Several of the program's components were successful in generating program participation. These were:
- $50 incentive to employees who participated in the company-wide health screening;
- free diabetes screening, education classes and materials;
- on-site medical clinic and fitness center access (This helps with referrals into their diabetes and diabetes prevention programs.); and
- support from upper management.
A variety of communication channels are needed to reach employees including:
- e-mails, and
- bulletin boards and presentations to promote programs and messages.
Additional diabetes prevention and management activities may include:
- a one-day diabetes workshop for employees and families/caretakers that will offer presentations and hands-on learning experiences;
- a quarterly brown bag “Lunch and Learn” series where employees will actually be given their brown bag lunch with the appropriate portion sizes and meal options; and
- a linkage between the diabetes prevention and management program and health plan benefit premiums as a participant incentive.
As Lands' End continues to conduct and refine its diabetes prevention and management program, the company is making a conscious effort to rely more on content from the www.diabetesatwork.org Web site.
For more information on Lands' End's diabetes management and prevention program, Elizabeth Weibe at Elizabeth.Wiebe@landsend.com