An article with a title like this can certainly cover a lot of ground in the fire service. For our purposes, it directly speaks to improving the health and fitness of firefighters.
In his May column in On Scene, Chief Jack Parow, IAFC President 2010-2011, emphasized how important it to maintain the endeavor to begin or improve health and fitness initiatives in spite of current economic challenges—a tough sell when many departments are fighting to keep stations open and firefighters on the job.
I applaud his important and timely reminder that we not lose sight of the essential value of improving the wellness and fitness of our firefighters as we are asked to do the same or more with less people and resources. I hope this article will leave you with a few ideas and tools to help your organization reduce healthcare costs through a fit workforce by creating a comprehensive wellness program.
As of 2009, healthcare accounted for over 17% of our gross domestic product, or $2.5 trillion dollars, according to the California Health Care Foundation. In a report called Health Care Costs: A Primer (March 2009), the Henry J. Kaiser Family Foundation reported that from 1999 to 2008 healthcare premiums rose 119% while workers' wages increased 34% and the overall cost of inflation was 29%. These numbers may lead one to say this is why there’s no money left for a wellness program, but they’re exactly where you’ll find the money to start or enhance a wellness program and slow the growth of health-insurance claims.
My city is self-insured to $180,000 per individual employee (2000 employees) with a stop-loss insurance policy when a claim goes beyond that amount. According to our risk-management department, the city experienced a nearly 300% growth in healthcare expenditures—from $1.4 million to just over $4 million—from 1982 to 1991. Healthcare claims rose from 4,881 to 13,597 per year during the same period. Healthcare claim expenditures were projected to reach six million dollars by 1993.
Armed with this fiscal information and the fact that over 50% of the city’s health insurance claims were for health issues that were lifestyle related, the city’s risk manager asked the City Commission to give him one percent of the projected health-claim expenditures—$60,000—to start a city-wide wellness program. He estimated the city would save the one percent by reducing the number of lifestyle related health claims impacting the self-insurance fund.
The wellness program actually saved five times the amount they were given.
Today, the budget for our citywide wellness program is approximately $150,000, which includes a fulltime athletic trainer, an exercise specialist and a nutrition consultant. Additional savings have allowed the city to add seven gyms and programs that include spouses and retirees, two groups that have a big impact on health insurance.
The benchmark the city uses to continue to monitor the wellness program’s success reveals that our healthcare costs are 20% less than other industries in the southeastern U.S. and 17% below similar organizations. After my department began a fitness program in 1988, the nutritional resources from the citywide wellness program led to our 150-person department losing nearly 2,000 pounds in the first year.
Most organizations have some type of group health-insurance plan and usually all employees have access to the plan. Some organizations are covered by one of the major health-insurance providers while others are self-insured.
First, begin by thinking outside your department to whatever kind or size of organization you are part of, whether it’s a city, county or parish. If your department doesn’t have the number of personnel to generate large savings, your organization may still be big enough after you analyze your healthcare and worker’s compensation claims to generate enough savings to help fund a wellness program.
If there’s one thing every organization is looking to control, it’s healthcare costs. And while it can be hard to convince the budget department to spend money to save money, the potential long-term savings from reducing healthcare claims are hard to ignore.
Information that can help make your case is available from several sources, including the National Institute of Standards and Technology, NFPA and USFA. The IAFF/IAFC Wellness Fitness Initiative (WFI) 3rd Edition reported a dramatic difference in the costs and claims of WFI departments versus non-WFI departments between the preimplementation years measured from 1991-1997 and the post-implementation years of 1998-2004.
| Category |
WFI Departments |
Non-WFI Departments |
| Healthcare Claims |
5% increase |
23% increase |
| Lost Days |
28% decrease |
55% increase |
| Total incurred Costs |
3% increase |
58% increase |
| Average Cost per Claim |
23% decrease |
35% increase
|
In summary, healthcare cost is an area of much concern throughout our organizations and our nation.
As leaders, we must look outside the traditional ways of funding programs. I encourage you to evaluate the example I have talked about in this article. Don’t give up easily; some ideas take time to grow and new programs take a while to catch on.
As chief officers, we’re responsible for setting the right example for those we lead. None can be more important than wellness and fitness. So don’t just talk about the importance of wellness and fitness; lead by example. It’s worth a lot more than the pound of advice you will ever give.
Gene Prince is the fire chief for the City of Gainesville (Fla.) Fire Rescue. He's a member of the Safety, Health and Survival Section.