Case Study
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Headquarters
Kerrville, TX
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Number of Employees
76,000
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Industry
Retail Trade
H-E-B Emphasizes Health for Partners and Communities
H-E-B is a large employer in Texas that offers a full spectrum of employee benefits, from health promotion to health care plans to disability coverage. Like many large employers, H-E-B has a benefit team that carefully evaluates and manages the company’s health care and disability costs. What makes H-E-B stand out is how and why the company organizes its efforts. Representatives from H-E-B’s team work together strategically to build a culture of health within each of the company’s many locations for the benefit of employees (called Partners), families, and communities — because it’s the right thing to do.
H-E-B emphasizes organizational effectiveness and involves employees in recognizing operational problems early and maximizing operational processes. When Partners see problems, leaders want to hear about them, and Partners are typically involved in fixing them. The continuity of this distinctive work culture involves carefully crafted communications, as well as programs, benefits, and training that emphasize total health and well-being. Cross-functional teams help ensure that the approach is coordinated.
Training and Communication
Many of H-E-B’s frontline and top leaders have attended a 2½-day leadership development course called “The Power of Full Engagement.” The program, provided by the firm Corporate Athlete, emphasized overall fitness, health, energy, and engagement (referring to high levels of involvement with and commitment to work) to help participants develop the high levels of physical and emotional health needed for the high productivity demands that retail companies face.
All H-E-B frontline and senior leaders were also involved in a training program called “Fit to Lead,” where they learned about company-specific health risks, costs of chronic conditions, program feedback from Partners, and detailed information about their own health risks. The Cooper Institute facilitated the program, but members of H-E-B’s Benefits Team and Partner Communications and Culture Team taught the H-E-B-specific sections. An important aspect of the meeting is “the big ask”: “Are you fit to lead the organization, as well as ensure the physical health and mental well-being of your Partners?”
Partners at all levels are paid to attend “Because People Matter” meetings, which cover the company’s finances and other topics of interest to Partners. The Partner Communications and Culture Team has developed a facilitator’s guide for store managers to use in conducting local meetings. At one session this year, for example, EAP program brochures and magnets were distributed and discussed at meetings in all locations. The meetings help to reduce confusion and reinforce appropriate use of benefits.
Wellness Program Growth Includes Communities
The company’s wellness program, Healthy at H-E-B, “is based on three pillars,” shares the program’s manager, Erica Strauss. “These include 1) food, 2) body, and 3) life.” When she was interviewing for the position, Strauss inquired about the goal of the program. Hearing that the goal was to improve the lives of H-E-B Partners and all Texans, she was pleased to be a part of the movement.
Healthy at H-E-B Program Components:
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Health risk appraisal
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Individual follow-up education and referral
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Broad-based Health Challenges to engage participation in health behavior changes
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Healthy Points — incentive rewards for healthy actions
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Wellness Champions — ambassador/ communicators at each location
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Healthy Heroes — positive peer role models who inspire and mentor other Partners
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Regional dietitians who assist Partners and customers in improving overall nutritional knowledge, including how to cook balanced meals
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Corporate Wellness Coach who visits worksites across the company to teach exercise and strategies for eating healthy at work and home
Health challenges, which encourage Partners to focus on health, are planned by the Benefits and Partner Communications and Culture Teams and communicated by senior leaders and store leaders. Two or three different health topics are covered each year. For example, the “Just Breathe” health challenge included a 6-week informational program that defined stress and described the physical symptoms and effects of excessive stress. Information was also provided on coping strategies, yoga, breathing techniques, and sleep strategies. More than 1,000 Partners joined in. Through the use of a comprehensive website and communication plan, H-E-B has been able to educate Partners and significantly increase program participation each year.
The continued growth is attributed to many things, yet one of the most powerful recruitment “tools” has been the network of nearly 600 volunteer Wellness Champions. Wellness Champions are the ambassadors for Healthy at H-E-B. They are Partners who are encouraged to:
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Create excitement about the wellness program
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Share information about health and wellness
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Announce key events.
The wellness program includes a health risk appraisal to assess employees’ lifestyles and risk factors, as well as follow-up education sent directly to Partners’ homes. H-E-B recently selected a new health promotion vendor, Live Healthier, to help the Benefits Team tailor their approach and better support healthy lifestyles. The team wanted a new strategy that goes beyond program participation to engage Partners and their families more actively in improving their health. H-E-B’s wellness program previously rewarded Partners with a reduction in health plan premiums for completing a health risk appraisal and participating in web-based seminars related to their health risks. Many people waited, however, until the end of the year to squeeze in completion of the online educational requirements, and they were not necessarily making a concerted effort at behavioral change. In addition, Partners who were already practicing healthy habits and had low health risks were not feeling rewarded. Moving forward, H-E-B will continue to provide incentives to Partners through a premium reduction, but it will also reward Partners for taking action and achieving healthy outcomes.
“It’s a new age for health and wellness,” says Strauss. “We are doing things that are more engaging, more face-to-face, not just providing online information.” Next year H-E-B will launch a company-wide Well Worksite campaign and a Diabetes Management program, pilot a Partner-centered onsite wellness clinic, promote effective medication therapy management, and launch new online and mobile tools to help make wellness fun. The company will also continue to leverage the Wellness Champions, who are very effective at recruiting participation, and Healthy Heroes, Partners who have completed and sustained a major behavior change.
To plan and promote the wellness strategy, the Health and Benefits Team works closely with the Partner Communications and Culture Team to drive healthy workplace cultures and increase the visibility of senior leaders who are involved. These cross-functional teams meet regularly, from weekly to monthly, to design strategies and work with their vendors to execute and coordinate activities. A recently revised program logo was used in a brand launch to emphasize both Partner and customer wellbeing. Activities in H-E-B stores complement the good-health message and may include new product development, labeling systems, and food tastings that promote healthy eating, as well as pharmacy screenings and flu shots. One store leader sponsored a jumping jack contest to highlight physical activity.
An exercise-related health challenge, called “Ready, Set, Go!,” included information for setting up running and walking groups. Wellness Champions organized more than 160 groups across Texas, and regional human resources teams worked with the Champions to organize 5K walks in 26 locations across the state so that Partners could walk together. More than 10,000 Partners participated in this challenge. Increasing evidence suggests exercise is an effective treatment for depression, as well as an adjunct to enhance effectiveness of antidepressant treatment (Blumenthal, 2008; Toups et al., 2011). In addition, combining health risk appraisals with education and healthy cultural and managerial support is reported to be more effective than health risk appraisals or educational programs alone (Goetzel & Pronk, 2010).
Behavioral Health Treatment and Disability Management
H-E-B recognizes that despite their best efforts in prevention and health promotion, some Partners will need behavioral health treatment and support in managing disabilities. Tammy Schoenert, H-E-B’s benefits manager, says the company moved to full parity of mental health benefits prior to the 2008 legislation requiring it because providing mental health care at a level equivalent to medical care fit well with the H-E-B corporate culture of “the right thing to do.” Costs and access to treatment have not been affected by the move. H-E-B’s total health care costs remained favorable, compared to companies against whom H-E-B benchmarks, with the company’s 2011 fiscal year trend being far below the typical trend.
The Benefits Team modified H-E-B’s disability management approach in recent years to encourage appropriate treatment and prompt return to work. EAP/behavioral health now initiates active outreach, typically within three days, for all disability claims regardless of diagnosis. Disability claims for medical issues where mental illness is the primary diagnosis are paid only if care is accessed through an appropriate EAP/behavioral health specialist. Otherwise, the disability plan will pay claims only for the first two weeks.
Results are favorable in short-term disability and long-term disability benchmarking, with duration decreasing significantly in 2011 due to the employee assistance program’s outreach. For example:
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Overall average duration for all diagnoses was 33.1 days for those who utilized EAP (versus 41.2 days for those who did not)
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Average duration for all mental health disability claims declined 37% since implementation of the program
These outcomes suggest to Shoenert that “. . . Partners are getting back to being productive in their lives sooner — and they have a better chance of increasing their overall health and resiliency — with a little help from EAP and behavioral health services.”
H-E-B also recently piloted providing onsite EAP services to Partners and managers at three of their grocery stores. The store directors and assistant store directors report they are spending less time trying to help Partners with personal issues and have more time to focus on their own work. In one store, a Partner who was previously very disruptive and caused problems in the store received help from EAP, and showed marked improvement in job performance. This Partner is now receiving positive praise and recognition for effective work. Partners report that having an onsite specialist available to them shows that H-E-B cares for their wellbeing, and Partners appreciate the company’s effort to help them.
Making Changes for the Long Term
H-E-B is addressing health improvement by building supportive workplace cultures and by offering a wide variety of programs and benefits to its employee Partners. Bringing health enhancements to the local communities where their Partners live and work is a good fit with the company’s goal of making lives better.
About H-E-B
H-E-B was founded in Kerrville, Texas, in 1905 with a single grocery store. For more than 100 years, H-E-B has been an innovative retailer known for low prices, fresh food, and high-quality products. The company has grown to more than 335 stores in Texas and Mexico with more than 76,000 employees who are referred to as “Partners.” H-E-B conducts a wide range of efforts geared toward helping the community and the environment.
Nancy Spangler, PhD, OTR/L, president of Spangler Associates, Inc., and consultant to the Partnership for Workplace Mental Health, is a prevention and health management specialist in the Kansas City, Missouri area.
Last Updated: January 2012
References
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Blumenthal, J. A. (2008). Depression and coronary heart disease: association and implications for treatment. Cleveland Clinic Journal of Medicine, 75(Suppl 2), S48–S53.
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Goetzel, R. Z., & Pronk, N. P. (2010). Worksite health promotion: how much do we really know about what works? American Journal of Preventive Medicine, 38(2 Suppl), S223–S225. doi: 10.1016/j.amepre.2009.10.032
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Toups, M. S., Greer, T. L., Kurian, B. T., Grannemann, B. D., Carmody, T. J., Huebinger, R., . . . Trivedi, M. H. (2011). Effects of serum Brain Derived Neurotrophic Factor on exercise augmentation treatment of depression. Journal of Psychiatric Research, 45(10), 1301–1306. doi: 10.1016/j.jpsychires.2011.05.002