When health care costs for city employees skyrocketed, Lewiston looked to an old aphorism — “an ounce of prevention is worth a pound of cure” — to find an innovative approach.

In 2005, Lewiston, ME, (pop. 36,299) decided to shift its emphasis with its employees from disease management to prevention. It developed a program to assess the health risk behaviors of employees and their spouses, educate them about the consequences of their decisions, motivate them to address their at-risk behaviors, and support them in setting reasonable, sustainable goals of enhanced good health.

The program also offered an incentive: as much as a 15 percent discount on health insurance premiums for participants.

It worked.

• Between 2006 and 2008, the city’s health care premiums fell by $736,757 thanks to decreased use of health care resources and absenteeism and increased productivity.
• Sick time use decreased from 8.18 days in 2006 to 6.75 days in 2007.
• Forty-two percent of municipal employees reported they increased physical activity in the program’s first year.
• Since the start of the program, more than half of the city’s employees lost a total of 3,364 pounds.

Word of Lewiston’s successful program spread beyond the public sector. “We have been benchmarking the city of Lewiston for their innovative health and wellness programs for the past several years,” said Susan Tufts, wellness manager of outdoors outfitter L.L. Bean, which is based near Lewiston. “I am amazed at the quality and comprehensiveness of their health care strategy. They are truly a shining example of what we are all trying to achieve!”