Employee and Community Wellness Programs in Austin, Texas


The city of Austin, Texas, has instituted a series of programs designed to improve the health and wellness of city employees, retirees, and the residents of Austin and Travis County. The primary elements of Austin’s comprehensive program are:

1) Steps to a Healthier Austin
2) Health Plus
3) Value Based Benefits Design

Steps to a Healthier Austin

Steps to a Healthier Austin is an $8 million, five-year program funded by the Centers for Disease Control and Prevention designed to help Austin citizens live healthier lives by reducing rates of diabetes, overweight, obesity, and asthma by addressing three related risk factors — physical inactivity, poor nutrition, and tobacco use.

Created by the Austin/Travis County Health and Human Services Department, Steps relies on an innovative outreach campaign entitled, “iThrive Austin.” This campaign involves a website, as well as television, print, radio, and billboard advertising. The Steps program focuses on employers and employees at their work sites, low income children, schools, business and political leaders, and others.

Partnership with Capital Metropolitan Transportation Authority

As part of its worksite efforts, the Austin/Travis County Health and Human Services Department partnered with the Capital Metropolitan Transportation Authority, Austin’s public transit agency, to design a worksite wellness program. Building on management’s desire to improve the health and wellness of its employees, half of whom are bus operators, Steps provided support and guidance for programs in which approximately 25 percent of the Capital Metro workforce participate. Specific initiatives include:

  • Opening and operating two on-site 24-hour fitness centers with free personal training and health
    assessments and nominal membership fees.
  • Cash incentives of up to $250 annually for achieving quantifiable health milestones, such as
    blood pressure reduction, weight loss, smoking cessation, and others.
  • Improved access to healthy food in the employee café and coupons for purchases of
    healthy food options.
  • Education and outreach events, such as cooking demonstrations, wellness fairs, on-site Weight
    Watchers meetings, and smoking cessation programs.


A study released in April 2009 found that Capital Metro’s employee health care costs were reduced dramatically as a result of this program.

  • Starting in 2003 when the wellness program was launched, until 2006, Capital Metro’s
    health care costs continued to increase each year, but at smaller rates each succeeding year and far below the national average.
  • In 2007, when participation in the program grew dramatically, Capital Metro saw a 4 percent
    decrease in total health care costs.
  • Similarly, rates of absenteeism among bus drivers remained stable at approximately 10 percent from 2001 through 2005. Rates declined to 8.2 percent in 2006
    and declined again to 7.6 percent in 2007, which represented a total savings of $450,000 compared with the cost of the 10.1 percent
    absenteeism rate in 2004.

These savings represent a return of investment of $2.43 for each dollar invested in the program.

Health Plus

Health Plus is an active employee and retiree wellness program launched in the city of Austin in 1994 to build a workforce community committed to total well being. Specific elements of Health Plus include:

  • HealthCheck—a one-stop wellness screening service that includes blood screening, bone
    density screening, blood pressure, body mass index, and other factors.
  • FitCheck—a fitness screening focused on cardiovascular fitness, endurance, flexibility,
    and other fitness factors.
  • Smoking Cessation programs.
  • Group exercise programs in yoga, pilates, tai chi, and other classes offered by local studios at
    reduced costs.
  • Farm to Work—locally grown fresh produce ordered by employees and delivered to worksites.
  • The Mayor’s Fitness Council—A physical fitness initiative for employees
    providing opportunities for coaching and organized walking, cycling, jogging, and swimming groups.

Like the Capital Metro initiative, Health Plus has been recognized for its health and wellness benefits. According to Rick Schwertfeger, director of the Austin/Travis County Health and Human Services Department, “Both the Capital Metro and Health Plus initiatives have increased employee well being. Managers report improvements in morale and reduced absenteeism.”

Value-Based Benefits Design

The city of Austin is a leader in value-based benefits design to promote positive employee and retiree health outcomes.

Value-based benefits design adjusts patient costs so that treatments with proven positive clinical outcomes become less costly to patients and cost sharing increases for treatments with little or no proven benefit.

As a result, employees and retirees have the incentive to obtain treatments with high probabilities of providing positive health outcomes.

For example, blood sugar monitoring for diabetics and blood pressure medications for patients with hypertension are critical to managing and preventing complications from these chronic diseases. Screening, prevention, chronic disease management, fitness support and smoking cessation have proven to provide dramatic health impacts as well as health care cost savings to the city.

Rick Schwertfeger, MAT
Health Program Manager
Austin/Travis County Health & Human Services
[email protected]

Kristy Hansen, M.Ed., CHES
Wellness Consultant
City of Austin – HealthPLUS Wellness Program
[email protected]

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