LM in the Workplace QSG

QUICK START GUIDE

A PRACTICAL IMPLEMENTATION GUIDE FOR EMPLOYER LEADERS AND CLINICIANS

A Guide to Bringing Lifestyle Medicine into Workplaces An ACLM & ACOEM Collaboration From the American College of Lifestyle Medicine (ACLM) and American College of Occupational and Environmental Medicine (ACOEM) LIFESTYLEMEDICINE.ORG | ACOEM.ORG

Authors Manijeh Berenji, MD, MPH, FACOEM, FACPM

Muhammad Asif, MBBS, MPH, FACOEM, DoccMed

Health Sciences Associate Clinical Professor, University of California Irvine School of Medicine and the Joe C Wen School of Population and Public Health

Saudi Aramco ExxonMobil Refinery, Ltd Marina Mathew, MD, MPH, FACOEM, DipABLM

A Society for Total Worker Health® Founding Member

Occidental Petroleum Corporation Beth Garver, MS

Robert McLellan, MD, MPH, FAAFP, FACOEM

Lifestyle Medicine and Community Health Center Consultant

Professor Emeritus, Medicine, Community and Family Medicine, and The Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine at Dartmouth

Divya Hedgren, MD, DipABLM Adult & Geriatric Psychiatrist

A Society for Total Worker Health® Founding Member

Nathan M. Jones, MD, MPH, FACOEM DipABLM Occupational Medicine Physician

Connie Chuang, MD, MPA, MPH, MSc, DipABLM, NBC-HWC

Board of Directors, Health and Human Performance Section, ACOEM

Health Life Work Medical Care, LLC

Lifestyle Medicine in the Workplace, ACLM Marielle Borom, DO Martha Shepherd, DO, MPH, FAAFP, DipABLM, FACLM

Annemieke De Wilde, MD, MPH, FACOEM, DipABLM

Vanderbilt University Medical Center

Optimizing Worker Health, ACOEM Valeria S. Tivnan, MPH, Med Vice-President of Population Health Strategy & Well-being, IMA Financial Corp.

Samuel Ko, MD, MPH Optimizing Worker Health, ACOEM

Acknowledgement: The authors wish to thank Nathan Jones, MD, MPH, the ACOEM - ACLM Board Liaison, for guidance and consultation, George Friedman-Jimenez, MD, DrPH for review and edits, and Alyssa Schultz, PhD for editing and document preparation.

© 2026 American College of Lifestyle Medicine. All rights reserved.

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How to Use This Quick Start Guide This guide is for employer leaders, benefits executives, occupational and environmental medicine clinicians, and practicing lifestyle medicine clinicians. It is designed to be deployable, not conceptual.

The guide provides:

CLEAR RECOMMENDATIONS

BEST PRACTICES GROUNDED IN EVIDENCE

PRACTICAL FRAMEWORKS

AN IMPLEMENTATION ROADMAP

TOOLS AND RESOURCES

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Table of Contents

Executive Rationale

page 5

The Employer as Agent of Change: Core Framework

page 8

Defining Lifestyle Medicine in the Workplace

page 11

Implementing a Lifestyle Medicine-grounded Organizational Health Strategy

page 17

Keys to Success

page 29

Case Spotlights

page 33

Call to Action for Employer Leaders

page 36

Resources

page 38

Appendices

page 40

References

page 47

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Executive Rationale

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Why Lifestyle Medicine is important to organizational success Lifestyle Medicine is a foundational framework for high-value care, prioritizing therapeutic interventions in six core domains—nutrition, physical activity, sleep, stress management, social connection, and substance avoidance— to treat and reverse the root causes of chronic disease. In a landscape where the federal health care spending is projected to cost $23.6 trillion between 2026 and 2035, the shift from a reactive “sick care” model to a proactive health ecosystem is a requirement for employer sustainability.1 With 80% of chronic disease burden and premature deaths rooted in modifiable lifestyle behaviors, employers can no longer afford to be passive payers in an unsustainable fee-for-service system.2

Employers are uniquely positioned to accelerate worker (and dependent) health through lifestyle medicine in the workplace by shaping:

80%

9 Health benefits and

of chronic disease burden and premature deaths rooted in modifiable lifestyle behaviors2

reimbursement pathways 9 Work conditions and organizational culture 9 Access to clinicians, programs, and environments

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LIFESTYLE MEDICINE

RESTORATIVE SLEEP

STRESS MANAGEMENT

OPTIMAL NUTRITION

PHYSICAL ACTIVITY

AVOIDANCE OF CONNECTEDNESS RISKY SUBSTANCES

Key Business Drivers 1

Chronic disease accounts for the majority of healthcare spending and productivity loss1

2

Physical health conditions and mental health challenges undermine worker health, safety, and organizational performance.

3

Employers directly influence social, environmental, and economic determinants of health

KEY DISTINCTION: Lifestyle medicine is no longer an adjunct wellness strategy.

It is a clinical, organizational, and financial imperative.

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The Employer as Agent of Change: Core Framework 8

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The Employer as Agent of Change Employers have a unique opportunity to

GUIDING PRINCIPLES

accelerate the adoption of lifestyle medicine through a Total Worker Health lens by implementing supportive workplace policies,

Equity-centered, whole-person health

practices, and programs. By expanding access to lifestyle medicine and primary care providers, they can enable employees to engage in health effective condition management. Employers can

Lifestyle medicine as a continuum

also interact with and exert influence on other

(prevention → treatment → remission)

promotion, screening, early detection, and

spheres within their ecosystem to affect whole health as depicted on the next page in Figure 1.

Integration with Occupational and Environmental Medicine and Total Worker Health®

ADAPATED FROM:

Team-based, multidisciplinary care Evidence-informed program selection Business value beyond ROI alone (Value of Investment)

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FIGURE 1 Employers Can Play Important Role in Advancing Lifestyle as Medicine

Reproduced from HERO, Grants, https://hero-health.org/research/grants/3

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Defining Lifestyle Medicine in the Workplace 11

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Defining Lifestyle Medicine in the Workplace

Occupational and Environmental Medicine (OEM) is the medical specialty trained to optimize the health of workers and prevent/ mitigate the health effects from hazardous

Lifestyle medicine is an evidence-based

occupational and environmental exposures.

clinical discipline that uses therapeutic lifestyle

Figure 2 highlights the alignment between

interventions as first-line treatment to prevent,

lifestyle medicine and occupational and

treat, and often reverse chronic disease.

environmental medicine.

FIGURE 2 Shared Principles of Lifestyle Medicine and Occupational and Environmental Medicine

WORKPLACE SAFETY ERGONOMICS OPTIMAL NUTRITION

EXPOSURE CONTROL

PREVENTION

PHYSICAL ACTIVITY

WELLBEING

INJURY PREVENTION

RESTORATIVE SLEEP

SAFETY

RETURN-TO-WORK

CONNECTEDNESS

HEALTH

CHRONIC DISEASE MANAGEMENT

AVOIDANCE OF RISKY SUBSTANCES STRESS MANAGEMENT

PRODUCTIVITY PSYCHOLOGICAL WELL-BEING

MENTAL HEALTH POPULATION HEALTH MANAGEMENT

ILLNESS/INJURY TREATMENT

LIFESTYLE MEDICINE

OCCUPATIONAL AND ENVIRONMENTAL MEDICINE

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Frameworks

FIGURE 3

Integrating lifestyle medicine within a Total

The CPH-NEW Total Worker Health model of integration

Worker Health® (TWH) framework (see Figure 3) offers employers a strategic, evidencebased pathway to create healthier, safer, and more resilient organizations.4 When leadership commitment, hazard elimination, worker engagement, confidentiality, and systems integration are aligned, workplace health initiatives move beyond isolated programs to become embedded components of organizational culture.

ACLM’s High-Value Care Framework (see Figure 4) closely aligns with the TWH (see Figure 5) approach by integrating whole-person health, team-based care, and system-level influences across the continuum of prevention, treatment, and remission. It reflects how worker health is shaped not only by clinical care, but also by workplace conditions, community environments, and organizational culture, reinforcing that

Reproduced from Punnett L, Cavallari JM, Henning RA, et al. Defining “Integration” for Total Worker Health®: A New Proposal. Ann Work Expo Health. 2020;64(3):223–235. doi:10.1093/ annweh/wxaa003. © 2020 The Authors. Used under CC BY-NC 4.4

optimal outcomes require coordinated strategies that address physical, mental, and social wellbeing both on and off the job.4

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FIGURE 4 Lifestyle medicine high-value care framework

Adapted from Marshall S, Patel P, Anand R, et al. Lifestyle Medicine as a Framework for High-Value Care: A Position Statement From the American College of Lifestyle Medicine. Am J Lifestyle Med. 2025. doi:10.1177/15598276251390437. © 2025 The Author(s).5

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FIGURE 5 Hierarchy of Controls Applied to NIOSH Total Worker Health®

Reproduced from the National Institute for Occupational Safety and Health (NIOSH), Centers for Disease Control and Prevention. May 24, 2024. https://www.cdc.gov/niosh/twh/php/hierarchy/index.html6

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The Six Pillars of Lifestyle Medicine in the Workplace

KEY DISTINCTION: Lifestyle medicine is clinical and prescriptive, not voluntary wellness programming.

Employers can operationalize this by embedding the six pillars of lifestyle medicine which are evidence based, therapeutic lifestyle interventions used to prevent, manage, and reverse chronic diseases. These core components include: nutrition, physical activity, sleep, stress management, social connection, and avoidance of risky substances.

WORKPLACE-RELEVANT APPLICATIONS OPTIMAL NUTRITION

PHYSICAL ACTIVITY

9 Healthy food procurement

9 Work design

9 Cafeterias

9 Movement breaks

9 Vending

9 On-site/near-site fitness

9 Food as Medicine benefits

RESTORATIVE SLEEP

STRESS MANAGEMENT

9 Shift design

9 Psychological safety

9 Fatigue mitigation

9 Workload design

9 Recovery-supportive policies

9 Leadership behavior to eliminate work psychosocial risk factors

CONNECTEDNESS

AVOIDANCE OF RISKY SUBSTANCES

9 Reporting structure

9 Tobacco-free worksites

9 Peer support

9 Substance-use support as medical care

9 Belonging and inclusion

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Implementing a Lifestyle Medicine-grounded Organizational Health Strategy 17

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Implementing a Lifestyle Medicine-grounded Organizational Health Strategy The CDC Workplace Health Model provides a

IMPLEMENTATION ROADMAP (12–36 MONTHS)

framework for implementation that includes assessment, planning and management, implementation, and evaluation, emphasizing

Phase 1: Assess & Align (0–6 months)

how organizational, individual, and community factors shape outcomes like productivity, costs, and overall health.7 Aligned with this

9 Organizational readiness assessment

framework, the following 12–36-month

9 Workforce health and claims analysis

implementation roadmap can be used to deploy

9 Leadership commitment

your lifestyle medicine-grounded organizational health strategy. The roadmap begins with

Phase 2: Build & Pilot (6–18 months)

assessing readiness, analyzing workforce (+/- dependents) health data, and securing leadership commitment; progresses to building

9 Determine lifestyle medicine-

and piloting a tailored lifestyle medicine-

grounded health strategy that best

grounded organizational health strategy with

meets organization’s needs

defined metrics; and culminates in scaling and

9 Select one condition or population

institutionalizing efforts by embedding them

9 Launch on-site, virtual,

into policies, expanding benefits, and sustaining

or contracted model

impact through broader partnerships.

9 Establish metrics and scorecards/ dashboards

Phase 3: Scale & Institutionalize (18–36 months) 9 Embed lifestyle medicine and occupational and environmental medicine principles into organizational policies, programs, and performance evaluations 9 Expand benefit coverage 9 Join values-aligned consortiums to leverage aggregated demand, vendor standardization, and negotiated value

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FIGURE 6 Workplace Health Model

Reproduced from the Centers for Disease Control and Prevention (CDC). CDC Workplace Health Model.

Published July 15, 2024. https://www.cdc.gov/workplace-health-promotion/php/model/index.htm7

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PHASE 1: ASSESS & ALIGN

Assess & Align Conduct an organizational assessment to determine worker health needs and organizational readiness. The table below provides a comparison of workplace assessment tools. See Appendix A for an organizational readiness checklist.

TOOL

FOCUS

ITEMS

American Heart Association (AHA) Well-Being Works Better™ Scorecard

Organizational

CDC Worksite Health Scorecard

Health Promotion

Healthy Work Survey (HWS)

Psychosocial Hazards;

96

Well-being Practices

FEATURES Online; Organizational assessment rather than for individuals; Recognition-based tiering (Bronze-Platinum)

154

Programs

Online/Manual; Comprehensive coverage of chronic disease

55

Health, Safety,

Online; Free; Employer guide available

Job-related metrics

HERO Scorecard

Organizational

67

Wellness Programs

Online; Can repeat annually and track longitudinally; can work with vendor to develop strategic plan based on results

Mayo Clinic Well-Being Index

Distress / Well-being

~9

Online; Very brief; Dual use: individual respondents receive immediate feedback and organizations can collect deidentified data in aggregate

NIOSH Worker Wellbeing Questionnaire (WellBQ)

Total Worker

126 + optional

Well-being

20

Online; Free; Measures multiple domains with validated scales

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PHASE 2: BUILD & PILOT

Build & Pilot Strategies STRATEGY 1 OF 4: Employer-Supported Lifestyle Medicine Benefits WHAT THIS LOOKS LIKE 9 Lifestyle medicine delivered as a covered clinical service integrated into OEM clinical practice and employee health clinics (See Appendix B) 9 Equal standing with pharmacologic and procedural care

BENEFIT DESIGN BEST PRACTICES

SAMPLE BENEFIT LANGUAGE

9 Cover lifestyle medicine visits (in-person

“Therapeutic lifestyle interventions delivered by lifestyle medicine-certified clinicians shall be covered as a first-line treatment option for cardiometabolic conditions.”

and virtual) 9 Reimburse group visits, registered dietitians, health coaches, and other lifestyle medicine clinicians who support six lifestyle medicine pillars (e.g. exercise physiologists, counselors, etc.)

9 Cover intensive therapeutic lifestyle programs for cardiometabolic disease 9 Cover family-based lifestyle medicine

RECOMMENDATION:

programming for healthy lifestyles

Cover lifestyle medicine before disease thresholds are met, not only after diagnosis.

9 Remove unnecessary prior authorization barriers

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PHASE 2: BUILD & PILOT

STRATEGY 2 OF 4: On-Site or Near-Site Lifestyle Medicine Clinics USE CASE 9 Self-insured employers 9 Large employers or multi-site organizations 9 Employers with safety-sensitive workforces

CORE CLINIC COMPONENTS

CASE STUDY

1. Clinical Team: Physician or Advanced

Caramel Clary Schools Wellness Center

Practice Provider (APP) with lifestyle medicine certification or training (e.g., Nurse practitioner (NP) or Physician associate (PA)); Registered dietitian (RD); health coach.

2. Care Model: Individual + shared medical appointments

Lifestyle Medicine INTEGRATION ROADMAP PURPOSE: A guide to support the integration of lifestyle medicine (LM) within a variety of clinical scenarios, as it pertains to three domains including Workforce Development, Clinical Transformation, and Organizational Alignment & Innovation.

3. Data: Claims integration, risk stratification 4. Access: Work-time appointments

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ACLM INTEGRATION ROADMAP

IMPLEMENTATION TIP: Start with one high-impact condition (e.g., hypertension, diabetes, obesity) before expanding. A model of conditionagnostic shared medical appointments can also be adopted.

Use as a guide to establish an on-site lifestyle medicine clinic.

Download

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PHASE 2: BUILD & PILOT

STRATEGY 3 OF 4: Direct Contracting with Lifestyle Medicine Providers WHAT IS DIRECT CONTRACTING? Employer contracts directly with: 1. Lifestyle medicine practices/providers 2. Certified programs

STRATEGY 4 OF 4:

3. Health systems delivering therapeutic

Expanding Provider Networks & Purchasing Collectively

lifestyle change

INCREASING LIFESTYLE MEDICINE IN

ADVANTAGES 9 Predictable costs

HEALTH PLAN NETWORKS

9 Alignment with outcomes

1. Require identification and categorization of lifestyle medicine-certified providers to

9 Elimination of fee-for-service constraints

streamline billing, verify coverage eligibility, and manage network status (i.e. carrier tagging)

CONTRACTING BEST PRACTICES 9 Vet potential partners (See Appendix C)

2. Set year-over-year targets for network expansion (See Appendix D)

9 Bundle services around conditions, not visits 9 Include remission-oriented outcomes

3. Include lifestyle medicine providers in

9 Provide shared savings reinvestment

preferred tiers

CONSORTIUM & GROUP PURCHASING ORGANIZATION (GPO) PARTICIPATION

EXAMPLE BUNDLED EPISODE

Ideal for small and mid-sized employers

12-month diabetes remission pathway

Benefits include: 9 Cost-sharing 9 Vendor vetting 9 Market signal amplification 23

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PHASE 2: BUILD & PILOT

Choosing Optimal Partners to Launch Lifestyle Medicine-grounded health strategy PARTNER SELECTION DECISION MATRIX:

KEY DECISION QUESTIONS:

Identifying the optimal partners to implement a

the leadership team/decision-making body

TWH/lifestyle medicine workplace intervention is

should consider these five questions:

To determine the optimal mix,

a strategic decision that can determine whether 1. Do we have internal expertise in

an initiative integrates smoothly into operations or remains fragmented and short-lived. Partner

implementation science and workplace/

selection should be guided not only by technical

organizational systems?

expertise, but by alignment with organizational

2. Do we need to focus on designing the

structure, culture, data capacity, and long-term

strategy and framework, or on executing

strategic goals. Selecting between internal

and delivering the solution in practice?

experts, external consultants, or third-party

3. Should this initiative begin as a small-scale

vendors to implement a lifestyle medicine-

pilot to test and refine the approach,

grounded health program is fundamentally a

or are we ready to deploy it across the

question of capacity, control, complexity, and

entire organization?

long-term institutional goals. Each model serves a distinct function. The decision should be based

4. What level of complexity is involved in

on implementation needs. The decision matrix

integrating this data across our systems

below highlights the effectiveness level of each

and workflows?

partner type based on various organizational

5. Is long-term organizational integration

factor and can be used to determine which

a priority?

partner type would be best suited to assist with achieving a particular organizational goal.

FACTOR

INTERNAL EXPERTS CONSULTANT

VENDOR

Governance Design

Moderate

Strong

Limited

Strategic Planning

Moderate

Strong

Limited

Operational Delivery

Variable

Limited

Strong

Cultural Alignment

Strong

Moderate

Variable

Data Integration

Strong

Advisory

Variable

Scalability

Moderate

Limited

Strong

Long-Term Sustainability

Strong

Advisory

Variable

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PHASE 2: BUILD & PILOT

Measurement Framework: What to Track ORGANIZATIONAL METRICS FOR LIFESTYLE MEDICINE-GROUNDED HEALTH STRATEGY On average, the employers surveyed by

absenteeism, wellness program satisfaction,

Ozminkowski et al. tracked about seven metrics

health risks, job satisfaction, and safety.

on their balanced scorecard. The authors found

This table is an example of metrics that could

the most commonly tracked metrics were:

be used to evaluate financial performance.

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wellness program participation, health care costs, TYPE

METRIC

Return on Investment (ROI)

Benefits Measures:

Cost Measures:

• Reduced healthcare expenditure (e.g. medical, hospitalization, medication use, worker’s compensation • Increased service/product output (productivity metric)

• $ invested into a lifestyle medicine intervention (e.g. smoking cessation program, nutrition education targeted to diabetes/ high cholesterol, functional strength training program; weight loss management targeted to obesity) • $ invested into a chronic condition intervention (e.g. Type 2 Diabetes Remission Program • ROI = (Net Benefit / Cost) * 100% • Follow year-over-year trend

Social Return on Investment / Value of Investment (VOI)

• Productivity • Duration of or quantity of disability claims • Sick days • Business performance metrics • Company profitability

• Presenteeism • Long-term medical restrictions for chronic diseases • Employee retention or turnover • Greenhouse gas emissions • Food or nutrition security

Medical Cost Savings

• Absolute cost reduction per participant per year • Percentage decrease in total medical expenditures • Longitudinal cost trends postintervention

• Workers’ Compensation Claims Cost Savings • Disease reversal (to be added in ICD coding) • Examples9,10

Benefit-to-Cost Ratio (BCR)

(BCR) = Total benefits of reduced healthcare expenditures or productivity gains / Unit of investment in a lifestyle medicine intervention

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PHASE 2: BUILD & PILOT

ROI goals can effectively demonstrate the value of workplace lifestyle interventions by utilizing company-specific baseline data, measurable outcome variables, and practical interventions tailored to individual corporate resources.

Value of Investment (VOI) is often a better choice for measuring ROI. Ozminkowski et al., offer recommended metrics, a method to prioritize metrics, and how to tell the VOI story.8

SPECIFICALLY, EMPLOYERS CAN:

1

Clearly state the reasons why they are offering lifestyle medicine interventions to their workers

2

Identify the metrics needed to support

3

Map out the source of each metric and

their lifestyle medicine rationale

RECOMMENDATION:

how it can be accessed by using:

Define the metrics that matter most to your workers and organization—such as remission rates and appropriate deprescribing. Establish your metrics before launching the pilot. Use the pilot data to demonstrate impact, build stakeholder support, and inform scaling of your workplace lifestyle medicine strategy.

9 Health plan data 9 Vendor data 9 Internal data (e.g. EHR, HR, Incident Reporting, etc.)

4

Measure the impact of lifestyle

5

Aggregate findings into a meaningful

medicine programs on their key metrics

dashboard based on their priorities

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PHASE 3: SCALE & INSTITUTIONALIZE

Creating a Culture of Health Lifestyle medicine and OEM align to improve workforce health by integrating healthy behaviors with safe, supportive workplace systems, advancing a TWH approach to create a culture of health. Organizations can use the

IMPLEMENTATION VIDEO

Hierarchy of Controls to improve worker health by eliminating or substituting harmful conditions,

The Value of Lifestyle Medicine

redesigning environments and workflows

in Employer Settings from

through engineering and administrative controls,

Dr. Bob Chestnut.

and ultimately supporting individuals with tools such as counseling, health coaching, and lifestyle medicine interventions.6

Watch

FIVE CULTURAL ENABLERS 11 1. Visible leadership modeling 2. Healthy defaults in the work environment 3. Manager capability and accountability

QUOTE FOR LEADERS

4. Norms that support recovery and vitality 5. Trust, privacy, and psychological safety

“Culture change at work changes behavior at home.”

These five cultural enablers support workplace lifestyle medicine implementation by embedding health into leadership, environment, and daily work norms.11 Visible leadership and manager accountability reinforce healthy behaviors, while healthy defaults and recovery-supportive norms make well-being the easier and expected choice. Trust, privacy, and psychological safety ensure employees feel safe engaging in lifestyle medicine programs, increasing participation and sustained behavior change.

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PHASE 3: SCALE & INSTITUTIONALIZE

FIGURE 7 | Hierarchy of Controls With Overlay of the Lifestyle Medicine PERFORM Framework

ELIMINATION Remove the hazard entirely

SUBSTITUTION Replace with a healthier option

HIERARCHY OF CONTROLS ENGINEERING CONTROLS Redesign the workplace

ADMIN CONTROLS Change policies and practices

BEHAVIOR CHANGE Healthy and safe choices

PERFORM FRAMEWORK

P E

Physical Activity

O

Example: Make stairwells visible, accessible, attractive, and safe.

Example: Replace performance reviews to focus on growth and celebrate process goal achievement.

Eat Well Example: Healthy meals subsidized by employer at 20% below less healthy options.

R

R

Reduce/Avoid Risky Substances Example: Offer Employee Assistance Program (EAP) with rapid access to counseling and treatment referrals.

Restorative Sleep Example: Eliminate rotating shift work in favor of permanent shifts.

F

Optimize Your Attitude and Mindset

M

Form Positive Social Connections Example: Voluntary peer mentoring program pairing early-career staff with experienced employees.

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Manage Stress Example: Implement Mindfulness-Based Stress Reduction program and continually reinforce strategies.

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Keys to Success

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Clinicians Practicing Lifestyle Medicine in Employer Settings Successful clinicians practicing lifestyle medicine in employer settings prioritize access and integration by offering work-time visits, delivering team-based care through Lifestyle

KEY SUCCESS FACTORS

Medicine Shared Medical Appointments

9 Work-time visits

(LMSMAs), and systematically assessing risk using the Lifestyle Medicine Whole Person Health

9 Team-based, interprofessional care

Index (LMWPHI*). Effectiveness is strengthened

through Lifestyle Medicine Shared

by organizational literacy and documentation

Medical Appointments (LMSMAs)

aligned with benefits and claims processes,

9 Assessing for lifestyle factors using the

ensuring sustainability and reimbursement.

Lifestyle Medicine Whole Person Health

Common pitfalls to avoid include positioning

Index (LMWPHI)

services as “wellness-only,” addressing behaviors in isolation rather than comprehensively, and

9 Organizational literacy

relying on short visit lengths that limit meaningful 9 Documentation aligned with benefits

behavior change.

and claims *The LMWPHI is appropriate to incorporate as an evidence-informed tool grounded in validated domain-specific screening tools, recognizing that the composite measure continues to evolve with ongoing validation and should not yet be considered fully evidence-based.

RED FLAGS TO AVOID × “Wellness-only” positioning × Isolated behavior challenges × Short visit lengths

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Equity & Access Considerations Equity and access must be central to workplace lifestyle medicine strategies by designing benefits that work for hourly, shift, and frontline workers, not just salaried staff. Programs should incorporate culturally relevant nutrition approaches and address real-world barriers such as food access and time constraints. Ultimately, lifestyle medicine should be implemented in ways that actively reduce health inequities rather than unintentionally widening them.

RECOMMENDED STRATEGIES

Design benefits for hourly, shift, and frontline workers Provide culturally relevant nutrition approaches Address food access and time constraints

REMEMBER: Lifestyle medicine must reduce inequities, not widen them.

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Common Pitfalls and How to Avoid Them Common pitfalls in implementing workplace lifestyle medicine strategies often stem from

PITFALL

MITIGATION

low engagement, narrow financial expectations,

Low engagement

Work-time access

Short-term ROI focus

VOI framing

Vendor misalignment

Evidence and certification screening

and misaligned partners. Low engagement can be mitigated by enabling work-time access, making participation convenient and integrated into the flow of work. A short-term ROI focus should be reframed toward broader value on investment (VOI), capturing impacts on productivity, retention, and well-being over time.

Finally, vendor misalignment can be avoided by rigorously screening for evidence-based approaches and appropriate certifications to

IMPLEMENTATION TIP:

ensure quality and alignment with organizational goals.

Use an ACLM-certified education or treatment program to avoid vendor misalignment.

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Case Spotlights

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This Hotel Chain Learned That Lifestyle Medicine Leads to Low Turnover

Forty percent of our employees come from other countries. They have their own cultures, food, and beliefs—and lots of diabetes and high blood pressure. It’s not easy, but our goal is to get people healthy and off medication.

Our on-site medical facility has providers from backgrounds that match our associates. And we’re always trying to provide whatever is required to help our associates make the lifestyle changes they need: Employees can access a doctor trained to identify underlying causes of disease, a dietitian, a chefled educational program, sleep medicine, Zumba classes, mental health services—they can even take part in challenges for things like healthiest recipe. Whatever it takes.

We have the lowest employee turnover in hospitality—the average is 50% and ours is almost single digits. And I believe our benefits are a big reason, especially healthcare. We talk to a lot of senior VPs in other companies about their approach and it’s sad. The other day, an employee gave me a hug as I was walking on a property. He said he smoked two to three packs a day when he started with us, and was told it was unacceptable. He went through our in-house nicotine cessation program and hasn’t had a cigarette in two years.”

Harris Rosen Founder and President, Rosen Hotels & Resorts

Kenneth Aldridge Jr. Direct of Health Services, Rosen Medical Center

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At Maryland’s Largest Private Employer, Lifestyle Medicine Is a Way of Work

Workplace impacts well-being, so we owe it to employees to create an environment that supports making healthy decisions. One way to do that is by integrating CDC worksite health score results into executive performance reviews. That way we understand how each area of our organization is performing and we bring accountability to that performance. Another approach is to ensure that the healthiest choices at work are the easiest choices. For example, all our snack machines include healthier choices, and we offer healthy foods in our cafeterias. We’ve created walking paths, to encourage physical activity, and we’ve added more lactation rooms to make breastfeeding easier. We’re also constantly learning. After discovering that 75% of our employees experience stress, our most recent five-year strategic plan included a focus on making work life less stressful. Our research has led to widely used Medicare- and Medicaid-reimbursed lifestyle-management programs that can prevent the onset of diabetes and eliminate the need for hypertension medication. The decisions we make today as leaders will impact our organization for generations to come and, ultimately, the health and wellness of our community. Lifestyle medicine helps us connect the dots and make decisions with a bigpicture, long-term view.

Kevin Sowers President, Johns Hopkins Health System

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Call to Action for Employer Leaders 36

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Call to Action for Employer Leaders Integrating lifestyle medicine as a workplace benefit transforms the employee health ecosystem from reactive sick care to proactive health creation. Employers, clinicians, and systems must act together.

REMEMBER: Lifestyle medicine is a strategic asset, not a perk.

Employers who act now will:

Improve health outcomes

Stabilize costs

Recruit and retain top talent

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Strengthen workforce performance

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Resources

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LM in the Workplace Resources RESEARCH Lifestyle Medicine High-Value Care Framework Lifestyle Medicine Performance Measures Employers as Lifestyle Medicine Change Agents Framework

ARTICLES The Economic Benefits of Lifestyle Medicine Incorporating Lifestyle Medicine into Occupational Medicine Practice

TOOLS Lifestyle Medicine Integration Roadmap Lifestyle Medicine Whole Person Health Index (LMWPHI) Lifestyle Medicine Shared Medical Appointment Toolkit (LMSMA)

EDUCATION ACLM-Certified Treatment and Education Programs Lifestyle Medicine Board Certification for Onsite Clinicians

COMMUNITY Lifestyle Medicine in the Workplace Member Interest Group (MIG) ACOEM Optimizing Worker Health Section

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Appendices

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APPENDIX A

Organizational Readiness Checklist

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CHECKLIST

Organizational Readiness Does senior leadership prioritize health as a strategic operational asset?

Are silos between HR, safety,

Is there a budget for lifestyle

Do you have a data system

medicine-certified clinical

capable of tracking disease

interventions?

remission and medication de-

Have you addressed health

escalation and deprescribing?

equity and socioeconomic

Is there a “Social Determinant

barriers in your plan?

of Work” assessment in place?

Does the environment support

Is there a clear communication

healthy defaults (e.g., plant-

strategy for “culture of health

based cafeteria options)?

creation”?

and clinical departments eliminated?

Are managers trained to mitigate resistance to change?

Is health integrated into annual performance reviews?

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APPENDIX B

Lifestyle Medicine as a Covered Benefit: Employer Checklist

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CHECKLIST

Lifestyle Medicine as a Covered Benefit Employer Checklist STRATEGY & LEADERSHIP ALIGNMENT

NETWORK & PROVIDER ACCESS Contract with qualified lifestyle medicine

Define goals (e.g., chronic disease reduction,

clinicians/programs

cost savings, productivity)

Integrate with primary care and care

Align with Total Worker Health® principles

management vendors

and overall benefits strategy

Ensure virtual and in-person access (including

Secure executive sponsorship and cross-

on-site/near-site clinics)

functional buy-in (HR, benefits, clinical,

ELIGIBILITY & MEMBER IDENTIFICATION

finance)

BENEFIT DESIGN

Define eligible populations (e.g., prediabetes,

Determine scope (preventive, treatment,

diabetes, obesity, CVD risk)

reversal/remission programs)

Use claims, biometrics, and screenings for

Cover the six pillars (nutrition, physical

identification and outreach

activity, sleep, stress, substance use,

Enable self-referral and provider referral

connection)

pathways

Include individual visits, group programs, and digital options Ensure parity with other medical benefits (copays, deductibles) LIFESTYLEMEDICINE.ORG | ACOEM.ORG

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CARE MODEL & SERVICES

HEALTH EQUITY & ACCESS

Offer multidisciplinary care (physicians,

Ensure culturally competent, inclusive

RDNs, health coaches, behavioral health,

program design

exercise physiologist, CHW, etc.)

Address barriers (cost, time, transportation,

Include shared medical appointments/group

digital access)

visits

Offer multilingual and literacy-appropriate

Provide personalized care plans and

materials

longitudinal follow-up

DATA, MEASUREMENT & ROI COVERAGE & CODING

Define KPIs (clinical outcomes, utilization,

Map services to covered CPT/HCPCS codes

cost, productivity, experience)

where applicable

Establish baseline and ongoing measurement

Establish reimbursement for group visits,

strategy

coaching, and digital therapeutics

Track ROI/VOI (return/value on investment)

Clarify billing pathways (e.g., primary care,

COMPLIANCE & GOVERNANCE

specialty, value-based arrangements)

Ensure compliance with ERISA, ACA, HIPAA,

INTEGRATION WITH EXISTING PROGRAMS

and nondiscrimination rules Document medical necessity and coverage

Align with disease management, EAP,

policies

wellness, and occupational health

Establish vendor oversight and performance

Coordinate with pharmacy benefits (e.g.,

guarantees

deprescribing support where appropriate)

COMMUNICATION & LAUNCH

Connect to community resources (food is medicine, fitness, social supports)

Develop clear employee communications and benefit guides

INCENTIVES & ENGAGEMENT

Train HR, managers, and care navigators

Offer incentives for participation and

Launch with targeted campaigns and ongoing

outcomes (HSA/HRA contributions, premium

education

differentials) Use behavioral nudges, coaching, and digital

CONTINUOUS IMPROVEMENT

engagement tools

Review performance quarterly with vendors

Support manager and leadership engagement

Gather employee feedback and outcomes data Refine benefit design, access, and incentives over time

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APPENDIX C

Partner Vetting: 10 Critical Questions

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QUESTIONS

Partner Vetting: 10 Critical Questions 1

3

Clinical Model & Scope How do you define and operationalize lifestyle medicine across the six pillars (nutrition, physical activity, sleep, stress, substance use, and connectedness)?

2

Outcomes & Evidence What measurable outcomes have you achieved (e.g., A1C reduction, weight loss, medication deprescribing, cost savings), and can you share peer-reviewed or real-world evidence?

Provider Qualifications 4

What credentials and training do your clinicians have (e.g., board certification, specialized training in American College of Lifestyle Medicine competencies)?

Data & Reporting What data do you track, and how frequently do you report outcomes to employers (e.g., engagement, clinical outcomes, ROI, absenteeism)?

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5

Integration with Benefits & Care Ecosystem

8

How does your program integrate with existing benefits (e.g., primary care, behavioral health, disease management, EAPs)?

6

How do you tailor your program to an employer’s population health needs, workforce demographics, and organizational goals?

Delivery Model & Access

9

What care delivery options do you offer (e.g., virtual, in-person, onsite clinics, group visits), and how do you ensure equitable access for diverse employee populations?

7

Employer Customization

Implementation & Support What does your implementation roadmap look like (timeline, staffing, onboarding, communications), and what level of support do you provide to HR and leadership teams?

Engagement Strategy

10

What specific strategies do you use to drive sustained employee engagement and behavior change over time?

Financial Model & ROI How are your services priced, and what is your demonstrated or projected return on investment (including healthcare cost reduction, productivity gains, and risk mitigation)?

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APPENDIX D

Request to Include Lifestyle Medicine Providers in Health Plan Network

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Dear [Health Plan Representative Name], On behalf of [Employer Name], we are writing to request the inclusion and expansion of qualified lifestyle medicine providers within our employee health plan network. As part of our commitment to improving population health, enhancing employee experience, and managing long-term healthcare costs, we are prioritizing evidence-based approaches that address the root causes of chronic disease.

Lifestyle medicine—focused on nutrition, physical activity, restorative sleep, stress management, avoidance of risky substances, and connectedness—aligns with our broader strategy to support prevention, treatment, and, where possible, disease remission. Expanding access to clinicians trained in these approaches will strengthen care delivery, complement primary care, and improve outcomes for employees with or at risk for conditions such as diabetes, cardiovascular disease, obesity and other chronic conditions.

We request your collaboration on the following: ●

Identification and credentialing of board-certified or similarly qualified lifestyle medicine providers for network inclusion

●

Coverage for key services, including individual visits, shared medical appointments, and multidisciplinary care (e.g., registered dietitians, health coaches, behavioral health)

●

Integration of lifestyle medicine services within existing care management and value-based care models

●

Development of appropriate billing pathways and reimbursement structures to support these services

We welcome the opportunity to meet with your team to discuss implementation options, timelines, and any data requirements to support this initiative. Our goal is to ensure employees have timely access to high-quality, coordinated care that meaningfully improves health outcomes.

Thank you for your partnership and continued support.

Sincerely, [Name] [Title] [Employer Name] [Contact Information]

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References

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References 1. CBO Projects High Federal Health Program Costs | Committee for a Responsible Federal Budget. Committee for a Responsible Federal Budget. Published February 25, 2026. https://www.crfb.org/blogs/cbo-projects-high-federal-health-programcosts 2. Healthy Living Is the Best Revenge. Archives of Internal Medicine.

2009;169(15):1355. doi:https://doi.org/10.1001/archinternmed.2009.237 3. Grants – HERO. (2025, December 2). HERO. https://hero-health.org/research/ grants/ 4. Punnett, L., Cavallari, J. M., Henning, R. A., Nobrega, S., Dugan, A. G., Cherniack, M. G., & CPH-NEW Research Team. (2020). Defining “Integration” for Total Worker Health®: A New Proposal. Annals of Work Exposures and Health, 64(3), 223–235. https://doi.org/10.1093/annweh/wxaa003 5. Marshall, S., Patel, P., Anand, R., Artz, K., Collins, A., Grega, M., Gulati, M., Hemmingson, T. A., Mansfield, S., Nathan, A., Pauly, K., Sugden, S. G., Tivnan, V., Wilson, A., & Staffier, K. L. (2025). Lifestyle Medicine as a Framework for HighValue Care: A Position Statement From the American College of Lifestyle Medicine.

American Journal of Lifestyle Medicine, 15598276251390437-15598276251390437. https://doi.org/10.1177/15598276251390437 6. CDC. (2024, June 26). Hierarchy of Controls. Total Worker Health. https://www.cdc. gov/niosh/twh/php/hierarchy/index.html 7. CDC. (2024). CDC Workplace Health Model. Workplace Health Promotion. https://www.cdc.gov/workplace-health-promotion/php/model/index.html 8. Ozminkowski RJ, Serener S, Marlo K, Kichlu R, Ratelis E, Van de Meulebroecke J. Beyond ROI: Using value of investment to measure employee health and wellness.

Popul Health Manag. 2016;19(4):227-9. doi: 10.1089/pop.2015.0160.

9. Horstman CM, Ryan DH, Aronne LJ, et al. Return on investment: Medical savings of an employer-sponsored digital intensive lifestyle intervention, weight loss. Obesity (Silver Spring). 2021;29(4):654-661. doi: 10.1002/oby.23117.

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10. Kim Y. The effects of smoking, alcohol consumption, obesity, and physical inactivity on healthcare costs: A longitudinal cohort study. BMC Public Health. 2025;25:873. https://doi.org/10.1186/s12889-025-22133-4 11. Lee MP, Hudson H, Richards R, Chang CC, Chosewood LC, Schill AL, on behalf of the NIOSH Office for Total Worker Health®. Fundamentals of total worker health approaches: Essential elements for advancing worker safety, health, and well-being. Cincinnati, OH: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health. DHHS (NIOSH) Publication No. 2017-112. Available from: https://www.cdc.gov/niosh/docs/2017-112/pdfs/2017_112.pdf?id=10.26616/ NIOSHPUB2017112&id=10.26616/NIOSHPUB2017112. Accessed February 23, 2026.

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