The Institute for Health and Productivity Management was created in 1997 to make employee health an investment in corporate success through enhanced workplace performance. It grows out of work done earlier under the "Two Pens" Project on Health Care Value, carried out jointly by the National Business Coalition on Health and the National Association of Managed Care Physicians. Two Pens, subtitled "Employer and Physician Dialogue on Health Care and Productivity," began exploring the connection between medical care and workplace performance from the dual perspectives of physicians and employers--the "two pens" that write the medical orders and pay the bills. In the course of the project it became clear to all involved--employers, physicians, and researchers--that the potential for realizing greater value gained from dollars spent on health care is huge. Employers' desire for value has led them to insist that costs be controlled while quality is measured and improved. But their concept of value has been limited mostly to the results of care being delivered to "patients" who happen to be their employees. A larger concept of value looks beyond just getting sick people well or even back to work. It expands the definition of value to include employee performance on the job--or productivity. Health promotion and care delivery models organized to produce outcomes that have a positive impact on the bottom line of total labor costs--rather than just health care costs--get us on to the next higher level of value for the health benefit dollar.