Employers rarely have the resources to implement all desired programs to manage workforce in a single undertaking. An evolutionary strategy to program development and implementation can help employers learn from what works and focus on areas that will have the greatest impact. Saint Luke’s Health System in Kansas City, MO, was an early leader in employee health and productivity (H&P) management with its first program in 1998, and continues to adjust and develop its programs. The 10-hospital, 10,000+-employee health system is has seen positive outcomes from its third-generation program