Objective: Our goal was to assess perceptions of acceptability and feasibility of implementing an “integrated” approach to worker health that coordinates health promotion and occupational health and safety. Methods: We identified decision-makers for employee health programming within small-to-medium-sized businesses (SMBs) in greater Minneapolis and conducted semi-structured interviews to assess awareness, perceived benefits and barriers, and capacity for implementing an “integrated” approach. Results: Worker health was widely valued by respondents. They reported strong management support for efforts to improve health and safety for employees. Most respondents indicated that their company was open to making changes in their approach to worker health; however, cost and staffing considerations were frequently perceived as barriers to action. Conclusion: There are opportunities for implementing integrated worksite health programs in SMBs that are based upon existing resources and values, however challenges exist.