Are employers expecting too much from wellness programs?

by Rob Pariseau | November 20, 2017
Here’s an interesting thought. Are wellness programs really delivering on their promises? Are they even making the right promises? If it was that easy, we’d all live long healthy lives.

I have relatives who are obese and smoke. I love them, and they love me. Even though I may have influence over them, that doesn’t mean I can change their behaviors —
and, in fact, I can’t. Yet America spends $6 billion annually on an army of consultants, brokers, web designers, biometric screeners, nurses and gyms that promise to do just that.

Why should you care? Because employers are spending more than $700 per employee per year on wellness incentives such as cash, gift cards, reduced payroll deductions or contributions to reimbursement accounts, according to the National Business Group on Health (NBGH). Sadly, only about 47 percent of employees earn the maximum incentive, and 29 percent earn none.

Two types of wellness programs with very different results
So what’s the return? According to the Rand Workplace Wellness Program Study, it depends.

Rand splits wellness efforts into two categories. The first is lifestyle management like diet, exercise and smoking. The second is disease management like heart disease and diabetes.

Lifestyle management depends on consistent behavior improvement over years in the hope of avoiding health problems in the long run. Success results from long-term investment in employees — but they may not stick around for the payoff.

Disease management is about helping people with current and/or chronic conditions take better care of themselves. Complying with prescription and lab testing regimens avoids hospitalizations in the short run. That’s why Rand claims that in their study the 13 percent of employees who participated in disease management programs generated 87 percent of the overall wellness savings.

Put another way, the ROI on disease management was a whopping 3.8 to 1, while lifestyle management was a negative .5 to 1. And disease management programs are more easily extendable to spouses.

So what’s the answer?
Intuitively, we know that a healthy workforce will generate lower health costs and absenteeism and improve productivity. The question is where to put our efforts.

According to the National Business Coalition on Health, the most popular wellness initiatives are onsite biometric screenings (72 percent), health risk assessments (70 percent) and physical activity programs (54 percent).

On-site biometrics has staunch defenders. Some claim lives have been saved and the cost and convenience are compelling vs. a visit to the primary care physician.

But wouldn’t it be more effective for the physician to have this data? Who has more influence regarding healthcare than one’s physician? And wouldn’t employees be more truthful with their physician rather than on a company-sponsored health risk assessment?

The wellness industry seems to be recognizing the financial reality of wellness. The language has transitioned from return on investment (ROI) to the softer value on investment (VOI) and from wellness to well-being. Maybe it never was about reducing health costs but more about improving morale and employee relations and reducing stress. Maybe it’s a culture thing. And maybe that’s okay.

The answer for employers may lie in rethinking the objectives of their wellness programs and, perhaps, adjusting their expectations as well as their measurement methods. Good results can show themselves in various ways — all of which can be beneficial. The key is to know which results you’re looking for and what
you’re willing to spend to achieve them.