Commentary: Why are some employers’ health management programs more successful than others? And what can companies struggling to engage their employees do to improve results?
Consider this hypothetical example. Suppose Company A and Company B offer the same programs – smoking cessation, fitness challenges, health risk assessments and wellness coaching – to their respective employee populations. Assume the companies have similar demographic characteristics.
But here’s where they differ: Company A’s program has poor incentive design, little executive support and a flat budget year over year. Company B boosts spending on communications to improve engagement, and its leadership embraces wellness as part of a firm-wide culture of health. It’s a safe bet that Company B will have better results than Company A.
Also see: “Wellness ROI comes under fire.”
The point is that generalizing about wellness program results isn’t very illuminating. Outcomes vary widely depending on the context in which they are being implemented. It’s also critical to understand exactly what – and how – programs are actually being measured.
It’s important to clarify what is meant by “do these programs work?” Expectations must be realistic. For example, lower healthcare costs, fewer absences and higher productivity won’t happen overnight. It takes time – and commitment from company leaders – to change employee behavior and workplace culture.
Based on responses from Optum’s most recent “Wellness in the Workplace” survey, which surveyed 545 benefits professionals at small, medium and large companies, embracing the following strategies can help employers create a healthy, high-performing workforce:
1. Beyond HR. Less than one-third of employers Optum surveyed reported that health and wellness is “very important” to their business strategy. When health and wellness programs are viewed solely as the human resources department’s responsibility and aren’t embraced by business line leaders, their full benefit won’t be realized. One way to achieve high level management support is to connect health and wellness outcomes to business performance goals.
2. Re-examine spending. Our survey research found that nearly 80% of companies have increased or kept their health and wellness program budgets the same this year. And 37% report that their budgets will rise over the next three years.
But more attention needs to be paid to how those dollars are actually spent. According to our survey, nearly one-third of budgets are allocated to program administration, while only 7% of spending is for evaluating whether a program is achieving desired results. And just 8 cents of every wellness program dollar is spent on creating a workplace environment that supports healthy decision making.
Spending more on rigorous program evaluation could drive increased organizational support for health and wellness efforts, and identify ways to improve the program itself. Employers should also consider allocating additional funds to building a healthy work environment and supporting on-site, dedicated staffing such as a wellness coach or fitness professional
3. Incentive innovation. According to Optum’s survey, a majority of employers – 87% – are offering health and wellness incentives, a significant increase from prior years. But most of those dollars are spent on so-called “one and done” activities such as flu shots or health risk assessments.
Among large companies, the average incentive value in 2014 per employee was $436. The majority of that amount was spent on incentives for biometric screenings and health assessments. While these investments help generate employee awareness about health topics and medical conditions, they need to be paired with more intensive interventions that can trigger behavioral change, such as wellness coaching and condition management.
4. Environmental changes. Too few employers are focused on building a physical workspace that makes healthy choices the easiest path for employees to take. Only 42% of employers have made changes to their workplace and an additional 26% aren’t considering making any changes, according to our research.
Some options for employers include:
- Encouraging regular stairwell use through attractive lighting and brightly painted walls;
- Providing healthy food choices to help employees manage calories and intake of unhealthy fats; and
- Offering sit-to-stand work stations, outdoor walking paths and bike-to-work policies.
5. Broader vision. Employers tell us that, besides addressing healthcare costs, they offer health management programs in order to reduce health risks, improve job satisfaction, attract talented employees and impact business performance. But measuring specific results is still a major challenge. Only one-third of employers that we surveyed report collecting the metrics they need to justify the investment in health and wellness programs.
Health and wellness programs should not be viewed as just a cost containment initiative. Rather, the health management agenda needs to be part of an overall business strategy. This is a cultural change that employers should embrace.
Seth Serxner, PhD, MPH, is chief health officer at Optum.
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