Virtually all large employers are committed to conventional wellness programs. Because of this market saturation, wellness vendors and their commercial partners, benefits consultants, are now setting their sights on smaller employers. These groups would do well to learn what hasn’t worked in wellness and avoid wellness programs built around health risk appraisals, biometrics, and preventive medical care.

Strategic thinking about wellness starts with understanding two essential elements: claims data and organizational atmospherics. Claims data has crucial information about the illnesses that actually affect employees; these data, which wellness vendors don’t routinely analyze, are essential to establish whether the largest sources of medical care spending are amenable to change through wellness. For example, in a company with a young workforce, a large cost driver is likely to be pregnancy. Even in older workforces, it is unlikely that programs for cancer or cardiovascular disease, the two disease states wellness programs claim to “prevent” will have much impact in workers younger than 60.

Also see: The truth behind 6 wellness myths

Atmospherics are the organization’s environmental factors that influence employee well-being. These include the entity’s relationship to food -- and all companies have one -- as well as policies, practices, and procedures that set the tone for how employees are treated. In wellness, tone and perception are critically important because employees are sensitive to whether management appears to be doing things ‘to’ them rather than ‘with’ or ‘for’ them. An example is bribing employees to have their cholesterol checked. Cholesterol levels do not predict the onset of heart disease, and blood lipid measurement will seem out of place in a company where the reward for going 90 days without an injury is a pizza party or new employees are welcomed with baskets of baked goods. 

Successful wellness initiatives in the small and mid-sized business space should focus strategies that are simple, sustainable, and enjoyable. We are skeptical that employees will clamor for the opportunity to run to the doctor when they are not ill or to answer highly intrusive health questions. But, we are hard pressed to understand how they will not be grateful for healthier food, opportunities for exercise, and positive organizational atmospherics that they will experience as management’s gratitude for the work that they do.

See also: Why paying employees to be healthy doesn’t work

Wellness is an opportunity for employers to open doors for their people. It should help empower people to make choices freely without being pressured financially or pushed into the medical care system for no reason. Small and mid-sized companies have a chance to shift the discussion from wellness programs to wellness cultures. If they succeed, leaders in the small and mid-sized companies could well receive credit for taking a sober approach to a strategy that so far has been propelled by emotion, not evidence.

Linda Riddell is Principal Consultant with Health Economy, LLC in Cape Elizabeth, Maine. Vik Khanna is an independent health consultant in St. Louis, MO, with strategic planning and assessment expertise in wellness and managed care. Along with Al Lewis, he is co-author of Surviving Workplace Wellness with Your Dignity, Finances, and Major Organs Intact. His new e-book, Your Personal Affordable Care Act: Making Yourself Scarce in the Dysfunctional US Healthcare System, will launch this summer. 

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