Commentary: Some days it seems that the more things change, the more they remain the same. Take, for example, healthcare. Regulatory changes have extended medical insurance coverage to millions more Americans, making care affordable for many and promising to lower costs for all of us. At the same time, technological advances have made healthcare more coordinated and accessible, closing care gaps to those previously isolated due to geography or mobility challenges. And despite increased healthcare spending, which comprises around 18% of the GDP, outpacing any other nation per capita, we’re not getting better. As a result, healthcare costs continue to escalate for employers and employees. 

Most employers have taken steps to promote better health in the workplace. Today, about 70% of employers currently offer wellness programs, but engaging employees remains a challenge. Less than half of employees participate in screenings or complete a health risk assessment used to identify employees for interventions. Consequently, a 2015 industry survey found that 79% of employers identified “motivating participants to make behavioral changes” as among the most significant challenges facing their organization’s healthcare strategy.

For wellness programs to take hold, employers need a sustainable engagement strategy built around strategic communications and use of appropriate incentives. But in order to do that, employers must first understand and appeal to their diverse workforce.

Today’s rapidly changing workforce spans at least three generations. More than one-in-three American workers are millennials, defined as adults ages 18 to 34. They’re not only the fastest-growing segment of the labor force, but now also the largest, surpassing Generation X, 35 to 50 years, and Baby Boomers, 51 to 69 years, whose numbers are declining with retirement. 

In terms of health behaviors, an Aon Hewitt survey found that millennials were the least likely to participate in activities focused on prevention and maintaining or improving physical health to other generations. Additionally, only 54% of millennials have had a physical in the last year, compared to 60% of Generation Xers and 73% of baby boomers.  

It may be tempting to generalize about the “personality” of each generation in an effort to understand behaviors and recommend interventions. For example, millennials are frequently described as tech-savvy and highly social, while Gen Xers are independent-minded skeptics, and boomers are self-involved and focused on remaining youthful. Age alone, however, fails to adequately capture complex social and emotional behaviors.

To effectively reach individuals across the age groups, employers will want to perform market segmentation. Segmentation is the practice of dividing a customer base into similar groups. High quality segmentation uses a mix of internal and external data sources — demographics (age, gender, ethnicity), clinical information (health history, HRAs) and attitudes (health behaviors, lifestyles) — to classify members into groups with common needs, desires and behaviors. It allows the entire member population to be broken down into smaller, more relevant segments, enabling employers to better:

  • Predict likely responses and behaviors;
  • Personalize outreach and communications;
  • Engage in product testing; and
  • Leverage resources to drive changes and improved results.

By way of example, ActiveHealth Management engaged in a segmentation pilot for a large state health plan to help boost member engagement. After analyzing all segment characteristics, four persona profiles stood out, providing a snapshot of experience based on individuals’ interaction needs, not age:
Validators. These individuals are highly engaged and responsive to care managers. They take responsibility for their health and seek advice on complex decisions. This persona’s key health behaviors include:

  • Finding physicians and specialists;
  • Scheduling and keeping appointments;
  • Seeking education on health issues and concerns; and
  • Understanding what to ask doctors.

Employers have a high opportunity to support these members through programs and services, educational materials, as well as personal outreach from a care manager.
Time-constrained. These members have little time available to put toward their health. These busy professionals are successful, highly educated and want what’s best for their families. When it comes to their health, they’re interested, but need support from others. This persona’s key health behaviors include:

  • Enrolling annually in comprehensive health benefits;
  • Providing coverage for the family; and
  • Reviewing information from lifestyle coaches, as long as it doesn’t take too much time.

Knowing this, the employer would do well to support these members through outreach by a care manager who can provide “quick hits” of advice and establish a trusted relationship. 
Avoiders. As a group, avoiders spend little time thinking about their health and are therefore not actively participating in employer-sponsored health and wellness programs. This persona’s key health behaviors include:

  • Seeking education on financial issues;
  • Managing the finances of his business; and
  • Accessing account information from various digital devices.

Understanding the needs of these members means the employer can refine and re-allocate their efforts to other segments that would benefit from additional support.
Self-directed. More self-reliant than their cohorts, these members make health decisions on their own. While actively participating in programs, they tend to ignore outreach and don’t require as much support and relationship-building as Validators. This persona’s key health behaviors include:

  • Providing health benefits for the family through their employer;
  • Periodically researching health and lifestyle information; and
  • On-the-go, not prioritizing health.

For these members, the employer can scale back on programs and instead provide more value-rich information that’s immediately accessible, easy to understand and actionable. 
Armed with a clear picture of members’ needs, the state plan was able to redesign engagement initiatives to reach more members through the right channels and with the right message, leading to an 87% participation rate.

Employer health and wellness programs tailored to a wide range of needs and interests of employees will lift engagement. Segmenting the member population helps companies recognize barriers to engagement and trial new, more personalized approaches to outreach that provide value to all members, from millennials to boomers.

An engaged workforce not only lowers healthcare and disability costs, but also yields benefits that go well beyond cost-savings. Productive, motivated employees feel respected by their employers, which in turn has a positive impact on the entire organization. The Harvard Business Review found that 92% of employees who feel respected by their leaders reported greater focus on and prioritization, while 56% reported better health and well-being, and 89% reported greater enjoyment and satisfaction with their jobs. In other words, it pays to be engaged.

Shawn Moore is senior vice president of customer engagement solutions for ActiveHealth Management.

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