As we start the New Year, many people are making resolutions to be healthier, so I think it’s fitting to spend a moment taking a closer look at the workplace wellness industry. Employees have come to expect workplace wellness programs, and are generally happy their employer offers them as long as there is benefit to employees for participation or, at the very least, no penalization for unwillingness to participate. And now, thanks to the ACA, the maximum value for incentives employers may offer their employees who meet wellness goals has risen from 20% to 30% of the cost of insurance coverage. This maximum value may be increased up to 50% by law if deemed appropriate by the Secretary of Health and Human Services.
According to the 2014 Kaiser Family Foundation Employer Health Benefits Survey, 74% of employers offering health benefits offered at least one type of wellness program in 2014, such as a weight loss program, discounted gym memberships, biometric screenings, a smoking cessation program, nutrition classes, flu shots or a wellness newsletter. Large firms with 200 or more workers were more likely to offer one of these programs than smaller firms (98% versus 73%, respectively).
Fidelity also released a survey that emphasized the popularity of wellness programs. The survey found that companies offering incentives to participate in wellness initiatives increased from 57% in 2009 to 74% in 2014. The energy surrounding wellness continues to sustain momentum: Fidelity found that companies plan to maintain or increase their investment in wellness programs, regardless of whether or not their company moves employees to the exchanges and away from employer-sponsored insurance.
Despite rapid adoption, wellness programs have not consistently shown a statistically significant impact on overall health outcomes. While RAND found that participation in a wellness program over five years is associated with lower health care costs and decreasing health care use, the change was not statistically significant. A 7-year study of PepsiCo, the most comprehensive evaluation of a wellness program to date (also performed by RAND), showed the program did not significantly reduce healthcare costs among those enrolled in lifestyle change programs (i.e. smoking cessation, weight management, etc.), and any gains seen in other areas were not statistically significant. A recent Health Affairs article made the claim that wellness programs actually increase employer spending on health care and a 2014 meta-analysis study published in the American Journal of Health Promotion found a negative return-on-investment in randomized controlled trials concerning wellness programs.
Inconsistencies aside, it is hard to argue that encouraging employee health isn’t a worthy investment. Every year, the American Psychological Association gives out the Psychologically Healthy Workplace Award to organizations that focus heavily on employee wellness and health. According to APA’s statistics, companies that have been awarded the Psychologically Healthy Workplace Award in the past benefit from improved work quality and productivity, lower absenteeism, less turnover, and better customer service ratings. In fact, the four employers who received APA’s award in 2013 had an average turnover rate of 6% in 2012, compared to the US Dept. of Labor’s national average of 38% that same year.
Seeing that the wellness industry is worth $6 billion, there needs to be a more demonstrable return-on-investment. Workplace wellness program administrators need to think outside of the box when implementing and measuring initiatives to improve employee health and well-being. The Centers for Disease Control and Prevention remind us of other ways that positively affect employee health without making employees feel that they need to make an extra effort to participate, including providing kitchens and open eating areas for employees, offering healthful food options, and holding “walk and talk” or standing (literally) meetings. This helps move away from the idea of a “program” and becomes more of a lifestyle change for both the employer and employee – which, arguably, aids adoption and becomes common place.
Vikram Khanna, a co-author of a recent book entitled “Surviving Workplace Wellness…with Your Dignity, Finances and Major Organs Intact” sums up the importance of workplace wellness being an ongoing, sustainable, lifestyle change: “The successful long-term pursuit of health within a company is exactly like it is within a family: create positive atmospherics, make choosing healthy the right, easy and happy thing to do, and have leaders who live and breathe the philosophy, with no expectation other than that their people will feel better and appreciate the support.”
We need to move away from boxing wellness into “programs” and use the money and time spent on wellness initiatives to yield a better return for a company’s investment. Employees will benefit more from ACA wellness incentives if an entire company adopts a mindset of health and well-being, if wellness is incorporated into the company lifestyle (i.e. becoming a “norm”), and if employers encourage rather than force employees to participate.