The Loop

Recent Developments in Wellness Incentive Programs

Filed under: Benefits

The first step to better healthcare is all about wellness. More than 30 years ago, Health Maintenance Organizations (HMOs) entered the healthcare industry with the goal of maintaining good health in an effort to avoid expensive medical treatments. While in theory this is a sound idea, in practice it has yet to produce universal results.

People who buy into the concept of healthy behaviors, such as a nutritional diet and regular exercise, make these behaviors a priority. Those who don't – more often than not due to time, monetary, knowledge or resource restraints – have mixed results. This is evidenced by the national obesity epidemic, in which adult obesity rates top more than 20 percent in all 50 states; above 30 percent in at least half of them.

Obesity spawns a quagmire of medical conditions, including high blood pressure, heart disease and diabetes. The cost of treating these and other conditions has increased exponentially over the last two decades, so much so that employers have instituted new programs to help their workers develop and maintain healthy behaviors.

Obesity Epidemic
At least one industry analyst has pinned the national employer cost attributed to obesity among full-time employees at $73 billion a year. This number is based on the premise that obese workers tend to be less productive.

Some employers have taken more aggressive action to address the issue. GEICO, with more than 30,000 workers, implemented a dietary intervention program that encouraged workers to eat more high-fiber foods and reduce their consumption of meat, dairy, and eggs. Again, not every worker got on board, but those who embraced the program experienced reductions in saturated fat and blood cholesterol levels.

Mental Stress
In light of the motivation necessary to make wellness programs more effective, many employers have started paying more attention to programs designed to address worker burnout and mental health issues. Some of the services designed to address mental health fitness include journaling, meditation, exercise, and promoting more time spent with family and friends. Bear in mind that many workers feel their job is the cause of much of their stress, so rather than offering coping skills it may be worth investigating the underlying symptoms that cause stress and anxiety in the workplace, such as too much work, unchallenging or unsatisfying work, poor supervisory relations or lack of trust among colleagues.
Enter: Corporate wellness programs – employer‐sponsored services designed to improve the health and well‐being of their workers. Formal programs started as early as the 1980s and increasingly spread throughout America's corporate culture during the rest of the 20th century. Today, 80 percent of companies offer a preventative wellness program, including 92 percent of large employers with more than 200 workers.

Traditional wellness programs feature biometric screenings and health fairs, as well as programs for targeted health issues such as fitness, diet or smoking cessation. According to the Society for Human Resource Management (SHRM), the following are among the most common wellness programs:

• Onsite seasonal flu vaccinations
• 24-hour nurse line
• CRP or first aid training
• Health and lifestyle coaching

However, some companies have branched out further, introducing unique services to create both a competitive recruiting/retention advantage and enhance worker well-being in mind, body and soul. Some companies feature:

• Onsite nap room
• Onsite vegetable garden
• Onsite stress reduction program
• Fitness equipment subsidy or reimbursement
• Onsite sick room
• Onsite medical clinic
• Pay for healthcare premiums when worker participates in a weight loss program
• Onsite massage therapy services

The healthcare industry has slowly but surely embraced technology as a means to connect with patients and reduce costs. Not every medical condition requires a physical examination, and many times it's unclear whether one is necessary or not. To this end, telehealth has emerged as one of the top mobile health trends in the millennium. The service enables people to communicate with nurses, doctors, and specialists from their home or workplace via phone, email, face-to-face video, and/or online chat, providing both a time and cost savings alternative to the traditional doctor's office visit.

Many employers provide mobile smartphone apps to help workers monitor their fitness and wellness goals. Some utilize text message alerts to let workers know when health screenings are available. In the U.S., half of the 65 percent of adults who own a smartphone have downloaded at least one mobile app designed to support healthy behaviors. About 20 percent report that they use at least one of these apps on a regular basis.

Tracking devices you can wear on your wrist, ankle, in your ear or clip anywhere on your clothing have become a trendy new way to merge technology with wellness objectives. Not only are there devices designed to track how many steps taken or calories consumed in a day, but also, medical versions can monitor heartrate, blood pressure, temperature, pulse, etc. Are they effective? Bear in mind that watching what you eat doesn't necessarily mean you consume less or healthier food. A recent technology-enhanced weight loss study found that participants who used fitness trackers lost 7.7 pounds while those without fitness trackers lost 13 pounds over the same time period.

Potential Missteps
A recent trend that has had mixed results is the concept of gamification, in which individuals or workplace teams compete to achieve health goals. Research has found that team challenges tend to work better than individual challenges, as evidenced by Fitbit competitions in which some workers have accused others of cheating (e.g., fudging their steps per day). These types of disagreements can cause distractions in the workplace that reduce productivity.

Bear in mind, too, that if you provide electronic tracking devices to your employees, make sure your IT department can support repairs or have an alternate source available. A wellness competition can be undermined if some people don't have properly working equipment. It can also backfire if some employees don't understand how to use the wearables, track their data online, or sync it with their team. These programs can take a lot of time and effort to ensure that all workers feel they get a fair opportunity to compete or participate.

As more employers embark on wellness programs, workers are rightfully concerned with the privacy and security of their own personal data. It's a good idea to make all programs available to everyone and offer the choice to share fitness goals and data for engagement in competitions or keep such information private, with the ability to track individual progress without all the public fanfare. It's important for engagement that these options are clearly communicated, as many employees may dismiss programs out-of-hand because they don't want co-workers know about their participation.

Communication Strategies
While email seems the logical vehicle to distribute information about new wellness programs to all employees, there are problems related to full inboxes and workers who don't have or take the time to read long emails. To keep associates engaged, emails should be brief, incorporate only one or two points at a time, and convey items of interest, such as an employee quote or story that others may find interesting.

Don't rely solely on email either, particularly if you have workers in the field who don't have a corporate email account. Use posters and breakroom table tents to communicate key messages with direction as to how they can obtain complete information.

However, while communication and resources are important, make sure you don't overwhelm your workforce with too many different messages, programs and/or information. It might be worthwhile to survey your workforce with ideas you're considering and get their feedback, then launch the most popular programs for maximum engagement.

Human Resources
Oftentimes a human resource department has enough on its hands with recruiting, retention, and managing healthcare benefits. Before you launch a comprehensive wellness program, consider if it might be a good idea to hire extra resources, either fulltime, part-time or on a contract basis to manage the program. You may set internal performance benchmarks to measure how well your wellness program is managed, allowing you time to decide if you'd like to hire those resources on a fulltime basis.

There is not a correct way to implement a wellness initiative. Programs should be designed based on the practical ability for workers to participate, and services should be aligned with the overall culture of the organization. Because wellness programs vary among companies, it is difficult to compare them. This is why it's important to develop internal measures and benchmarks by which to gauge effectiveness among your own worker population.

Overall, there is some consensus that wellness programs do contribute to reductions in absenteeism, staff turnover, and worker stress. An oft-touted statistic is that each dollar spent on a wellness program yields a $3 return on investment. While this data may be successful at selling the viability of a wellness program to management, it's more important to track success at the individual level. After all, the key objective is that a healthy worker is a productive worker...and costs less in healthcare spending. However, just making a handful of already healthy workers healthier is not likely to make an impact on your bottom line.

Have wellness programs moved the bar for developing and maintaining healthy behaviors among Americans? Perhaps their efforts can best be described by comparing them to the success of those early HMOs. People who buy into concepts of healthy behaviors, such as a nutritional diet and regular exercise, make these behaviors a priority. Those who don't – more often than not due to time, monetary, knowledge or resource restraints – have mixed results.

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