Wellness Programs Work

By: Abbie Leibowitz, M.D., F.A.A.P., is Chief Medical Officer, Founder and President Emeritus at Health Advocate

A study published recently in the Journal of the American Medical Association has raised questions about the value of workplace wellness programs. While the findings confirmed that employees who participate in wellness programs make positive behavior changes, the results of this study indicated that these changes did not influence health outcomes or costs. For years, research has generated mixed reviews of workplace wellness initiatives. However, it is important to note that many of these studies, including the most recent in JAMA, are limited in scope and do not account for the best practices successful organizations utilize to maximize their wellness programs and drive engagement, improve health outcomes and lower costs.

A Narrow View Doesn’t Show the Full Picture

The study published in JAMA analyzed results among employees participating in an 18-month long standalone wellness program. While this narrow focus may be necessary for a scientific study, it does not necessarily consider other factors at play in most organizations’ wellness programs. For example, participation rates were relatively low at about 35 percent, which may have skewed the results. As the study authors acknowledge, employees participating in the program tended to be in good health already. There are obviously benefits to having healthy workers engaged in a wellness program, but there is more potential impact to be made among the segment of the population in less-than-ideal health. This study did not examine some of the strategies organizations use to drive participation among this group.

Incentives are one means to achieve this. In the study, program participants received incentives of about $250. While this is about average among most employers, higher incentives are more effective at motivating participation, which in turn can generate better results.

Additionally, the study did not mention what other population health initiatives the organization had in place. Enthusiastic support from management is important to the success of any program. A wellness program integrated into an overall culture of health is more likely to be more successful. This may include offering biometric screenings to help identify employees at risk or a chronic condition management program to further support their health goals. Providing access to expert support from wellness coaches and others can also make a positive impact versus an online program alone. Wellness in a silo is not as effective as an integrated program, which could skew the results when compared to the broader, more holistic approach many organizations are now implementing, Finally, looking for short-term “savings” from a wellness program is a mistake. Behavior change takes time, and it is premature to anticipate sweeping shifts in cost trends and outcomes in such a short window. The three-year results the study authors plan to revisit may be more telling, but true return and value on investment in a wellness program is a long-term reality that is not accounted for in this particular study.

Strategies for Optimal Wellness Programs

In order to widen the focus of workplace wellness beyond a narrow, siloed approach, there are a number of best practices proven to drive engagement and achieve successful outcomes.

• Utilize data to inform the design of a meaningful program. Data, such as health risk assessments, claims data and biometric screening results, can provide a more detailed picture of the specific needs of a population and allow the employer to tailor the program accordingly.
• Address the full spectrum of population health needs. Providing multiple touch points to meet people where they are based on their health status, risk level and readiness to change can assure that employees are able to access the right support at the right time to reach their personal health and well-being goals.
• Energize participation, and make it fun! Weave the organization’s culture into the program with unique activities, incentives, success stories and challenges.
• Demonstrate internal support. Build a culture of wellness, incorporating both employee input and executive participation.
• Create visibility. Work with a wellness expert to create an effective and impactful communications strategy so employees are aware of the benefits and resources available to them.
• Make the program easy to access via technology and personal support. This includes taking advantage of telephonic support, health coaching, an easy-to-use website and mobile app, and personalized emails and notifications to drive awareness and utilization.
• Integrate health and well-being programs for greater impact and engagement. Provide a streamlined, simplified, all-inclusive program to reduce confusion and maximize participation.

Implementing one or more of these strategies into workplace wellness programs can have a major impact on both employee participation and results.

The Value of a Holistic Approach to Wellness

Integrating wellness with other related health and benefits programs is one of the most effective ways to generate measurable results. For example, biometric screenings can establish a strong starting point for employees’ wellness journeys. Oftentimes, employees may learn about a potential condition like hypertension or hyperlipidemia during a screening, prompting them to seek treatment from their physician and support from a wellness program. Further, better understanding the health of an organization’s workforce can help the employer customize the wellness program to meet their needs, increasing the odds of participation and success.

A recent analysis of a cohort of nine companies utilizing Health Advocate’s wellness program demonstrates that best practices like this make a difference. Each of the participating groups offered wellness coaching and strong incentives of $300 or greater, access to online workshops and wellness information, as well as integrated biometric screenings. The research assessed changes in high-risk participants over three years. Of the 16,741 employees who participated in biometric screenings, 9,689 participated all three years. Among this group, 1,674 members (17%) reduced their risk level from high-risk to normal or borderline-risk within 3 years for the following conditions:

• 1,497 people identified as high-risk for hypertension
• 76% reduced to normal or borderline within 3 years = 1,138 people
• Potential savings of up to $1,378 pp./y x 1,138 = $1,568,164

• 425 people identified high-risk for diabetes
• 49% reduced to normal or borderline within 3 years = 208 people
• Potential savings of up to $1,653 pp./y x 208 = $343,824

• 3,775 people identified as obese
• 9% were no longer obese and improved their health within 3 years = 340 people
• Potential savings of up to $1,090 pp. x 340 = $370,600

The savings estimates are based on data looking at the cost of medical care needed by people with these conditions. As these results show, when compared to a standalone program, utilizing best practices including integrating a wellness program with onsite health screenings, will amplify the effects. By incorporating best practices into workplace wellness, it is possible to realize both improved health outcomes and cost savings, and maximize the impact of the overall program.

About the Contributor

Abbie Leibowitz, M.D., F.A.A.P., is Chief Medical Officer, Founder and President Emeritus at Health Advocate, a leading health concierge and benefits solutions company serving more than 12,500 organizations nationwide. Dr. Leibowitz is a nationally recognized leader in the healthcare industry with more than 40 years of experience in managed care, clinical management, quality assurance, and medical data and information systems. Twitter – @healthadvocate