Making worker wellness programs work

By Lin Grensing–Pophal

Employee wellness programs seem like a no–brainer. They promise to improve employee well–being, reduce health care costs, boost productivity and decrease absenteeism.

But making wellness programs actually achieve results is difficult. Experts say too many efforts are poorly designed, ineffectively implemented and rarely evaluated in terms of bottom–line impacts.

Kimberly Roberts is health management director with the Exigence Group, a national health care management organization based in Amherst, N.Y.

“I can say that even the most passionate wellness advocates have struggled with proving that the traditional work–site wellness programs have been linked to any large savings—other than feeling good,” Roberts says.
The problem is three–fold:
1. From the start, programs aren’t designed to achieve specific results
2. Employee participation falls short of expectations
3. Without specific objectives, program effectiveness can’t be measured.

By example

Still, staunch supporters of wellness programs insist that they can achieve results and point to companies that manage to do so as models for others.

Take Intel and IBM, for example.

Intel saw a 0% increase in health care costs from 2008 to 2009 and expects to see the same in 2010. Zero percent! Intel credits the results, in part, to employee participation in a wellness program. About 37% of Intel employees have participated in the 3–Step Wellness Check and 25% of those have seen significant improvements to their health, according to the company.

At IBM, wellness programs have become a business imperative, says spokeswoman Laurie Friedman.
“Healthier employees have fewer absences and are more productive,” she says. “Not to mention the cost benefits: Healthy employees see less out–of–pocket health care expense.”

According to Friedman, IBM has saved $190 million in health care costs because employees took responsibility and adopted healthier behaviors.

Broad–based is better

But, Rosie Ward, health management services manager for RJF Agencies in Minneapolis, says that Intel and IBM are among the few companies that can make—and support—such claims. Ward specializes in assessing wellness programs for companies across the country.

She says most wellness programs are incorrectly designed and too narrowly focused.

“The way that we typically go about designing wellness programs doesn’t work,” Ward says.

For starters, too many efforts try to segregate health issues into discrete programs—one for smokers, another for people who are overweight, a third for people who have high blood pressure, etc. Instead, companies should take a holistic approach to employees and their health.

Ward points to the book, Well–being by Tom Rath and Jim Harter, as a guide to creating more integrated programs. Based on years of Gallup workplace research, the book lays out five essential and interconnected elements of well–being: career well–being, social well–being, financial well–being, physical well–being and community well–being.

When designing an employee wellness program, Ward says companies need first to focus on those elements of the organization’s culture that can negatively impact its workers’ well–being.

“How do your leaders treat your people? What kind of relationships do they have at work? What are you going to do to retain top talent? What are you going to do to have employees be engaged, committed and productive?” Ward asks. “If you have employees who don’t like management and feel frustrated—or whatever it might be—you can get them to go through the motions, but at what cost?”

Ward says companies that implement programs in this type of environment will find that “between years two and five they peter out because they’ve gone about it with too narrow a focus.”

Bradley Warrick, managing partner of consulting firm Warrick LLC in Charlottesville, Va., agrees that “silo” programs create the wrong focus for companies and fail to produce results.

“Without creating and maintaining a strong, health–promotion culture, every stand–alone wellness program will have limited success,” he says. “This has been one of the biggest problems with traditional wellness programs. They place too much emphasis on individual change and too little emphasis on cultural change.”

A financial incentive can help people move from considering change to actually making changes to benefit their health and well–being.

“But without continual support and motivation thereafter, they will typically go back to their old ways,” Warrick says. “Creating and maintaining a strong health–promotion culture is the best way to prevent this from occurring.”

Simma Lieberman agrees that companies need to take a broader approach—and wellness programs and institutional practices need to be aligned. Lieberman is an organizational development consultant in Albany, Calif., who has coached people and organizations on wellness for more than 25 years.

One common problem, Lieberman says, is that companies will put programs in place and then discover that employees’ schedules and workloads don’t allow them to take full advantage.

“If you’re not going to tell your managers to give employees time to participate then, of course, you’re going to say, ‘We tried it and it didn’t work.’ Of course not. If they’re working from 7 a.m. to 8 p.m., no, they’re not going to use it (the fitness center, etc.),” she says.

Are you promoting wellness but stocking the vending machines with fatty, salty snacks? Do you encourage hourly workers to participate in wellness programs but the management team is nowhere to be found?
All of these “little things” can make a difference.

Steps to success

To make your wellness program effective, you need to take key steps, the experts say.

Step 1 Get employees involved Workers should be involved in both planning and implementing any wellness program, Ward says.

“If employees are part of creating it, they don’t need to have all of those heavy incentives to get them to do things,” she says. Start by determining employee needs and interests with a culture assessment.
“You need to have discussions about ‘What do we want life at this company to look like three years from now?’,” Ward says. Employees will likely envision a place where they are engaged, healthy, safe and where they want to come to work every day.

Lieberman agrees.

“You need to find out what people want,” she says. “You need to look at the demographics in your organization.”

In addition to asking employees for their input, companies should examine their current rates of absenteeism, workers’ compensation claims and recurring health problems among their work force.

“Why are people out a lot? What are the reasons that people miss work?” Liberman asks.
Based on this input and research, companies can decide where they want to focus their efforts. Simply defining what you mean by “wellness” can be a key. Is wellness lower health insurance rates? Reduced absenteeism? Lower blood pressure? Less depression?

Wellness can mean many different things to many people. Clarifying intent and identifying areas of focus can help ensure that everybody is on the same page.

The U.S. Department of Health & Human Services’ Healthy People 2020 guidelines (www.healthy
people.gov/hp2020/comments/default.asp) can help you target specific areas for improvement.

Step 2 Measure success As the experts noted, a key problem with many wellness programs is an inability to determine their effectiveness. Keep in mind the adage, “You can’t manage what you can’t measure.”
Companies need to put metrics in place to track, first, whether employees are using the programs and, second, whether the use is generating results, Lieberman says.

Edward Trieber is managing director of Harris Rothenberg International Inc., a provider of employee assistance programs in New York.

“Encouraging people to join gyms does not ensure that they will use them or use them effectively,” Trieber says. “Measuring how many times they go or having them download heart rate data may make for a more compelling case.”

Step 3 Ensure accessibility Once a program is in place, make sure the details are effectively and clearly communicated to employees—and make sure its components and benefits are accessible to them.
Commit to creating a positive, supportive environment for workers, ensuring management is involved and focusing on measurable outcomes. If you do, your wellness program can deliver on its promise—healthier, happier workers and an improved bottom line.

Making wellness pay

Companies with effective wellness programs are more financially successful than other companies, according to the 2009–2010 Staying@Work report.

Organizations with the most effective health and wellness programs had total returns to shareholders of 14.8%, compared to companies with less effective programs, where returns reportedly declined 10.1%. In addition to better returns for shareholders, the companies recorded higher rates of employee productivity, lower rates of work loss and lower health care costs.

The research was jointly sponsored by global consulting firm Watson Wyatt (now Towers Watson) and the National Business Group on Health. The study focused on identifying the programs that are most effective and essential to improving employee health and productivity—and increasing corporate profitability.

One of the key findings of the study was that companies with the most effective programs had a strong commitment from senior managers who regularly communicated the importance of a healthy lifestyle, volunteered to be health “champions” and provided adequate financial resources to support wellness efforts.
In addition, the more successful companies approached health and wellness from a business perspective, creating a balanced set of practices and monitoring the effectiveness of their approach.