Workplace wellness programs aren’t new. For decades some employers have aimed to prevent disease, promote good health and save money through programs and activities. They’ve offered gym discounts, distributed newsletters, sponsored weight-loss challenges and fielded Bloomsday corporate cup teams.
According to a RAND Health study sponsored by the U.S. Department of Labor and the U.S. Department of Health and Human Services, about half of U.S. employers offer wellness promotion initiatives.
But with health care risks and costs growing much like the collective American waistline, the corporate approach to creating wellness may be expanding from saving money to saving lives.
“Health care costs are huge but they haven’t really seen in the short term that wellness programs improve the bottom line,” said Lisa Randall, clinical coordinator for INHS’ community wellness services.
A two-year study at BJC HealthCare, for example, showed hospitalizations decreased by 41 percent for conditions targeted by the St. Louis hospital system’s wellness program, but those health care savings were offset by increased outpatient care and medication spending.
The benefits of well-designed wellness programs should show up long term, Randall said, with more employees preventing disease as they reduce risk factors associated with weight, waist circumference, blood pressure, blood glucose, cholesterol and tobacco use.
“The hope is to reduce hospitalizations for controllable things. We’re trying to keep people well for that reason, to avoid a preventable catastrophic event,” said Randall, adding that when employees take steps to get healthier they feel better and may have less absenteeism and greater productivity, which should impact the bottom line.
But employees need to know the state of their health before they can do something about it.
“Especially with so much obesity in the community, we’re seeing things pop up in younger people. They don’t understand their risk factors,” said Randall. “Two-thirds are overweight or obese. It’s the new normal. People don’t look at it as unhealthy. They say, ‘I look like everybody else.’ ”
Kathy Worden, co-owner of Workwell Consultants, said about 80 percent of the time they conduct biometric screenings for employers they find people with undiagnosed issues, such as high blood pressure or diabetes.
Screenings are privacy protected. Employers only receive aggregate information, which they can use along with workplace surveys that assess needs and barriers and create a customized wellness program.
“We want them to incorporate it into the culture and business model,” said Worden. A discounted gym membership may work well for one company while a tobacco cessation class and migration to smoke-free workplace may be more appropriate for another.
“We ask, ‘Where do you choose to work out? If you do workout, where do you go?’ ” she said, explaining that to help employees make lasting health improvements, employers must be strategic.
“Boxed feel-good programs are not strategic,” she said. “If you can’t change the culture, if you can’t engage the at-risk employee, it’s for naught.”
Financial incentives are the best way to engage employees, both Worden and Randall said.
“Outcome-based incentives encourage people to know their risk and do something about it,” said Worden, explaining that paycheck rewards are big motivators.
Under the Affordable Care Act, employers can rebate health insurance costs up to 30 percent for employees who demonstrate good health through those biometric screenings, as long as they also provide an alternative standard to avoid penalizing employees with unhealthy risk factors.
A nonsmoking employee who has blood pressure, blood glucose, cholesterol and weight in a healthy range, for example, may pay less each month for health insurance premiums.
To receive the same discount, an obese employee with high blood pressure and uncontrolled diabetes might need to meet goals established with a health care provider, like losing 10 pounds in six months and lowering blood pressure and blood sugar a certain amount.
“We believe it should be provided by their doctor. I’m not the one who should be deciding the course of action,” stressed Worden, adding that employees who do this often discover additional benefits beyond the paycheck.
“They say, ‘I didn’t realize I felt so crappy until I felt better.’ That’s who you see succeed on an individual level,” said Worden. “If companies use incentives right, it’s a very positive experience.”
But for real change in worker wellness, experts said companies need to change workplace culture.
That’s why in 2013 the Spokane Regional Health District released a Worksite Wellness Toolkit, partially funded from the Centers for Disease Control and Prevention, to help employers strategize and implement evidence-based wellness programs.
Making worksites healthier is important, too, said Natalie Tauzin, healthy community specialist at SRHD, because employees spend more than a third of their lives at work.
“What we do at work really matters to our health,” she said, noting that policy changes like going tobacco-free, providing healthy food in vending machines or conducting stand-up meetings can impact employee health but require management support.
“It starts with an engaged leadership. To adopt a policy takes a lot of education and really bringing people on board with the concept of a healthy worksite,” Tauzin said. “If your employer is willing to invest in your health, be a partner with it. Take advantage of the potential benefits you’ll get from being healthier.”