Wellness Program Incentives

Organization America is increasingly investing in employee wellness because it is great business.  In order to meet productivity demands, corporations must rely on a healthy, beneficial workforce to succeed in the highly competitive global marketplace.  Over a hundred studies in both corporate and governmental settings have documented the economic advantages of Corporate Wellness Programs, including reduced absenteeism, reduced injuries and workman’s compensation costs, reduced healthcare costs, reduced employee turnover, as well as enhanced productivity, greater worker satisfaction, and improved morale.1-10  

The more recent literature reflects improvements in wellness programming along with greater return on investment (ROI).  In general, the more focused and intensive the program, the greater profit realized.  To enhance their performance federal government Corporate Health Promotion Programs may be able to incorporate some of the features described.  Employee wellness programs established to have positive returns on investment frequently include the following features:

1.   Health and productivity management model
Programs characterized by this model focus attention on identification and reduction of specific risks or behaviors such as smoking, lack of physical activity, excess weight, unhealthy diet, high cholesterol, high Blood Pressure (BP), stress, depression, and so on.  High-risk staff members are specifically targeted for intervention, although the most efficacious programs also direct efforts towards healthy staff members in order to maintain their low-risk status.  This model emphasizes outcomes as opposed to simply offering wellness activities for their own sake.  

2.   Health risk appraisal
Use of a computerized health risk appraisal (HRA) instrument with individualized feedback and recommendations is almost universal in efficacious programs.  Staff Members take the questionnaire each year in many cases.  The HRA serves to increase awareness, provide direction, and encourage people to better specific behaviors.  In some cases, the personalized report is directly linked to appropriate resources related to identified risks.  Research indicates that the use of an HRA is effective if it is followed by some kind of educational or therapeutic intervention for identified risks.  It often serves as the entry point into wellness programs.

3.   Health Screening
Many programs combine the outcome of the health risk appraisal with measurement of each employee’s biometrics, including weight and Body Mass Index (BMI), Blood Pressure (BP), cholesterol, fasting glucose, and assorted other metrics.  Combining the results of the HRA with biological measures results in a more accurate risk profile.   Computer health risk appraisals often incorporate biometric data in their risk analysis.

4.   Incentives
staff members are usually given monetary or other valuable rewards for completing an HRA, participation in a program or class, specific accomplishments such as stopping smoking, losing weight, or working out, and for maintaining healthy status and/or behaviors.  In numerous cases the monetary incentives/rewards are associated with reductions in health care insurance premiums.  Some programs use disincentives as well as incentives/rewards, such as charging staff members who smoke higher rates for their health care insurance contribution.

5.   High participation rates
Successful programs use incentives and rewards to drive participation rates up.  They also market their programs extensively, and may use contest or challenge strategies to heighten enthusiasm and bolster participation.

6.   Wellness coaching
employees with identified risks or desire to better their health habits may be periodically coached via phone by trained health and wellness coaches.  Health Coaching helps employees set and achieve realistic lifestyle-related objectives including those addressing stress, work life balance, smoking, weight, physical activity, and various behavior modifications.  Three or more sessions are generally available.  In some intensive programs, the coaching extends to actual disease management intervention for employees with identified high-risk diseases.

7.   Multiple formats
Programs may offer wellness content in online, paper, and seminar formats to support stimulating variety and alternatives in order to accommodate the needs of all workers.  In addition to on-Site physical exercise and healthy eating events, on-line programs, e-mail reminders and notices, printed newsletters and materials, and employer seminars are common dissemination strategies.

8.   Senior Management backing
Enthusiastic and common endorsement by upper management is essential to achieving high rates of participation.  When senior executives are wellness role models themselves the effects of endorsement are enhanced.

9.   Frequent contact
Successful programs have persistent contact of some sort with every employee.  This may be through marketing efforts (e.g., posters, e-mail notices, reminders, or messages, etc.), bulletin boards, newsletters, employee meeting presentations, discussion in new employee orientation, supervisory sessions, etc.   The key is to enhance employee awareness of health and wellbeing opportunities and reinforce the corporate emphasis on wellness through persistent and multiple “touches”.

10.   Open enrollment
To bolster high participation rates employees must have easy access to the wellness programs and activities.  Open and uncomplicated enrollment processes achieve this.  Some businesses automatically enroll all employees and then allow those who do not wish to take part to “opt-out”.  This practice has been demonstrated to boost enrollment rates in some settings.

11.   Family involvement
Many programs promote spouses and other family members to take part in the corporation wellness activities and to adopt a healthy lifestyle along with the designated employee.  It is far easier for the employee to have a healthy lifestyle if his/her family does so as well.

12.   Smoking cessation
Because smoking and other tobacco use is the number one threat to health it is essential to offer staff members effective and convenient assistance with stopping.  Access to tobacco cessation pharmaceuticals is frequently part of such programs.  In-house programs support the most convenient access to these services, although on-line or telephone-based programs may be available as well.  

13.   Physical Activity
Regular physical activity is a core component of every wellness program.  Staff Members must be strongly encouraged to engage in regular physical activity.  Most programs provide either periodic or continuous workplace opportunities, and some locations have workplace gyms, swimming pools, walking trails, etc.  Discounted or paid memberships to community exercise facilities is a common alternative to workplace facilities.

14.   Weight management
Because obesity is a major threat to health it is imperative that programs offer effective assistance with weight management.  Enthusiastic encouragement from management to shed excess weight is valuable.  Internet based programs, worksite programs, or discounted access to weight management programs in the neighborhood may all be available.  Long-term follow-up is vital for maintenance of weight loss.

15.   Stress management
Workplace stress is perhaps the most common issue among employees and a major contributor to absenteeism, presenteeism (reduced work rate), and low morale.  Almost all efficacious wellness programs offer assistance with personal and workplace stress.  Some programs refer employees to outside resources for more somber conditions like depression and anxiety disorders, but most offer internet based or common worksite general stress reduction programs.  Some companies endeavor to structure the work environment to minimize stress, both physically and operationally.

16.   Health screenings/immunizations
employees are actively encouraged to complete recommended health care screenings for Blood Pressure (BP), blood lipids, BMI, colorectal and breast cancer, and others.  Annual influenza immunizations are also encouraged.  Some sites offer these services at the worksite.  Incentives are frequently awarded for completion of these screenings/immunizations.

17.   On-Site health care
Actual provision of onsite primary care medical services is a growing trend.  The rapidly escalating costs of medical care insurance for workers has stimulated this trend.  Some employers have saw that it is less expensive to offer primary care services themselves than to fund those services through health care insurance.  On-Site care also reduces the amount of time workers would otherwise spend away from the worksite getting such services.

References

1.   Aldana, Steven G.  (2001)   Financial Impact of Workplace Health Promotion Programs:  A Comprehensive Review of the Literature.   Am J Health Promotion 15(5):296-320.
2.   Chapman, Larry.  (1998)   The Role of Incentives in Health Promotion.  The Art of Health Promotion  2(3):1-8.
3.   Chapman, Larry.   (2003)   Biometric Screening in Health Promotion:  Is it Really As Important as We Think?  The Art of Health Promotion  7(2):1-12.
4.   Chapman, Larry.  (2005)   Meta-Evaluation of Corporate Health Promotion Programs Economic Return Studies: 2005 Update.  The Art of Health Promotion, July/August, 1-15.
5.   Chapman, Larry.   (2006)   Employee Participation in Employee Health Promotion Programs and Employee Health Promotion Programs:  How Important are Incentives, and Which Ones work Best?   North Carolina Medical Journal   67(6):  431-432.
6.   Chapman, Larry, Lesch, Nancy, and Passas Baun, Mary Beth.   (2007)   The Role of Health and Wellness Coaching in Company Health Promotion Programs.   The Art of Health Promotion, July/August, 1-12.
7.   Chapman, Larry.  (2007)   Proof Positive:  An Analysis of the cost-Effectiveness of Job Site Wellness.  Northwest Health Management Publishing, Seattle, WA.
8.   Chapman, Larry.  (2007)   An In-Depth Look at the Economic Evidence for Rewarding Health Behavior Change.   Workshop presentation at the World Research Group “Rewarding Healthy Behaviors for Health Plans and Employers” Conference, Orlando, FL, January 23-24.
9.   Edington, Dee.   (2001)   Emerging Research:  A View from One Research Center.  American Journal of Health Promotion 15(5): 341-349.
10.   Edington, Dee W.  (2007)   Health Management as a Serious Business Strategy.  Presentation at the World Research Group “Rewarding Healthy Behaviors for Health Plans and Employers” Conference, Orlando, FL, January 23-24.
11.   Pelletier, Barbara, Boles, Myde, and Lunch, Wendy.  (2004)  Changes in Health Risks and Work Productivity.   Journal of Occupational and Environmental Medicine, 46(7): 746-754.
12.   Pelletier, Kenneth R.  (2005)   A Review and Analysis of the Clinical and Cost-Effectiveness Studies of comprehensive Health and Disease Management Programs at the Job Site: Update VI 2000-2004.  JOEM 47(10)1051-1058.
13.   DeVol, Ross, Bedroussian, Armen, et. al.  (2007)  An Unhealthy America:  The Economic Burden of Chronic Disease.  Report released by the Milken Institute.   www.milkeninstitute.org.
14.   Partnership for Prevention.  (2008) Investing in Health:  Proven Health Promotion Practices for Workplaces.   http://www.prevent.org/images/stories/2008/investinginhealth_finalfinal.pdf.