Taking Aim at Employee Wellness

Why Narrowing Your Focus Can Have a Bigger Impact

On paper, it all looks so logical. Go the extra mile to keep all of your employees healthy, and they’ll be happier, more productive, and more loyal. Oh, and you’ll also save money on your healthcare spend. Who wouldn’t jump on that train? Your company is probably chugging down the “wellness” track as you read this, along with thousands of other well-intentioned employers. But are your employees actually getting any healthier?

As the cost of healthcare started its meteoric ascent in the 1980s, wellness benefit programs started popping up like kale at a salad bar, pledging to help companies contain their rising healthcare costs. For the most part these were, and continue to be, broad platforms aimed at engaging all employees in healthy lifestyles. Weight-loss and walking challenges, gym memberships, consultations with personal coaches, and wellness classes are common among their offerings.

Again, they look good on paper. Because sure, we all could benefit from at least one of those things. If we were to actually, you know, engage in them. But according to Gallup research, “Only 60% of U.S. employees are aware that their company offers a wellness program — and only 40% of those who are aware of the program say they actually participate in it. The upshot is that at companies that offer wellness programs, only 24% of employees are participating.”

Because of these notoriously low engagement rates, most wellness companies charge Per Employee Per Month (PEPM). That is, they base their fees on a company’s total number of employees, whether or not they all enroll in the benefit. And whether or not those who do, succeed or even engage in any meaningful way. In a healthcare environment that’s heading toward outcomes-based payment models, the PEPM scheme seems antiquated at best; a total waste of money at worst.

Entire books and blogs have been written about how the preponderance of wellness programs don’t work, for employers or employees. But to say no one is benefitting may be going a bit far. Folks who already enjoy going to a gym regularly can continue to do so at a reduced out-of-pocket cost. Those whose lives aren’t already jam packed with obligations might actually have time to meet with a personal coach on a regular basis. But these aren’t the folks who are draining your healthcare budget. More on them in a bit.

One of the biggest bones that wellness watchdogs are picking with broad wellness providers is their lack of scientific rigor. And you should be picking that bone too. Crucial questions to ask before signing on with any wellness benefit include:

1. How are they monitoring engagement, measuring outcomes, and validating their claims? Spoiler alert: their answer will likely be, “We’re not.”
2. How are they calculating any ROI they may be claiming? There’s a good chance their answer will have something to do with shifting employer healthcare costs to employees. A lot of companies are now offering employees biometric screenings or health risk assessments, to measure certain health indicators like BMI, cholesterol, blood pressure, etc. Which can be great stuff to know. But some employers are making participation in these screenings mandatory. And employees whose results are deemed subpar, or who refuse to participate at all, get dinged financially. So the ROI isn’t coming from healthcare savings. It’s coming from unhealthy employees.

Let’s circle back to the employees who have the most impact on healthcare budgets. Obviously, these would be the ones who require the most doctor appointments, ER visits, hospital admissions, surgical procedures, and prescription medications. Shorthand: the chronically ill. For instance, employees with type 2 diabetes can cost companies 2.5x as much as healthy employees. Employees with heart disease can cost 5x as much.

They’re also the ones who miss the most work. Employees with type 2 diabetes use 3x more sick days than healthy employees on average. And as you might imagine, they’re also lugging around a lot more stress, balancing standard work and family obligations with failing health and mounting medical bills.

The employees who are at the Tipping Point of developing one of these preventable chronic diseases are the ones you want — scratch that — need to help get healthy. So it makes much more sense to take a more targeted approach when considering health and wellness benefits. And when you do start evaluating providers who claim they can help employees at risk of costly chronic diseases, be sure to insist on clarity on these important issues:

Each of your employees falls into one of three groups. Let’s call them Well, Tipping Point, and Unwell. Understanding who they are and what they need can go a long way to helping you shape your benefit offerings.

You now know what you have to do for the Tipping Point population. But what about the others?

People who already have a chronic disease need targeted medical interventions, not “wellness” programs. And there’s really no money to be saved nor behaviors to be changed with the Well population. That said, both of these groups still want to feel supported by you. Sure, some might appreciate a typical wellness offering. But what if you could reach all of them with a benefit they would appreciate — and actually benefit from — even more? Something less costly, for instance.

Below is a quick brainstorm of some traditional and not-so-traditional ways to let your Unwell employees know you care about their well being on a holistic level, and get your Well employees even more excited about staying well. And a lot of them are way less expensive to implement than the average wellness program. But don’t stop here. Tap your own employees for more ideas on what could make a healthy difference in their lives (odds are they won’t be asking for a wellness program). Feel free to share what they come up with, and your own ideas, in the comments section below. You can also download and share this list to help start the dialog at your company.

Keep your active people active, and inspire sedentary folks to try healthy activities that actually interest them.

• Provide a new pair of sneakers every year.
• Reimburse for yoga, meditation, dance, or other classes that promote healthy activity and wellbeing.
• Provide an on-site fitness center.
• Reimburse for sporting gear purchases or repairs.
• Provide locker spaces and showers for bike commuters and runners.

Make it easier for your people to develop better eating habits by making healthy food more accessible to them at work and at home.

• Provide free, fresh salads for lunch every day.
• Provide only healthy food and beverages in vending machines instead of sugar- and carb-laden snacks.
• Provide vouchers for local farmers’ markets.
• Reimburse for produce delivery boxes or healthy meal delivery.

Make a healthy work life-balance achievable by eliminating some unnecessary stressors and allowing time for your people to engage in healthy endeavors.

• Offer a 4-day work week for the same pay.
• Offer 4 weeks paid vacation for all full-time employees.
• Provide on-site childcare.
• Reimburse for a fixed amount of babysitter costs per month/year.
• Provide on-call babysitters for employees’ sick children.

Omada Health provides engaging, effective, scalable behavior change to adults at risk for type 2 diabetes and heart disease. Our published, clinical outcomes are peer reviewed and our fees are outcomes-based.

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