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Wellness financial incentives alone are inadequate for changing unhealthy behaviors
Our experience tells us that often, wellness programs do not work. Return on investment can be poor (or nonexistent) and behavioral change is hard to measure, and often transitory.
But studies published in various reputable publications report the opposite. Consider the titles alone of articles in the Harvard Business Review (“What’s the Hard Return on Employee Wellness Programs?,” December 2010), Health Affairs (“Workplace Wellness Programs Can Generate Savings,” January 2010), and Occupational and Environmental Medicine (its report on a two-year impact of lifestyle changes on workplace productivity loss, March 2015).
Their positive-impact conclusionsseem to make perfect sense, including that:
• The triggers that impact personal behaviors are various, and so consequently wellness financial incentives alone are inadequate for many.
• The workplace nevertheless offers a significant opportunity to influence behaviors.
• Better health behaviors and improved productivity are strongly correlated.
• Lifestyle changes offer both short- and long-term paybacks.
The stakes are high. Not just in the desire to lower health care costs but in reducing absenteeism, improving productivity and lowering turnover as well.
Despite such positives, we can't help but recognize the stubborn persistence of bad behaviors all around us, and sometimes even in ourselves. And if you’re an HR professional or business owner, you may have a satchel full of failed wellness initiatives you can also point to.
The challenge is complex. The study in the Harvard Business Review (HBR) cited above, for example, outlines the attributes of a successful wellness program, including multilevel leadership, alignment (unsurprisingly, it’s a culture thing), scope, relevance and quality, accessibility (convenience and low cost are a must), partnerships, and communications.
If this doesn’t sound like your company’s initiative that may consist merely of conducting health risk assessments, penalizing smokers or doing biometric screenings, you are right. Successful wellness programs are more than that; they are comprehensive and multiyear … and hard to do.
Let’s compare today’s workplace wellness programs to workplace safety programs that are now successfully embedded in most of American business. The contrast is stark. If we measured our safety programs against the HBR criteria cited above, they would pass with honors. Think about the level of buy-in, the ongoing conversation and problem-solving, as well as the recognition of the total costs of job injuries such as lost time, lost productivity, health care costs and permanent disabilities.
No one in the workplace is left out of safety programs. If we use the broad-based, durable success achieved by these safety programs over the past two decades as a yardstick, the positive impact on your company and your workforce would be enormous if this same level of success could be achieved in the area of wellness.
All too often we introduce wellness as a personal, optional item, sometimes with a bit of incentive such as a T-shirt or a Fitbit or a wellness app, or perhaps credits to health savings accounts. And more often than not we include penalties for specific noncompliance, such as premium differentials or higher out-of-pocket costs.
When designing a successful wellness program, my personal checklist looks like this:
Leadership at all levels. I know very few if any executives who have successfully lectured their employees on wellness. They can, however, lead by example. To be truly effective, wellness must be a grassroots effort, led by co-workers (not bosses). This is because peer influences are far more effective. Bosses can grant permission, make resources available and enable a workplace that supports wellness, but it’s so much more effective when employees themselves recommend that the rib smoker in the parking lot be replaced by healthy options.
Open your wellness programs to spouses and kids. Family is the ultimate peer group, although it’s hard to predict who the change agent might be. In a two-earner family, the fifth-grade son or daughter could very well be the family’s wellness advocate—someone will be, and that will make a difference.
Make room for change. Invite exercise into the workplace and make it fun. Whether it’s a walking track around the building, working platforms mounted on treadmills, group clinics and classes for those with common health issues, or monthly contests with prizes, it’s critical that management encourage (but not dictate) workplace wellness initiatives.
Get your safety director involved. Your safety director has experience and an informed point of view, plus an existing support structure in the workplace that can substantially improve your chances of success. So include your safety director in the discussion.
Measure and celebrate success. One of the most effective wellness environments I have witnessed was a manufacturer with a weight-loss contest run by the employees, with regular weigh-ins and posted outcomes around the worksite. The biggest success of that program? A previously 400-pound employee who ended up losing 200 pounds. Be sure to include initiatives that can actually be measured, so that success can be celebrated.
Finally, place the big bet. Why notmake wellness cost-control a companywide goal? After all, we do this for recycling! And anotherbest practice:Broadly advertise the health budget and track spending, and then share the findings on savings with employees—and explain how the results will help to rein-in premium increases.
Improved wellness is not an option for employers, or for American society. The human and financial costs are unaffordable. Poor health remains one of the most significant barriers to the success of individuals and families. While sticks and carrots—financial penalties and incentives—are helpful, they are not nearly enough to complete the job. A truly profound and durable change in attitudes and behaviors requires more. Nothing less than a culture of wellness is essential.
Tom Kelly is CEO of HealthSmart, an independent administrator and provider of customizable health care solutions for all types of organization.
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