Originally posted May 29, 2014 by Andy Stonehouse on https://ebn.benefitnews.com.

For all the talk of the benefits of onsite wellness programs – in both the healthier, more productive lives of workers, as well as the presumed employer cost savings as sickness, injury and absenteeism are reduced – are American companies really getting the most out of their wellness dollars?

A new EBN survey, which drew responses from 245 benefits managers, administrators and human resources professionals, finds that wellness programs work best when employee incentives – be they cash or decreases to insurance premiums (or penalties for not achieving goals) – are clearly established. But meeting wellness objectives, be they cutting costs, increasing employee productivity or lowering on-the-job absences, remains a struggle, and companies who’ve implemented wellness programs say they sometimes find it difficult to justify the investment in those costly ventures.

Wellness programs, as a result, are still on the “to do” list of many respondents; only 44% are currently running a wellness initiative, with more than a third either thinking about or almost ready to roll out a program of their own. A lack of benefits/HR managerial resources and the challenging nature of showing the financial justification for wellness’s costs are the biggest factors holding them back, according to the survey.

Among those who’ve actively adopted a wellness program at their workplace, the results are largely positive, but not breathtaking. Just 5% of respondents say they’ve completely met their top objectives – cost savings and cost avoidance – though 53% say they’ve “somewhat” met those goals and a third say they’ve achieved “a little” of that goal. The same goes for other top goals – improving employee health and longevity, and enhancing employee engagement and participation – with respondents reporting only mid-level success, at best.

Respondents said they personally had far less interest in using wellness to increase employee retention and satisfaction, reduce absences or increase overall productivity. “Turnover is an issue in our industry; spending money on wellness for people that leave hurts the ROI on wellness,” one respondent added.

What works

In order to make wellness successful, those who’ve set up and retained a program say that it’s critically important to offer easy-to-use wellness educational tools for employees. This is a much easier task to accomplish, they say, than objectives such as transforming their workplace culture into one centered on wellness, or getting employees engaged in wellness offerings.

But there are still plenty of success stories, and examples of what helps to get workers fully engaged. “A culture of wellness and associate programs requires a long-term commitment,” one respondent noted. “We are beginning to see results after only two years in effect.” Most of those with positive wellness outcomes say they’ve used incentives to help push participation in their programs, with almost half offering cash or gift cards and 40% offering health insurance premium discounts … or penalties, on the other side of the coin, for employees who do not take part.

Survey participants offered their opinions on the vendors that they work with; according to the results, the top five wellness partners include Cigna Behavioral Health, WebMD Health Services, HumanaVitality, OptumHealth Care Solutions and Alere Health Improvement. The various units of Blue Cross/Blue Shield are also important strategic partners for many companies. Interestingly enough, 19% of those respondents with wellness plans in place admitted they did not work with a specific wellness vendor at all, opting to do the heavy lifting of implementing and running a wellness program on their own.

Wellness’ saturation also appears to be directly connected both to the type and the size of business respondents are engaged in. While office-based workplaces such as banking and financial services, plus health care – rife with potential health issues among sedentary workers – make up the largest percentage of those taking the survey, manufacturing and industrial worksites are also important settings for wellness programs. More than 65% of our respondents work with employee populations of 1,000 or fewer, almost a third in companies less than 100.

The survey’s results echo the experiences of benefits managers such as Katie Sens, director of human resources for Chemprene, a small manufacturing firm in New York’s Hudson Valley. Sens oversees the wellbeing of about 115 employees, and says that like many workplaces across the country, those involved in daily physical labor out on the manufacturing floor tend to be in better shape than the company’s desk-bound workers.

“We’ve tried to create interest by offering gym memberships, but we had problems with our health insurance providing coverage,” she says. “But we’ve been inspired by our boss, who walks every day and has lost about 75 pounds in the process, so we worked out another arrangement with Gold’s Gym – we’ll pay if they go eight times a month.” In addition to standard wellness pushes such as smoking cessation and flu shots, Sens says her company has partnered with online weight loss and nutrition and lifestyle coaching provider Retrofit, paying half of employees’ costs up front and hosting group programs.

“Our boss is aboard, I’m in it, as are several other managers and their sponsors, hoping to lead by example,” she says. “Now I’m getting a lot more questions about the program, and certainly raising awareness.” As for ROI on Chemprene’s wellness efforts, Sens says the company is hoping to achieve a better bottom line for its health insurance costs, which she and management will be keeping a close eye on as the wellness programs develop; their efforts are too early to tell, she admits.

Offerings matter

Employee participation in our survey respondents’ wellness efforts also greatly varies by the complexity of the programs they offered. Overall, the highest participation was experienced in safety and injury prevention programs – more than half of respondents said the majority of their workers took part, followed by health screenings (including biometric tests, flu shots, health risk assessments and on-site health clinics), with at least 50% of employees taking part. Significantly less participation was noted in awareness, education and support programs, stress relief efforts and disease management programs; in workplaces where direct physical activities were offered, the majority of respondents said that less than 50% of their workers took part.

Teisha Haynes, global benefits supervisor for international oilfield service company Halliburton, continues to work to find productive and cost-efficient wellness options for her 35,000 U.S. employees and 75,000 dependents, spread out at 104 worksites across the country. Haynes says that the teamwork atmosphere among the company’s largely laboring workforce can actually be beneficial, when it comes to getting workers more actively engaged in physical activity.

“We realize that our employees like to work in teams and compete, so we have implemented a number of physical activity challenges that allow them to work together and compete against other business units for not only bragging rights, but a donation to the charity their select,” she says. “We have had participation from the executives, all the way down.”

For Halliburton, many larger worksites now include an on-location physical activity coordinator (“wellness champions”) to help provide compatible, healthy exercise, even for those employees not necessarily dragging pipes on an oil rig. Those coordinators are tasked with figuring out what works best in their local environment – and what vendors can provide the best services at annual wellness fairs, be they biometric screenings, heart health clinics, mammograms, or exercise programs (Red Wing Shoes, for instance, has helped with foot health assessments at various locations).

Do the efforts pay off? Haynes says measuring the investment in wellness can be a challenge, though the company is moving to quantify things more clearly by comparing claims numbers and data from health risk assessments. “We get some positive signs, like ‘employees are feeling better,’ but that produces pretty fuzzy numbers, so we’re thinking of working with Truven’s health analytics database to get more solid results,” she says.

Among those companies that are reluctant to implement a wellness program, common impediments emerge: 46% say that wellness is simply not a priority for them now, while 20% of others say that they lack the staff resources and time to help establish a wellness system. More often than not, they admit they are “still questioning whether we need one or not,” as well. As a result, a quarter of those still on the fence about wellness say it will be at least a year, if not two, before they’re able to get underway with a full wellness push.

Those who have yet to start up their own wellness program say they are primarily frustrated by a lack of time and resources to do so, as well as the financial costs involved in both start-up and administration of a wellness offering. “Our company is just a year old so it takes time to find out what employees want and will participate in,” one respondent wrote. Others said that their upper management has yet to be convinced of the merits of a wellness program; quantifiying the potential savings, whether they be direct cost reductions or overall decreases in sick leave, remains the biggest stumbling block.

Those cost-related fears may not be unfounded: 40% of survey participants who formerly had a wellness program but have abandoned those efforts say they did so primarily for financial reasons, as well as out of concerns of issues of employee privacy or anti-discrimination laws. Some changed health care providers or lost a partnership with their wellness vendor, as well.

As a more successful alternative, some survey respondents say they have worked to establish very specific objectives for their wellness programs, working with wellness vendors to find the right fit. Dale Johnson, employee benefits manager for the city of Cary, N.C., says that involved developing an innovative functional movement screening – not unlike those used in professional sports – to better understand the musculoskeletal strains of an aging workforce engaged in medium to heavy physical work, and use exercise and better day-to-day techniques to reduce strain and injuries. Johnson says the holistic program, developed with the input of research from nearby Duke University and initially implemented with the city’s public safety employees, resulted in a tangible negative trend in health care utilization and costs.

“The jury’s still out on the long-term impacts of the program, but we’re now considering expanding it to our employees in public works and utilities,” Johnson says. If this variation of a wellness program can significantly cut costs, Johnson says it could be a very positive sign that focused wellness efforts pay off.