Giving onsite clinics an engagement booster shot

In efforts to reduce healthcare spend and increase the population's health, many employers are offering a variety of employee wellness services and programs. Read this blog post to learn more about increasing engagement in onsite clinics.


Employers of all sizes and industries are currently offering a variety of wellness services that include preventive, acute, primary, chronic disease and occupational healthcare programs at or near the worksite. These benefits are intended to reduce healthcare spend, increase the population’s health and productivity and positively impact recruitment and retention efforts.

In fact, according to two 2018 studies by the National Association of Worksite Health Centers, more than one-third of all employers and close to 50% of large firms are now operating worksite clinics. But just because employers offer such benefits doesn’t mean employees will take advantage of these services, even when they’re free.

But many employers are frustrated to find that 20% or less of the targeted or covered workers utilizes their programs — with millions of dollars in benefits wasted.

Failure can be caused by lack of promotion, inadequate incentives, poor communications or providers who don’t fit into the culture of the employer. However, one of the most significant problems than can undermine a benefit program, especially a worksite clinic, is when employees don’t trust that their personal health data will be confidential and fear it will be used for employment decisions.

Employers who achieve high benefit utilization build the foundation for success by informing their workforce, prior to a benefit or clinic being available and on an ongoing basis, of the many federal and state confidentiality and privacy laws that dictate who can receive personal and occupational health information and the limitations placed on employers.

Communications, posters, presentations and other marketing vehicles must assure employees that the employer will only see aggregate, not personal data from the offered benefit programs. Emphasize that the program’s or clinic’s medical providers will be the only individuals dealing with this information, and that by law they are legally and ethically obligated to keep this confidential.

Understanding the culture and labor-management dynamics of an organization are also critical to building trust. To increase use, it’s often best to market the program or facility under a new brand name, such as “The Healthy Life” or use the name of the provider who manages the program or clinic, rather than the employer’s name.

The physical design or location of a benefit program or clinic also needs to be kept in mind. Clinical or counseling activities should be separate from business offices or fitness centers where a person taking advantage of the benefit could be seen by their peers, managers and supervisors.

Achieving engagement in a health benefit program or clinic is key to its success, as well as obtaining the resources and support of senior management for its expansion and continuance. The design, marketing and location of benefit programs need to be well-planned so the workforce is confident that the confidentiality of their patient records will be maintained and not used for employment decisions.

SOURCE: Boress, L. (9 July 2019) "Giving onsite clinics an engagement booster shot" (Web Blog Post). Retrieved from https://www.benefitnews.com/opinion/how-to-increase-employee-engagement-in-healthcare-benefits


The Occupational Phenomenon Called Employee Burnout

According to the World Health Organization, "burn-out is a syndrome conceptualized as resulting from chronic workplace stress that has not been successfully managed". Unfortunately, workplaces are dismissing burn-out as an employee's issue rather than a workplace issue. Read this blog post to learn more.


Employee burnout is fast becoming prevalent in many workplaces and is also a recurring theme in my day-to-day conversations with people. Unfortunately, many workplaces dismiss the subject and make it more of the employee’s issue than a workplace issue.

“Burn-out is a syndrome conceptualized as resulting from chronic workplace stress that has not been successfully managed. It is characterized by three dimensions: 1) feelings of energy depletion or exhaustion; 2) increased mental distance from one’s job, or feelings of negativism or cynicism related to one’s job; and 3) reduced professional efficacy.”

— World Health Organization

An organization’s culture and the work expectations in those organizations can foster employee burnout. Below are examples of situations that make employees prone to burnout:

  • Digital Culture: A digital workplace, according to Deloitte, is one where many operational activities are performed over technology devices. These days, you can access your work emails, phone and video conferencing applications, instant messaging tools, and work documents through a single device. It is even more tempting to resist the notifications that continuously nudge you to respond to work-related matters. While I appreciate the digital workplace and understand that it is here to stay, it often implies that we need to be available around-the-clock, even during weekends. You have managers or coworkers sending work requests during early or late hours of the day, leading to a work-life imbalance for the employee. When work begins to encroach into an employee’s personal life, then they are at risk of burnout.
  • Excessive Meetings: Collaboration is a skill required in many workplaces, and there’s no doubt that it is essential. However, some organizations tend to go overboard with their expectations from employees. Study shows that the average employee spends approximately six hours in meetings per week, while senior managers spend about 23 hours in meetings per week, and this increases by the size of the organization. Meetings, whether in-person or virtual, provide excellent opportunities for collaboration. When meetings become excessive and leave employees with little to no time to decompress, this can cause stress for employees and eventually lead to burnout.
  • Dysfunctional Work Environments: In these work environments, employees face issues such as bullying, micromanagement, gossip, favoritism, or microaggression from coworkers or managers. A workplace that encourages such undermining behaviors can cause undue stress, which can eventually lead to burnout.
  • Overworking Top Performers: It is quite easy for managers to overwork the best-performing employees. While the managers have the assurance of quality work, such employees become the victims of burnout because it seems like the reward for top performance is more work. Worse still, burnout is likely to occur when these employees do not receive fair compensation for the work they do.

What are the Signs of Employee Burnout?

The following are some signs of burnout in your employees:

  • Reduced drive and work performance
  • Increased absences from work
  • Frequent tardiness
  • Mental health conditions like anxiety and depression
  • Poor concentration at work
  • Increased sick days
  • Visible frustration
  • Lack of trust in the company and its leaders

If you or your colleagues are exhibiting any of these signs, you might be burned out.

Some Data

  • A 2018 Gallup report states that “two-thirds of full-time workers experience burnout on the job.”
  • A Harvard Business School article reports that “the estimated cost of workplace stress is anywhere from $125 to $190 billion a year.”
  • An article by The World Economic Forum states that “the annual cost of burnout to the global economy has been estimated to be £255 billion.”
  • Research by Stanford Graduate School of Business states that “workplace stress—such as long hours, job insecurity and lack of work-life balance—contributes to at least 120,000 deaths each year and accounts for up to $190 billion in health care costs.”

The data shows that employee burnout is now a workplace epidemic. To prove the seriousness of this issue, the World Health Organization (WHO) recently classified burnout as an “occupational phenomenon” in its latest revision of the International Classification of Diseases (ICD-11).

Ways to Reduce Employee Burnout

  • Create and Maintain a Positive Work Environment: You can do this by being aware of your actions and how they impact those around you. Do not bully or micromanage your employees, or gossip about them to other employees you manage. When making decisions about your employees, be fair and consistent to avoid feelings of favoritism. Also, empower your employees to apply their skills by giving them autonomy. These help to increase satisfaction and create trust in the workplace.
  • Set Realistic Goals: Plan projects ahead of time with your employees, set realistic deadlines or meetings, and be mindful of their personal commitments when assigning projects with tight deadlines.
  • Show Support: Create communication channels for your employees to share their concerns or frustrations with you. Having an open-door policy or weekly check-in meetings where they can share their concerns with you can make your employees feel supported. Listen to them and help to address their issues.
  • Show Appreciation: Recognize your employees for their contributions to your team. Recognition makes your employees, especially your top performers, feel like their work is impactful. When employees feel appreciated, they are more likely and willing to do great work.
  • Promote Self-Care: Encourage your employees to practice self-care by permitting their requests for personal time off or vacation when they need it. You can also encourage them to fully unplug while they are out of the office by not sending urgent requests. Another way to promote self-care is to remove all expectations that employees need to be reachable around-the-clock. Also, do not encourage employees to stay long hours at work.

Originally published on Osasu Arigbe blog.

SOURCE: Arigbe, O. (13 June 2019) "The Occupational Phenomenon Called Employee Burnout" (Web Blog Post). Retrieved from https://blog.shrm.org/blog/the-occupational-phenomenon-called-employee-burnout


One overlooked way to promote well-being: Target oral health

Are you promoting oral health when promoting employee wellness? Research shows an association between gum disease and conditions like diabetes and coronary artery disease. Continue reading to learn more.


With the cost of employer-sponsored healthcare benefits approaching $15,000 a year per employee, according to the National Business Group on Health, innovative companies are looking for new and creative ways to get maximum value from their benefits dollars.

By embracing benefits strategies focused on overall health, companies can help their current employees be healthier and more productive and attract and retain the workers they need to succeed in today’s competitive labor markets.

And although wellness programs or health apps might first spring to mind, there’s an overlooked way to promote employees’ health: oral care.

Guided by research that shows associations between gum disease and conditions like diabetes and coronary artery disease, forward-thinking dental insurers are developing products that emphasize the importance of regular oral care, particularly for workers with those conditions — and smart companies are jumping on board.

Products that emphasize the importance of maintaining oral health are an important step in integrating care. Over the next several years, leading-edge insurers will create new ways to engage patients in conversations about their dental and overall health, as they seek to encourage behavior changes and improve health outcomes. To help improve oral and overall well-being, insurers will need to share oral care information with their members through targeted emails, text messages and phone calls.

Additionally, because individuals dealing with a complex treatment plan may put off receiving oral care while they address their medical issues, they could benefit from plans featuring a case manager, or a “dental champion.” Working in conjunction with medical case managers, a dental champion can help employees understand how receiving regular oral care can influence their overall health. They also can ensure a company’s workforce is getting the oral care they need, helping them find providers and arrange appointments.

Savvy employers recognize that any realistic effort to limit the increase in healthcare costs begins by addressing chronic ailments. According to the Centers for Disease Control and Prevention, six in 10 Americans live with at least one chronic disease, like heart disease, cancer, stroke or diabetes.

By promoting overall health — including regular oral care — employers can encourage positive lifestyle changes that help their employees reduce the likelihood of many chronic problems. Those who brush and floss their teeth regularly, receive frequent cleanings and checkups and deal with oral issues at early stages are taking steps to improve their overall health.

Because everyone’s individual situation is different, insurers and employers will need to include a more personalized approach, engaging members in conversations about their dental health and how it contributes to attaining their overall health goals.

SOURCE: Palmer, T. (13 June 2019) "One overlooked way to promote well-being: Target oral health" (Web Blog Post). Retrieved from https://www.benefitnews.com/opinion/promoting-wellbeing-through-dental-health


Move over, financial wellness. It’s time for financial flexibility

Are your employees stressed out about their personal finances? Many find it hard to believe that a majority of employees live paycheck-to-paycheck, despite the fact that most Americans have recovered from the Great Recession. Continue reading to learn about financial flexibility.


It’s somewhat hard to believe that most employees today continue to live paycheck-to-paycheck. Despite the fact that Americans have recovered from the Great Recession a decade ago and that the unemployment rate is the lowest it has been in many years, employees are essentially making the same amount of money they did during the pre-recession “good days” many years ago. Of course, living costs have gone up in this same period.

That means employees are stressed about their finances. They don’t have enough emergency savings for unexpected expenses and struggle to make minimum monthly payments on credit cards and loans. And the problem is bigger than that because their financial stress also distracts them at work. Whether it’s student loans, car payments, mortgage/rent payments, credit card debt, an unexpected expense or some other financial matter that they are worried about, the bottom line is they are spending time at work on these issues rather than doing the job employers are paying them to do.

Thus, employees’ personal financial stress affects employers as well. When employees bring that financial stress to work, it results in low productivity, absenteeism and, in many cases, higher healthcare costs.

Today’s employees want to make their money to do more. Financial flexibility can help them get there.

So what is financial flexibility? It’s the ability to manage expenses and make everyday life affordable. It’s the financial stage beyond living paycheck-to-paycheck. It means being smart about how we use our monthly income and finding ways to make our money do more so that we are able to pay bills on time, take a vacation, have an emergency fund for unexpected expenses and perhaps splurge on something small occasionally. Financial flexibility is the stage between living paycheck-to-paycheck and financial security (a level few employees ever achieve).

Being financially flexible means finding ways to make our money do more by following a monthly budget, being wise shoppers and taking advantage of employer-offered financial wellness tools and voluntary benefits such as financial counseling, student loan refinancing programs, employee purchase programs and payroll-deducted savings programs.

Providing financial flexibility at work

Financial education benefits can help employees with budgeting and debt reduction needs, and over the past several years, growing numbers of employees have begun using the services their employer provides to assist them with their personal finances.

But it takes more to have financial flexibility. While financial education benefits can help employees with budgeting and debt reduction needs, employers should adopt additional voluntary benefits that provide employees the opportunity to have some financial flexibility.

Among these are:

  • Low-interest installment loans and credit that help employees avoid payday loans and cash advances from credit cards when they have emergency needs such as unexpected out-of-pocket medical expenses.
  • Student loan repayment benefit programs in which employers are making contributions to loan balances or providing methods for employees to refinance their debt.
  • Automated savings programs that encourage employees to start taking control of their financial future by saving money each month from their paycheck. Many employees don’t have $1,000 or more in savings to use for emergencies and saving a little each month can help build that emergency fund.
  • Employee purchase programs that allow workers to purchase consumer products and services through payroll deduction when they are unable or prefer not to use cash or credit. The program is an alternative to high-interest credit cards and other sub-prime financing options for customers desiring to pay for a purchase over time.
  • Bill payment programs that empower employees with debt paydown strategies and the ability to make recurring bill payments on-time each month through payroll deduction

Today’s employees want — and need — their money to do more so they aren’t living paycheck-to-paycheck. Employees who are less financially stressed are happier. That results in more engaged, productive workers and an increased bottom line for employers. The new normal is financial flexibility. And there’s a role for voluntary benefits in helping employees get there.

SOURCE: Halkos, E. (23 April 2019) "Move over, financial wellness. It’s time for financial flexibility" (Web Blog Post). Retrieved from https://www.employeebenefitadviser.com/opinion/use-voluntary-benefits-to-help-employee-financial-wellness


Here’s how to get the best ROI on a wellness program

How many hours do your employees work per year? According to the International Labour Organization, Americans work nearly 500 more hours per year than French workers and 260 more hours per year than British workers. Continue reading to learn how employers can get the best ROI on a wellness program.


U.S. employees are working harder than ever and need more support from their employers as a result.

In fact, according to the International Labour Organization, Americans work 137 more hours per year than Japanese workers, 260 more hours per year than British workers, and nearly 500 more hours per year than French workers.

With that growing burden — along with more individuals of all ages recognizing how important their health is — comes an increased need for companies to invest in well-designed health and wellness programs. Rolling out these programs can lead to better employee morale and engagement, a healthier and more inclusive culture and fewer absences due to illness, according to research — all of which are especially important in today’s fast-paced work atmosphere.

In addition, the rise of social media means that businesses are being held accountable by their employees in a way that was not the case for previous generations. According to the British Standards Institution, employees trusting their employers’ commitments is now an increased focus. Health and well-being are becoming a significant part of that workforce trust agenda.

With these points in mind, it’s important to recognize that your organization needs to make and keep commitments to investing in and executing successful health and wellness programs for your workforce. These programs must keep trust momentum going to ensure healthier and happier workers, and it is proven that happier and healthier workers are more productive. This can lead to overall company success.

For example, a recent employee wellness study from the U.S. Chamber of Commerce showed that effective wellness programs have good return on investment of $1.50 to $3.00 per wellness dollar spent over a two to nine year timeframe. Another study from the Australian-based Black Dog Institute concluded that thriving and healthy workforces typically perform more than two times above average, compared with organizations that do not invest at all in their employees’ health and well-being.

BSI recommends a three-pronged approach for successfully investing in your employees’ health and wellness. First, it’s important to define your health and well-being initiative and what it means for your company. While there are many definitions, BSI recommends considering one that recognizes the need to manage workplace occupational health and safety, in addition to the promotion and support of managing healthy behavior, such as stress management, work-life balance and an ever-changing work environment.

Next, employers should define what their health and wellness program for workers should include. In particular, BSI suggests a good model to follow: the U.S. federal government’s recommended approach for workplace health and well-being programs. Created by the Center for Disease Control’s National Institute for Occupational Safety and Health, the program is called Total Worker Health.

TWH is a holistic approach to occupational health and safety and worker well-being. It recognizes that work has an important function in the social determinants for health and is defined as “policies, programs, and practices that integrate protection from work-related safety and health hazards with promotion of injury and illness prevention efforts to advance worker well-being.”

However, this program also goes much further than other wellness programs and reflects the nature and challenges of the changing workplace, from new forms of employment to new technologies. It also reflects that non-work-related illness and stress can be adversely impacted by work, can have health and safety implications within the workplace, and the way an organization manages absence and rehabilitation policies can have hugely positive or negative impacts on the individual and the business.

Once you know what health and well-being means to your business and what kind of program your organization wants to execute, it’s time to move forward. For step three, BSI recommends companies review and implement ISO 45001, the new global management system standard on occupational health and safety. This standard has physical, mental and cognitive well-being and health at its core, while continuing to drive high safety standards for companies.

ISO 45001 also recognizes that the most successful and productive organizations take a holistic approach and therefore, good occupational health and safety management can be integrated with employee well-being initiatives. Related to this, holistic employee wellness programs can be used as a recruitment tool. Evidence from WhenIWork.com suggests that employees want their employers to take an active role in their health, so if you can show potential employees that you are invested in their well-being, you will gain an advantage over companies offering only bare-bones benefits.

As a global standard, ISO 45001 also enables a consistent worldwide approach. With its focus on culture and employee participation, it also provides businesses a best practice model for developing an effective health and well-being program. And employee participation will happen. For example, experts from the Johns Hopkins Bloomberg School of Public Health recently analyzed surveys to determine the overall perceptions of wellness programs from employee and employer perspectives. Its data analysis revealed that nearly 60% of employees think employers should attempt to improve the health of their workers.

Overall, seeking accredited certification of the standard not only builds trust within the organization, but also provides external assurance to customers, shareholders and the wider community. Investing in employee health and wellness programs increases healthy behavior and curbs the risk of lifestyle-related disease, leading to happier workers, more productivity and overall company success.

SOURCE: Field, K. (4 June 2019) "Here’s how to get the best ROI on a wellness program: (Web Blog Post). Retrieved from https://www.employeebenefitadviser.com/opinion/how-to-get-the-best-roi-for-your-wellness-program


Getting employees up to speed with health literacy

Do your employees know how much sugar is in a granola bar or how much radiation is in a CT scan? If not, it's most likely because no one is teaching them. Continue reading to learn more on getting your employees up to speed with health literacy.


Your employees probably don’t know how much sugar is in a granola bar or how much radiation is in a CT scan. They may not even know how to reach your employee assistance program.

That’s because no one is teaching them. Which is what happens when wellness program education ends at eat more fruits and vegetables and avoid added sugar.

Sometimes the advice is even wrong. For example, below is a clipping from a popular health risk assessment. Focus on the lower right quadrant.

It isn’t entirely true that low-fat and nonfat dairy is healthier. In fact, full fat dairy does have health benefits, for example some studies suggest it could help protect against diabetes. By comparison, low-fat or nonfat yogurt could be a significant source of sugar.

This is why employee health literacy is so important. With easy access to mis-information, employees need to learn to sift through the noise to determine what is actually good for them.

Plus, there is plenty to learn. Spanning from everyday health, employee medical education and health benefits literacy. I’ve outlined just a few of the ways to employers can better educate their population.

Everyday health education

Sugar is one place where health education could be more impactful — but it should go beyond just telling workers to avoid added sugars. Education starts at work. Chances are your break room is stocked with granola bars, maybe Clif Bars. The first ingredient in a Clif Bar is organic brown rice syrup. That may sound healthy, but it’s really just sugar. In fact, there are almost 60 different sugars disguised with fancy names like turbinado or malted barley extract.

Another example is sleep. We all want employees to get enough of it, but do they know how? They may not know little bits of information that could help them get more shuteye, like there is a night shift setting on their iPhone or that energy-efficient light bulbs contribute to insomnia.

But teaching everyday health is just the beginning of health literacy. The real impact comes with employee medical education.

Employee medical education

U.S. consumers are voracious purchasers of healthcare services and yet our outcomes remain poor. Americans have about 240 CT scans per 1,000 people. To put that in perspective, only about 1 in 1,000 covered people in your employee population was hospitalized for diabetes last year. So 240 times more employees are getting scans than uncontrolled diabetes.

CT scans have risks. They have about 500 times the radiation of an x-ray and are especially concerning for children because their cells are dividing more rapidly than adults and are more sensitive to radiation exposure. The dye used intravenously also carries a risk.

But many employees don’t know about these risks. So it may be important to educate your workforce about these common medical procedures and how to decide whether or not it is right for them.

Health benefit education

Here’s a wild guess: your employees don’t appreciate the health benefits you provide for them. If so, you’ve got company. Most large organizations face the same issue.

Consider the employee assistance program. Do workers know you offer one? Do they know it’s confidential? They know their emails aren’t confidential, so don’t assume they know this. Do they know the URL, username and password? How many free sessions do they get?

Repeat a similar set of questions for all your benefits. You can’t expect that some memos and a website will implant your benefits firmly in their mind.

SOURCE: Lewis, A. (25 April 2019) "Getting employees up to speed with health literacy" (Web Blog Post). Retrieved from https://www.benefitnews.com/opinion/educating-employees-through-health-literacy


Workplace Wellness Programs Barely Move The Needle, Study Finds

A recent study from JAMA found that workplace wellness programs do not cut costs for employers, reduce absenteeism or improve workers' health. Read this blog post to learn more about this recent study.


Workplace wellness programs have become an $8 billion industry in the U.S. But a study published Tuesday in JAMA found they don’t cut costs for employers, reduce absenteeism or improve workers’ health.

Most large employers offer some type of wellness program — with growth fueled by incentives in the federal Affordable Care Act.

A host of studies over the years have provided conflicting results about how well they work, with some showing savings and health improvements while others say the efforts fall short.

Many studies, however, faced a number of limitations, such as failing to have a comparison group, or figuring out whether people who sign up for such wellness programs are somehow healthier or more motivated than those who do not.

Now researchers from the University of Chicago and Harvard may have overcome these obstacles with one of the first large-scale studies that is peer-reviewed and employs a more sophisticated trial design.

They randomly assigned 20 BJ’s Wholesale Club outlets to offer a wellness program to all employees, then compared results with 140 stores that did not.

The big-box retailer employed nearly 33,000 workers across all 160 clubs during the test.

After 18 months, it turned out that yes, workers participating in the wellness programs self-reported healthier behavior, such as exercising more or managing their weight better than those not enrolled.

But the efforts did not result in differences in health measures, such as improved blood sugar or glucose levels; how much employers spent on health care; or how often employees missed work, their job performance or how long they stuck around in their jobs.

“The optimistic interpretation is there is no way we can get improvements in health or more efficient spending if we don’t’ first have changes in health behavior,” said one study author, Katherine Baicker, dean of the Harris School of Public Policy at the University of Chicago. (Dr. Zirui Song, an assistant professor of health policy and medicine at Harvard Medical School, was its co-author.)

“But if employers are offering these programs in hopes that health spending and absenteeism will go down, this study should give them pause,” Baicker said.

The study comes amid widespread interest in wellness programs.

The Kaiser Family Foundation’s annual survey of employers found that 53% of small firms and 82% of large firms offer a program in at least one of these areas: smoking cessation, weight management and behavioral or lifestyle change. (Kaiser Health News is an editorially independent program of the foundation.)

Some programs are simple, offering gift cards or other small incentives to fill out a health risk assessment, take a lunch-and-learn class or join a gym or walking group. Others are far more invasive, asking employees to report on a variety of health-related questions and roll up their sleeves for blood tests.

A few employers tie financial incentives to workers actually lowering risk factors, such as high blood pressure or cholesterol — or making concerted efforts to participate in programs that might help them do so over time.

The Affordable Care Act allowed employers to offer financial incentives worth up to 30% of the cost of health insurance, leading some employers to offer what could be hundreds or even thousands of dollars off workers’ deductibles or premiums to get them to participate. That led to court challenges about whether those programs are truly voluntary.

In the study reported in JAMA, the incentives were modest. Participants got small-dollar gift cards for taking wellness courses on topics such as nutrition, exercise, disease management and stress control. Total potential incentives averaged $250. About 35% of eligible employees at the 20 participating sites completed at least one module.

Results from those workers — including attendance and tenure data, their self-reported health assessment and results from lab blood tests — were specifically compared with similar reports from 20 primary comparison sites where workers were not offered the wellness gift cards and classes. Overall employment and health spending data from all worksites were included in the study.

Wellness program vendors said details matter when considering whether efforts will be successful.

Jim Pshock, founder and CEO of Bravo Wellness, said the incentives offered to BJ’s workers might not have been large enough to spur the kinds of big changes needed to affect health outcomes.

Amounts of “of less than $400 generally incentivize things people were going to do anyway. It’s simply too small to get them to do things they weren’t already excited about,” he said.

An accompanying editorial in JAMA noted that “traditional, broad-based programs like the one analyzed by Song and Baicker may lack the necessary intensity, duration, and focus on particular employee segments to generate significant effects over a short time horizon.”

In other words, don’t give up entirely on wellness efforts, but consider “more targeted approaches” that focus on specific workers with higher risks or on “health behaviors [that] may yield larger health and economic benefits,” the editorial suggested.

It could be, the study acknowledges, that 18 months isn’t enough time to track such savings. So, Baicker and Song also plan to publish three-year results once they are finalized.

Still, similar findings were recently reported in another randomized control trial conducted at the University of Illinois, where individuals were randomly selected to be offered wellness programs.

In one interesting point, that study found that wellness-program participants were likely already healthier and more motivated, “thus a primary benefit of these programs to employers may be their potential to attract and retain healthy workers with low medical spending.”

Everyone involved in studying or conducting wellness agrees on one thing: Changing behavior — and getting people motivated to participate at all — can be difficult.

Steven Aldana, CEO of WellSteps, a wellness program vendor, said that for the efforts to be successful they must cut across many areas, from the food served in company cafeterias to including spouses or significant others to help people quit smoking, eat better or exercise more.

“Behavior is more complicated than simply taking a few wellness modules,” said Aldana. “It’s a lifestyle matrix or pattern you have to adopt.”

SOURCE: Appleby, J. (16 April 2019) "Workplace Wellness Programs Barely Move The Needle, Study Finds" (Web Blog Post). Retrieved from https://khn.org/news/workplace-wellness-programs-barely-move-the-needle-study-finds/


How employers can take advantage of the best-kept wellness secret

How can you take advantage of insurance companies’ best-kept secret? Some insurance carries pay wellness dollars to companies who implement wellness programs. Read on to learn more.


Did you know some insurance carriers pay companies to implement wellness programs? It’s called wellness dollars, and it is insurance companies’ best-kept secret.

Wellness dollars are a percentage of a company’s premiums that can be used to cover wellness-related purchases. The healthier employees are, the fewer dollars insurance carriers need to pay out for a policy. Many insurers have incentives like wellness dollars for employers to improve the well-being of their workers.

The benefits of adding a wellness program are plenty. These programs typically generate a positive return on investment for companies. Research done by three Harvard professors found that overall medical costs decline $3.27 for every dollar spent on wellness programs. Costs from absenteeism fall about $2.73 for each dollar. Well-designed programs can improve employees’ overall wellbeing and life satisfaction, according to a report from the U.S. Chamber of Commerce.

It’s a new year, and group health insurance plans are starting fresh. Here’s how employers can take advantage of wellness dollars.

Get in touch with your carrier. The first step is to get in touch with your insurance carrier to find out if your self-insured or fully-insured plan covers participatory or health-contingent programs. If you don’t have wellness dollars, it’s still early in the year, and it’s worth negotiating to see if you can include them in your company’s current package.

You will work with your insurance carrier to determine how your wellness dollars can be spent, based on an agreed-upon contract. The amount of wellness dollars that you receive depends on the number of employees and profitability.

Every company is different, so the range of services varies and could include wellness programs, gym memberships, nutrition programs, massages and more. Sometimes incentives for wellness activities can be used; sometimes it can’t. Ask your carrier for a complete list of covered expenses. This will help you as you shop around to find the right offerings. Save receipts and records for reimbursements.

Determine the best use. There are a few ways to determine what offerings you should use for your company. Before making any decisions, ask your employees and the leadership team what type of program they would be most likely to engage in. Gallup named the five elements that affect business outcomes: purpose, social, community, physical and financial. Look for a comprehensive program that includes these five elements, instead of coordinating with multiple vendors. If only a portion of your expenses will be reimbursed, it’s still worth getting a wellness program. They have cost-savings on an individual and team level.

Wellness programs are all about building culture, and with unemployment at a record low, it’s a sticking point to keep employees invested in your company. A few examples of wellness offerings include fitness classes, preventive screenings, on-site yoga, financial wellness workshops, healthy living educational workshops, and health tracking apps.

Once you’ve implemented wellness offerings in your workplace, keep track of your company’s progress. Create a wellness task force, a healthy workplace social group, or conduct monthly survey check-ins to make sure employees are staying engaged. Some wellness programs utilize technology to track participation, integrate with wearables, and report other analytics. Ask your insurance carrier if wellness dollars have flexibility in adding or changing the services throughout the year, based on engagement.

SOURCE: Cohn, J. (14 February 2019) "How employers can take advantage of the best-kept wellness secret" (Web Blog Post). Retrieved from https://www.benefitnews.com/opinion/how-employers-can-take-advantage-of-the-best-kept-wellness-secret


Employee wellness programs and compliance: What to know right now

How do you decipher any given wellness program's compliance under the law? Under the Health Insurance Portability & Accountability Act (HIPAA) current guidance, employers need to assess whether the plan is “purely participatory” or “health-contingent.” Read this blog post to learn more about wellness program regulations.


Defining “wellness” for any one person is no simple task, and neither is deciphering a given wellness program’s compliance under the law.

In 2016, when the Equal Employment Opportunity Commission (EEOC) released its final regulations defining a “voluntary” program under the Americans with Disabilities Act (ADA), the entire landscape — at least what can be seen on a hazy day — appeared defined. But thanks to AARP’s successful challenge to these regulations and the EEOC’s recent acknowledgment of the demise of its incentive limitations, employers find themselves back in the “Wild West” of sorts for wellness compliance.

That being said, the uncertainty is not new for employers with wellness programs, and there is now more guidance than before, so let’s take a moment to take in the current view.

The current guidance under the Health Insurance Portability & Accountability Act (HIPAA) remains unchanged, so any wellness program integrated with a health plan or otherwise constituting a health plan itself, employers need to assess whether the plan is “purely participatory” or “health-contingent.” The health-contingent plans (which condition the award of incentives on accomplishing a health goal) will require additional compliance considerations, including—but not limited to—incentive limitations, reasonable alternative standards (RAS), and notice requirements.

The RAS should be of particular importance because they can be missed most out of the compliance parameters. Often there is an “accidental” program such as a tobacco surcharge, and the employer does not even realize the wellness rules are implicated, or the employer’s RAS is another health-contingent parameter that actually necessitates another RAS.

The Department of Labor is actively enforcing compliance in this area, so employers will want to take care.

Additionally, the EEOC’s ADA (and Genetic Information Nondiscrimination Act) regulations are still largely in force. This seems to be a common misconception—ranging from a celebration of no rules to a lament for the end of incentivized wellness programs that include disability-related questionnaires (like an average health risk assessment) or medical examinations (including biometric screenings).

The truth is somewhere in the middle.

The ADA’s own RAS and notice concepts still apply, along with confidentiality requirements. All that has changed is that the EEOC has declined (again) to tell us at what point an incentive turns a program compulsory. So employers sponsoring wellness programs subject to the ADA have three choices, based on risk tolerance (In truth, there are four options, but charging above the ADA’s previous incentive limitations would be excessively risky):

  • Run incentives for ADA plans up to the 30 percent cap that existed before. This is the riskiest approach. To take this route, an employer must rely upon HIPAA’s similar (though not exactly the same) incentive limitations as indicative of non-compulsory levels. The fact that Judge Bates did not accept this argument in the AARP case advises against this approach, but this case does not have global application. If this path is chosen, it will be imperative to document analysis as to why this incentive preserves voluntariness for your participants.
  • Keep the incentives below the previous 30 percent cap but incentivize the program. This approach does have risk because no one knows at what point an incentive takes choice away from participants. However, the incentive is a useful tool to motivate and reward health-conscientious behavior. The wellness incentive limitations stood at 20 percent under the HIPAA regulations for quite some time without much concern, so this could be a relatively safe target. But the most important thing is to carefully assess the overall structure of the program(s) offered, consider the culture and demographics of the employees who may participate, and balance the desire to motivate against the particular tensions of the program to decide on a reasonable incentive. Make sure to document this analysis and reconsider it every time a program changes.
  • Not incentivize the program at all. This is the most conservative approach from a compliance perspective but ultimately not required. Before the EEOC’s 2016 regulations, employers were incentivizing programs subject to the ADA, and nothing about the AARP case or the EEOC’s response to it prohibits incentives.

There’s no doubt the wellness compliance landscape has changed a little over this last year, but this is also just the tip of the iceberg. With enforcement heating up, it is imperative for employers to carefully consider compliance, document the reasonableness of incentive choices and lean on trusted counsel when necessary to avoid potentially costly and time-consuming issues.

SOURCE: Davenport, B. (13 February 2019) "Employee wellness programs and compliance: What to know right now" (Web Blog Post). Retrieved from https://www.benefitspro.com/2019/02/13/employee-wellness-programs-and-compliance-what-to-know-right-now/


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Why chiropractic services could be the next big thing in wellness

Could chiropractic services be the next big thing in wellness? The American College of Physicians' care guidelines recommends the conservative, non-pharmacologic treatment chiropractors provide. Read on to learn more.


The next popular wellness perk could be offering chiropractic services at on-site medical centers.

On-site or near-site clinics typically offer services to employees including first aid, occupational health, condition management, wellness and ancillary services — and increasingly chiropractic care.

Employees, healthcare administrators and physicians are recognizing the health and employee satisfaction benefits of integrating chiropractic care into multidisciplinary settings, research suggests. Care guidelines from the American College of Physicians recommend the conservative, non-pharmacologic treatment chiropractors provide. Employers are finding that adding chiropractic care to their worksite health center teams reduces direct costs of care, decreases opioid prescriptions for neuro-musculoskeletal episodes and improves health outcomes.

Healthcare costs for employers are expected to reach $15,000 per employee in 2019, according to the National Business Group on Health. The direct and indirect costs associated with low back pain are estimated between $85 billion and $238 billion, and expenditures for back pain are rising more quickly than overall health expenditures. To help stem that growth, as many as 65% of large companies are expected to offer on-site or near-site care by 2020, NBGH reports.

Employer focus on improving workers’ health and wellness has gained momentum in recent years, as evidenced by last year’s announcement from Amazon, Berkshire Hathaway and JPMorgan Chase that they would form an independent healthcare company for their U.S. employees. Another example is employers with self-funded health plans contracting with narrow, high-quality provider networks and even negotiating directly with local hospitals on their prices.

Clinics offer similar cost control and oversight benefits. More importantly, they offer faster and easier access to care that keeps employees healthy, motivated and engaged — and out of the emergency room or hospital. As such, 54% of large employers currently offer on-site or near-site clinics, while another survey showed that 94% of employers reported their clinics improved employee health and 95% said they contributed to increased employee productivity.

Each clinic’s services, cost-sharing, use privileges and staffing can be customized to meet the needs of a specific organization and employer benefit plans. These decisions should be reflective of the objectives of the sponsoring employer and the healthcare needs of the population.

While most healthcare clinics are located on-site or close to the workplace, a growing number are near-site or shared clinic locations, serving populations from multiple locations of the same employer or various employers. Additionally, more care is being delivered virtually. The objective is to provide easy access and immediate attention for employees, at little or no cost, for a host of services and products that an employee would normally have to leave the work site to obtain.

According to a recent survey by the National Association of Worksite Health Centers, the majority of employers reported their workers had expressed interest in chiropractic services at their clinics. The nationwide cost for treatment and management of low back pain and arthritis has reached $200 billion annually. Another study attributes two-thirds of these costs to lost wages and reduced productivity.

The fact that chiropractors deliver drug-free therapies should be particularly meaningful to employers in light of the country’s opioid abuse epidemic. The good news is a recent study published in “The Journal of Alternative and Complementary Medicine” concludes that for adults receiving treatment for low back pain, the likelihood of filling a prescription for an opioid was 55% lower for those receiving chiropractic care than for adults not receiving chiropractic care.

In particular, chiropractors follow evidence-based and value-based guidelines to promote safety and effectiveness. Findings like these and many others show that by adding chiropractic care, employers will strengthen the opportunity for cost savings, improved outcomes, greater worker productivity and stronger employee retention.

SOURCE: Lord, D. (25 January 2019) "Why chiropractic services could be the next big thing in wellness" (Web Blog Post). Retrieved from https://www.benefitnews.com/opinion/why-chiropractic-services-could-be-the-next-big-thing-in-wellness?brief=00000152-14a7-d1cc-a5fa-7cffccf00000