Different Point of View

While ROI can often be elusive when it comes to wellness programs, such initiatives still can create tangible shareholder value.

By Carol Harnett

I've been more contemplative about the workplace and employee benefits lately. Some of that may be related to my mom's death, which in many ways was cause for reflection. This is also my 40th column for Human Resource Executive ®, and I can see the patterns emerging in what I've written and what I want to open up for discussion.

What I realize from all this soul-searching is that I crave success and being a positive influence in people's lives. And, at times, I do not feel successful.

On my watch as a clinical physiologist, obesity in America essentially doubled in adults as well as in children and adolescents. While I do not bear this burden alone, I was working in healthcare and was responsible for a variety of prevention, wellness and rehabilitation programs.

What most bothers me is that while we learned a great deal about health and our ability to influence people's behaviors since the late 1980s, we largely don't seem to apply those lessons. If insanity is repeating the same mistakes and expecting different results, then many of us should be making better use of employee-assistance programs.

I take some solace from a growing number of outspoken colleagues such as Tom Emerick (a former client) and Al Lewis, who are actively challenging health and wellness initiatives in the workplace. But it was Dee Edington who first gave me pause when we were both speaking at a health- and productivity-management conference in 2007.

During his presentation, Edington commented that, on average, the best-performing wellness program in terms of return-on-investment was a smoking cessation initiative. The caveat, however, was that it takes -- on average -- about eight years before a positive ROI is captured. For all the other wellness-related schemes, approximately 16 years must go by before you realize a return on the money spent.

I expected a revolution of sorts after Edington shared his research, or, at minimum, an evolution on how best to address employee health and productivity. But nothing much happened on a widespread basis.

There are, however, pockets of hope.

In my mind, the open discussion of failures -- in addition to readily shared successes -- is critically important. The American Speech-Language-Hearing Association's human resource leader, Janet McNichol, wrote a blog post following HRE's Health and Benefits Leadership ConferenceTM that described one of her company's wellness program failures. A failure that came even though McNichol thought she anticipated everything.

In a January 2013 blog post, Bob Merberg, Paychex's employee-wellness manager, recommended that employers focus on the value of investment -- not the return on investment -- of wellness programs. He points to analyses where "good employee-wellness programs are associated with increased employee motivation, engagement, retention, attendance and productivity." Merberg also believes healthcare costs are the wrong metric to follow.

It turns out that Merberg and Edington are on the same page.

I checked in with Edington prior to completing this column to talk about how I've watched his focus change since 2007. He's spent a lot of time contemplating why wellness programs largely haven't worked and where we've made mistakes.

"Wellness puts all its money on behavior change," Edington shares. "And employers put all their attention on the workforce instead of the workplace - even though recidivism is so high."

Edington believes wellness programs can't save enough in healthcare costs to make a difference - "maybe $200 to $300, at best" - but he thinks a wellness program can create shareholder value.

How? By increasing job satisfaction, happiness factors and creating a great place to work. By association, according to Edington, wellness programs raise employee loyalty, decreases turnover and increases creativity and productivity. And that's good for the business' bottom line.

Edington summarizes it this way: "Happiness [is] the new, ultimate metric."

And Emerick and Lewis - the co-authors of Cracking Health Costs - are, like Edington, calling for human resource executives to focus on both the workplace and a term that's been overused in the past - workplace culture.

I recently interviewed Emerick and Lewis for a radio broadcast with my CoHealth Checkup friend and colleague, Fran Melmed, and found these wellness naysayers are actually positive about what employers can do to address employee health costs and performance.

The top five things they believe companies should start doing -- if they haven't already -- is:

*           Offer healthy options in vending machines and cafeterias if the employer has them onsite. HR executives can consider subsidizing the healthy meal of the day.

*           Take steps to address unnecessary stressors at work. Emerick says "stress literally makes people sick."

*           Address defective work processes as an initial methodology to reduce workplace stress.

*           When things go wrong, counsel managers to focus on process improvement instead of blaming employees for errors made.

*           Design worksites to include open, clean and well-lit work areas, clean restrooms and soothing break rooms.

And the two things the duo would advise employers to stop doing?

Lewis warns businesses to "stop playing doctor and poking your employees with needles." Much as Merberg and others have recommended, there is little science behind most biometric screens. 

Emerick suggests that when human resource executives look at reports from their medical-related benefits and disability plans, they stop looking at averages and start looking at distributions. "Averages can mask your actual problem areas," he counsels. "Instead, look at your outliers, which might represent only 4 percent or 5 percent of your employee population." Emerick believes this type of review will change how companies view wellness and set prevention targets and goals.

As for my advice on how HR leaders can impact workplace culture, I return to my first column and one of my music idols, Bruce Springsteen, who I quoted from his Nov. 1, 2007 interview with Rolling Stone. In my opinion, Springsteen may understand more than most what it takes for leaders to create a positive work environment that connects employer goals with employee desires.

"My business," Springsteen says, "... is trying to connect to you ... . You are involved in an act of the imagination together, imagining the life you want to live, the kind of country you want to live in, the kind of place you want to leave your children. What are the things that bring you ecstasy and bliss, what are the things that bring on the darkness, and what can we do together to combat those things?"

Carol Harnett is a widely respected consultant, speaker, writer and trendspotter in the fields of employee benefits, health and productivity management, health and performance innovation, and value-based health. Follow her on Twitter via @carolharnett and on her video blog, The Work.Love.Play.Daily.


Jul 29, 2013
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