What's Missing from Health and Wellness Programs?

Employees may be participating, but are they really engaged? Are they just going along to get the incentive? Many programs offer information and guidance, but not the kind of help employees really need to make lasting, healthy changes.

Wednesday, May 7, 2014
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A national employer survey last year found that more than two-thirds of companies offer health and wellness programs, and 86 percent offer a financial incentive for participation, up from 57 percent in 2009. Employers are starting to move toward new incentive structures, such as penalties for not participating. Less than 20 percent actually tie incentives to measureable behavior change, but 31 percent plan to implement outcomes-based incentives this year.

At the same time, however, employers are recognizing that no one factor alone, including financial incentives or penalties, is enough to sustain healthy behaviors over the long term. In the survey, employers indicate they are grappling to discover the missing ingredient -- they are constantly searching for innovative tools and strategies for their ever-evolving programs.

Sound familiar to you?

If so, you are on the right track. But, that doesn't mean you need to adopt the latest "shiny objects" into your program hoping something sticks. Often what's missing from a wellness program is the right combination of services based on the specific needs of your population, combined with a focus on delivering an outstanding participant experience.

Here are some steps you can take:

1) Lead with healthy behavior change.

Certain key risk behaviors have been shown to negatively impact health outcomes and drive the highest healthcare costs. They are tobacco use, obesity, excessive alcohol use and medical non-adherence. These four areas along with unmanaged stress, inadequate sleep, low physical activity and poor nutrition or diet lead to the onset of chronic illness or disease exacerbation.

Leading with personalized lifestyle behavior coaching and support systems that focus on helping people improve behaviors in these key areas can have a short term and significant impact on your results. For instance, studies show that a smoker who quits can save an employer up to $7,800 a year in smoking-related medical expenses, while the cost savings for an obese person who loses just 7 percent of his or her body weight and engages in healthier behaviors can be as high as $6,600. A diabetic patient who improves medical compliance by 10 percent can reduce healthcare costs by 9 percent to 29 percent.

So, leading with behaviors, not conditions, can deliver health outcomes. Even better, these health changes impact more than just a single condition. You'll create longer-term employee engagement, promote a holistic view of their health and empower them with coaches that will help them live their best life.

A best practice is to provide access to live coaches, combined with a virtual experience that builds tailored action plans. Integration within a web/mobile platform, surrounded by consumer-friendly resources, will let your employees carry out their action plan in the flow of their day-to-day lives.

Even with these tools, changing behavior is never easy or simple. The vast majority of people need help to get started, and they need support to maintain progress when the stresses of life mount. Health coaches can use techniques such as social cognitive theory, to take into account personal factors (past experiences, expectations and emotions), the environment (social factors and physical environment), and an individual's behavior to develop a plan to remove barriers and work towards lasting healthy changes.

Offering a health advocate or concierge approach could act as a key upfront engagement tool. This individual develops a personal relationship with your employee, establishes trust and helps the employee identify and come up with a plan for dissolving any barriers that will hinder success. The health advocate gets to know the employee's personal situation and pain points, is able to connect him or her to additional resources, services and support, and keeps consistent contact with your employee throughout their health journey.

2) Create a healthy workplace culture.

If you are not creating a culture to promote and support healthy behavior change, then no matter how great your programs are, or what type of incentives you offer, your employees will not feel motivated. Developing a supportive workplace culture includes these three factors:

·         Engaged leadership. If your employees don't see your managers and senior leaders participating in healthy lifestyle changes and promoting the programs from the top down, your wellness program won't be taken seriously. It will be easier for your employees to make healthy changes if they see healthier behaviors all around them (e.g., shared testimonials at the start of meetings, exercise class schedules, healthy snacks in vending machines, walkways on campus, fruit served at breakfast meetings instead of donuts, etc.).

·         Grassroots support. Employees may be even more influenced by their peers. Employers with high participation rates identify and engage social influencers to encourage participation among their peers and promote their programs. Social influencers are employees who are well liked, well-respected and always seem to have a crowd around them. These folks don't have to be "health nuts" but can be harnessed into a team of "wellness champions" on the ground that can contribute ideas and generate excitement around the benefits offered. Smart employers employ a balance between the "top down" and grass roots "ground up" promotional approaches.

·         Organizational health objectives. If organizational health is going to impact your bottom line and retain talent, why wouldn't it be represented at the same level as your organization's revenue goals? Tie these initiatives to your vital business objectives and quarterly goals. Weave these into your promotional materials and frequently communicate about them and accountability at all levels, to employees. Goals don't have to be complex. They can be simple like striving for 90 percent of your population to take the HRA, participate in biometric screenings or join a coaching program.

3) Embrace a consumer orientation.

Your employees are being bombarded with numerous health and fitness options outside of work as more brands are getting into the space. Don't feel like you have to compete. Rather, jump on the band wagon! Embrace a consumer orientation in your wellness program.

If your employees can walk into Best Buy and purchase a Fitbit device for themselves, then offer it in your program. Make sure they know they can get a device in your program for free. You can learn from outside brands what is popular and attractive to people. Find ways to integrate consumer friendly tools and applications right into your program.

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Examples include health games, online support groups and social media, as well as a range of lifestyle devices. Embrace the use of communications via mobile phones. Offer mobile health applications that allow people to track and stay engaged at any time during the day. Enable your employees to access their online activities via their phones or to communicate with their health coaches using email and texting.

By adopting a true consumer orientation, your program will be more attractive to your employees and will offer intrinsic motivation to keep them engaged.

4) And yes, put a little money in employees' pockets.

Financial incentives are a great way to jump-start your employees on the road to better health, but they should be meaningful to promote long-term engagement. In short, it's not just about offering $25 to take a health risk assessment. Here are some tips:

·         Make it meaningful and significant. Embedding financial incentives into your benefits strategy that are tied to deductibles and plan options will not only engage your employees with the financial upside, but will also enable them to be more accountable, educated healthcare consumers.

·         Drive greater visibility to costs. Five years ago, nobody saw the cost of an x-ray. Adding incentives to your benefits strategy gives employees a chance to evaluate costs, take control of their actions (e.g., see their doctor, participate in a program, impact their biometrics) and see how their healthcare choices can benefit their pocketbooks.

·         Explore the carrot and the stick. Take risks. Explore new ways to frame your incentives based on value, rules of engagement and outcomes. Rewards are nice, but sometimes a penalty or "price" (e.g. increased deductible) for lack of participation or non-compliance may work too. You'll need to explore your legal limits, but test the waters and see what works.

·         Align with culture. When designing your incentives program, it's important that you take time to evaluate and understand your population. What is considered a strong incentive for one team may not be viewed favorably by another. The best incentive programs reflect the culture and characteristics of your workforce.

Financial rewards have proven to provide the extrinsic motivation that can be helpful for more difficult employees or to get most people started. However, when pairing this with the other approaches outlined above, you should be able to create an experience that inspires them to want to continue on their own because it is engaging, effective and brings value to their life.

Heather Zeitz is vice president of participant experience and health programming for Waltham, Mass.-based Alere Health. 

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