Employers missing out on wellness benefits

Explain reasons for wellness programs

Despite the tremendous amount of buzz about the cost savings from wellness initiatives, the vast majority of employers are missing out on the big picture. Few firms implement comprehensive programs likely to make a meaningful difference in employees' health, according to a new study conducted by the Center for Studying Health System Change (HSC).1

After conducting 45 interviews with wellness industry experts, researchers learned that most felt that in order to make a real difference, a comprehensive program must be strongly linked to a firm's business strategy and championed by senior leadership and managers throughout the company.

Ha T. Tu, MPA, a senior HSC health researcher, says, "It was somewhat surprising to us, that given all the buzz about employee wellness as a solution to rising health care costs, that so few programs have the kind of comprehensive, integrated, program elements that are likely to make a big difference."

Many employers are implementing wellness in a "sort of superficial way," says Tu, such as offering online health risk assessments with incentives of small cash rewards.

"Especially in a recession environment, they are just dipping their toes in Most experts are saying, pretty much universally, that is not likely to have much of an impact in itself," says Tu.

Employers may purchase behavior modification programs for tobacco cessation and weight management, but doing these things in isolation doesn't give lasting results. "Often with those programs, especially with strong financial incentives to participate, people will quit smoking or lose weight," says Tu. "But if you follow those participants over time, they tend to bounce back to their previous behavior."

The kind of comprehensive work programs which change the work environment to promote healthy behaviors are actually very rare. "It is not terribly surprising in some ways. It requires an investment — not only a financial investment, but a commitment from senior leaders down through the company," says Tu. "Very few companies are taking a meaningful approach to wellness."

New role for occ health?

Tu notes that one large employer shared insights regarding their progression from having an onsite clinic for occupational health, to providing wellness and primary care to their workforce. "They found that the qualities they look for in health professionals can be quite different for those two roles," notes Tu.

In the occupational health environment, the focus is on treating particular injuries and getting the person back in the workforce as efficiently as possible. "With a wellness program, you are looking for someone who takes a holistic approach," says Tu. "This employer was saying that some occupational health professionals are able to make that transition and do it really well. For others, it's been a struggle."

If companies have had adversarial relationships with their workforce, implementation of wellness programs is often received with mistrust. "The workforce might question the motive of management," says Tu. "Unless you can transition successfully to that trusted provider role, the wellness program doesn't tend to have much of an impact."

Employers need to be honest and candid with their employees about why they are implementing wellness programs, and how this is related to the core business strategy.

"Sometimes, wellness programs are imposed on employees without that kind of candor," says Tu. "Then the implication for the health professionals who are delivering the wellness services is that it doesn't tend to be a very satisfying and meaningful relationship."

In some cases, the occupational health clinic was regarded as a place that tried to push people back to work before they were ready to do so from a health standpoint. "When the employer tries to put on an overlay of wellness, it is not well-received," says Tu. "This is the larger issue of corporate culture. The attitude is, 'Why did they even bother?'"


1. Tu HA, Mayrell RC. Employer wellness initiatives grow, but effectiveness varies widely. National Institute for Health Care Reform Research Brief. July 2010.


For more information on employer wellness programs, contact:

• Ha Tu, Senior Health Researcher, Center for Studying Health System Change, Washington, DC. Phone: (202) 484-4690. Fax: (202) 484-9258. E-mail: HTu@hschange.org.