Employers
have tried several strategies to control health care costs. For example they
have; reduced expensive plan options, shifted costs to employees, and reduced
the number of employees eligible for benefits. However, many companies have
experienced negative reactions to these strategies and worse; the cost of
health care continues to climb. As a
result, employers appear to be turning toward wellness programs to promote a
healthy workforce, hoping that this effort will improve productivity and
contain health care expenses.
However,
“Wellness” is an often used, yet little understood term. For example, is
wellness the same as health? Probably not. The definition of “health” as
contained in the constitution of the World Health Organization is broad and
culturally neutral. They define it as, “The state of complete physical, mental
and social well-being and not merely the absence of disease or infirmity.” What
this definition reflects is the state of an individual but the description
fails to consider any individual commitment to healthy behavior, which is so
crucial to wellness.
HRA
uses the following definition to describe a wellness programs: “Those
activities embraced and practiced on a regular basis by an individual that will
prevent, mitigate or correct problem health conditions, which would otherwise
contribute to lost productivity and/or costly medical care”.
We
believe that conditions such as: heart disease, distress, drug abuse, obesity,
hypertension, and the loss of health due to tobacco use, can be prevented and
even corrected. However, the individual who is experiencing a health risk must
take the appropriate actions to overcome their unhealthy state. Therefore, a
wellness program that simply makes things available (e.g. discount gym
memberships) is not a relevant course of action. Furthermore, a wellness
program that primarily appeals to people who would otherwise be healthy is also
not relevant.
To
be meaningful and of value, HRA sponsors wellness programs that target those
conditions that are driving cost, are preventable and can respond positively to
healthy behaviors. Furthermore, we
believe that an organization’s wellness program must take into account a host
of company related factors in addition to the employee, including:
1.
The employee’s dependents
2.
The organization’s
insurance plan
3.
Company strategy, goals, objectives, policies and practices
4.
The firm’s accident prevention program
5.
Workers compensation practices and policies
6.
Absence management efforts
7.
Attendance policies
8.
The ERP program
9.
EE productivity measurements and incentives
10.
The cause for turnover at the company
11.
Recruitment challenges for the enterprise
12.
The degree of presenteeisim within the firm
13.
The firm’s commitment and involvement in the community as a
corporate citizen
14.
The level of employee engagement
15.
A firm’s internal practices
regarding; gain sharing, benchmarking,
communication, progress reports, accountability, reinforcement and recognition
practices
16.
The level of participation by the local health care community
(doctors, heath care facilities, sources of education and information)
17.
Financial incentives, support programs, sponsorship or champions,
and community collaboration.
18.
And possibly, even an extension of the wellness program and its
objectives into the contingent work
force (temps, contractors, consultants, vendor staff)
Is
a wellness program the answer to a vexing problem faced by both employees and
employers? A comprehensive survey conducted by ADP and the results of numerous
other investigations suggests that traditional wellness programs fall short of
a panacea.
The
Office of Disease Prevention and Health Promotion7, defines a comprehensive
work site health promotion program as having five key elements. Among a
nationally representative sample of employers, only 6.9% reported that they had
all five of these key elements in place.
ADP’s
survey2, finds that the wellness programs offered in midsized companies include
an average of five programs or interventions and in large companies the average
is six. Of these initiatives, Employee Assistance Programs (EAPs) are the most
common component of a wellness program followed by health promotional materials
and the practice of providing access to a nurse as the fifth most popular
program.
Furthermore,
results from the same ADP survey state that only one-quarter of midsized companies
and slightly more than one-fifth of large companies actually measure the ROI of
their wellness programs.
The
only conclusion that we can draw from this data is that the vast majority of
wellness programs, no matter how well intended they may be, miss the mark.
Sadly, the focus is on making an effort rather than striving for achievement or
being accountable for the results.
As a further illustration of our concern over traditional
wellness programs, let me draw your attention to Biometric screenings, which
most wellness programs encourage. The assumption is that such screenings will
find illness at an early stage thereby saving both money and lives. However, a
$40 biometric screen will find at best, one avoidable heart attack in every
4,000 people …at a cost of $160,000. Add in, company wellness incentives and
the cost of time off from work to perform the test and you've now have created
a very expensive and ineffective heart attack prevention screening experience.
Given
the questionable practices, the absence of an ROI, the fuzzy focus on what
wellness means, the tendency to focus on initiatives that promote healthy life
style activities as opposed to results, all suggest that wellness offerings
only appear to be of value to employers seeking to address problems associated
with employee health, the rising cost of health care, workforce morale, staff
productivity, employee retention and the attraction of talent.
2.The ADP Research Institute conducted the ADP HR /
Benefits Pulse Survey on Wellness in October 2011.
7. Linnan L, Bowling M, Childress J, et al. Results of
the 2004 national work site health promotion survey. Am J Public Health.2008;98(8):1503-1509.
If you would like to learn more about how to create and
implement an effective wellness program for the benefit of employees and your
organization, reach out to HRA by phone (818) 970 0730 or email us at hralliance@att.net.
From Michael Salisbury, Principal of the Human Resource Alliance (HRA) at www.hralliance.biz