We’re now about two thirds of the way through the fifth annual National Employee Wellness Month (NEWM). Across the country, employees in companies large and small are clipping pedometers to their pants and using their lunch breaks to stroll around the neighborhood in hopes of besting their coworkers in walking challenges.
These programs represent a broad shift in the way Americans think about wellness. People are slowly starting to realize that we don’t have to wait until 5 p.m. to think about making healthy choices. In fact, for many, the workplace is where they find the greatest inspiration to lead a healthy lifestyle and health experts are finding that employee wellness programs are about more than just cutting healthcare costs.
Unfortunately, that doesn’t mean employee wellness programs are a cure-all for the nation’s health struggles. Experts are still perplexed as to how to measure the impacts of these programs — and what to measure in the first place. For the majority of business leaders, the future of employee wellness is still focused on figuring out what makes these programs successful.
Employee Wellness — More Questions Than Answers?
The month-long NEWM initiative is the brainchild of Virgin HealthMiles, an organization that’s part of the Virgin Group run by Richard Branson, and that helps companies develop a culture of health and wellness. NEWM is about pushing business leaders to make employee wellness a priority and highlighting the workplace as an important factor in helping people stay healthy. Sponsors include the STOP Obesity Alliance, the Partnership to Fight Chronic Disease, and World at Work.
While NEWM has been around for half a decade now, employee wellness programs have never gotten more attention than they have in the last few months. Much of this spotlight stems from debates about political issues such as privacy and discrimination. CVS, for example, got some bad press back in March when it announced that employees would have to reveal personal health data in order to qualify for discounts on health insurance. Meanwhile, in May, the Obama administration clarified how the Affordable Care Act applies to employee wellness programs. Starting in 2014, employers will increase the incentive percentage rewarded employees for practicing healthy behaviors (such as quitting smoking or losing weight).
Most media coverage of employee wellness is based on the assumption that these programs can help employers cut healthcare costs. And, for a while, the main question about corporate wellness was: How cost-effective are they? But recently, the conversation around employee wellness has changed. Health and wellness experts are taking a step back, wondering whether wellness programs are ultimately about cutting costs, or if maybe they’re about something bigger, that has to do with improving people's lives.
NEWM and the Growth of Employee Wellness
Over the last few years, the number of workplace wellness programs has drastically increased. Among large companies (those with at least 200 employees), 92 percent offered wellness programs in 2010. That’s an increase of 34 percent since 2009.
It’s hard to say exactly what’s prompted the recent growth in employee wellness programs, but perhaps the most obvious reason is the fact that Americans work more than ever before (8.8 hours in 2012, compared to 7.9 hours in 2007). Whereas health experts once focused on the home environment, there's a new focus on the importance of the workplace for promoting long-term health solutions. We're hearing about how coworkers can motivate each other to start working out, and how posting calorie counts in office soda machines can keep us away from the sugary stuff.
NEWM capitalizes on the recent flurry of excitement surrounding employee wellness. This year, Virgin HealthMiles CEO Chris Boyce has recruited more than 175 organizations to participate in the initiative. Many of those companies partner with Virgin HealthMiles year-round to create customized wellness plans for their employees. The highlight of this year’s NEWM is the walking challenge, in which employees earn rewards, or “HealthMiles,” for racking up as many steps as possible. Employees can exchange those HealthMiles for rewards such as gift certificates or plain old dollar bills, some of which they can choose to donate to charity.
Walk and Talk — Why Workplace Wellness Works
When I spoke with Boyce over the phone, he was almost ecstatic about the potential to create “meaningful change” (when it comes to health and wellness) by improving in “small things.” The idea, he said, is that the easiest changes are the easiest to maintain. It’s a lot harder to imagine going vegan or taking up CrossFit for the long term than it is to think about parking a little farther from the office every morning.
Corporate wellness programs also take advantage of the fact that most businesses are at least partly based on people working together. Part of the reason why a walking challenge is so appealing is that it’s something coworkers can do in a group, whether they’re competing against each other or working together to achieve their goals.
For many people, the workplace also provides the structural support that’s harder to establish at home. It’s one thing to return home after a long day to a house full of hungry kids and try to work up the motivation (or time) to hit the treadmill; it’s another for the boss to support, or even to mandate, employees taking a group walk around the campus after lunch. According to a recent survey conducted by Virgin HealthMiles, about 31 percent of employers offer on-site fitness centers, while a growing number of companies subsidize their workers’ gym memberships — resources that employees might not otherwise be able to access or afford.
Corporate wellness programs don’t just benefit employees by enabling them to get more fit. They also tend to inspire people to like their companies more. According to the Virgin HealthMiles survey, almost 90 percent of employees said they consider health and wellness offerings when deciding where to work, and research suggests wellness programs are as important to job satisfaction as raises and promotions. For Boyce, inspiring people to love where they work is central to his concept of success.
Measures and Metrics — The Trouble With Employee Wellness
Based on anecdotal evidence alone, employee wellness programs are awesome. Every NEWM supporter I spoke to was thrilled to tell me about how many HealthMiles they’ve racked up so far and the walking paths they’ve built on their campus to encourage employees to reach their step goals.
The difficulty lies in trying to back up these personal stories with hard numbers. According to the Virgin HealthMiles survey, the biggest obstacle currently facing employee wellness is measuring the impact of these programs. Some health experts insist that a successful employee wellness program will save employers a significant amount of money in the long term; others are less certain A systematic review of the evidence concerning the economic impact of employee-focused health promotion and wellness programs. Lerner, D., Rodday, A.M., Cohen, J.T., et al. Progrm on Health, Work and Productivity, Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Tufts University School of Medicine, Boston, MA, USA. Journal of Occupational and Environmental Medicine 2013 Feb;55(2):209-22. .
To be fair, the companies that partner with Virgin HealthMiles throughout the year do receive tools for annual health risk assessments, which measure data such as weight, BMI, blood pressure, and even self-reported stress levels. But, at this point, no one really knows what we’re supposed to be measuring. Is it how much employers spend on healthcare costs? Is it something more specific, like number of pounds lost, or the number of emails an employee can answer per hour?
Among researchers, there’s a sharp divide between those who think employee wellness programs can really improve employee health (thereby cutting healthcare costs), and those who don’t. A recent report by the RAND Corporation (a non-profit research institution) sought to quantify the impact of corporate wellness programs, and most media outlets interpreted the findings to mean that employers lose more money than they save. Other researchers say it just takes a while for these programs to work, and that implementing a wellness program is a good long-term business strategy, especially for small companies.
One big concern is that any savings in healthcare costs come as a result of cost-shifting, as opposed to improving employees’ health equally across the board Wellness incentives in the workplace: cost savings through cost shifting to unhealthy workers. Horwitz, J.R., Kelly, B.D., Dinardo, J.E. University of California, Los Angeles, School of Law, USA. Health Affairs 2013 Mar;32-3):468-76. . Walmart, for example, was criticized back in 2011 for charging employees who smoked higher health insurance premiums. Critics of cost-shifting argue that employees who are already healthier end up getting even healthier — and paying less for insurance — while less healthy employees end up staying less healthy (even if they make small health gains) and paying even more for health insurance. Those less healthy employees are typically of a lower socioeconomic status, prompting some researchers to assert that wellness programs reinforce the divide between the health habits of people at different SES levels.
Given the difficulties involved in tracking the success of employee wellness programs, it’s unclear whether the solution is to develop better measurements or, perhaps, to abandon metrics altogether.
The Future of Employee Wellness
Looking ahead, it seems like there are two growing trends in the health and wellness space. On the one hand, health experts like Dr. William Baun (Wellness Officer at The University of Texas MD Anderson Cancer Center and a leading expert in employee wellness) expect that, in the next few years, companies are going to develop better and more specific metrics for measuring the success of their wellness programs. On the other hand, some of the same experts are starting to realize that perhaps we’ll never be able to measure the real impact of employee wellness. The question, then, is whether we should pursue these programs at all.
I asked Greatist Expert and health policy analyst Carolyn Engelhard whether it was worth employers' time and effort to implement wellness programs. She said yes, she thought so — but not necessarily because they’ll cut healthcare costs. “Employer wellness programs have many merits, including … the potential for early detection of disease and health improvement,” she said. On the other hand, “they should not be seen as the next ‘silver bullet’ to reducing overall health morbidities or health care spending.”
Baun is of a similar mindset. He talked about the difference between ROI (return on investment) and a less official term called “VOI,” or value on investment. The second term refers more to what happens when you improve people’s lives, and is substantially harder to measure. But what Baun really wanted to stress was that we don’t have enough data to prove that workplace wellness programs have benefits or what those specific benefits are.
Still, anecdotal evidence consistently suggests these programs have something to offer. Baun, who’s been in the business of employee wellness for more than 30 years, told me multiple stories about employees who’d lost weight, recovered from diabetes, or started practicing an overall healthier lifestyle with the help of workplace wellness programs. As he spoke, I could hear him start to get a little choked up on the phone.
In so many of these cases, it would be impossible to measure the effect of a workplace wellness program, he said. But even without the clinical data, he was able to say with confidence: “It changed their lives.”
Does your company offer a wellness program? How do you think it’s influenced your personal health habits? Let us know in the comments below or tweet the author at @ShanaDLebowitz.
Special thanks to Chris Boyce, Dan Gaffney, Lisa Meddock, Dr. Scott Kahan, Dr. Carolyn Engelhard, Susan Saunders, Elizabeth Oliver-Farrow, Gina Beckmann, James Zervios, William Baun, and Peter Davis for their contributions to this article.