The Health of Wellness

This survey of 1598 companies of varying sizes across the country tells a story of commitment and evolution. Wellness programs are here to stay, and the survey results point to gradually increasing investment and an increasingly nuanced view of what it takes to make the programs work and achieve the desired results: healthier, happier employees and more successful companies. This year's survey theme was work/life balance. Most companies offer at least some work/life balance programs, such as flexible work hours for those with primary responsibility for the care of a dependant. These programs, like many wellness programs, run into a familiar set of complexities - uncertain support from top management, differing and contradictory perceptions among employees, and the pressure employers are under to increase productivity and lower costs while at the same time creating a positive and desirable workplace…

The number of companies offering wellness programs continues to rise, and programs are expanding. Measuring the success of these programs remains difficult, but even recessionary times have not turned the tide against wellness initiatives in the workplace.

Wellness proponents do not, however, enjoy consistently smooth sailing. Top management support remains an issue. Another issue is employee resistance. Some feel their health is none of their employer's business. Wellness programs are continually being adjusted to find more effective ways of encouraging healthy behaviors, as in the end, the choice to participate lies with the employee. Experts are talking about a concept called “choice architecture,” which can be as simple as displaying fresh fruit in the front of the line and burgers and fries at the back - and charging higher prices for the less healthy options. Wellness programs reflect financial, personal and cultural issues that all affect the programs' ultimate success.

This year's survey went global for the first time, examining the progress of wellness programs outside the U.S. for global companies based here. It's just catching on: 29% of survey respondents identified themselves as global companies and only 15% offer programs for their global employees, with the most activity in Europe, UK and Canada. Here in the U.S., wellness is quite well.

Key Findings from 2011's Health & Productivity Survey

This year, 60% of respondents said they are offering wellness programs vs. 53% last year. Programs are also growing. The percentage of programs described as basic decreased from 57% to 44% while intermediate programs increased from 33% to 40% and the number of companies indicating they offer comprehensive programs jumped from 10% to 17%. Further, 58% plan to expand programs.

Work/life programs include those that offer flexible scheduling, employee assistance programs (EAPs) and health advocacy services. Such programs are quite common: 81% of companies offer flexible start/end times, 85% offer EAPs and 72% offer health advocacy. In assessing the value of these offerings, 32% said they improved morale and 26% said they improved retention. (Numbers were higher for smaller employers - 45% for morale, 36% for retention.) These figures may explain why management supports work/life programs at only 47% of companies. A disconnect between the perceptions of the HR professionals filling out the surveys and the managers they work for is clear in the data on flexible scheduling programs: 85% of respondents said that dependant care responsibilities impact work performance; 88% said that flexible scheduling helps employees manage these responsibilities; and, as mentioned above, 81% offer such programs. Barely more than half, 52%, however, said that management supports the use of flexible scheduling. Ambivalence is not reserved for the top: 47% disagreed or strongly disagreed that flexible work policies are applied uniformly.

The three most popular programs remain unchanged, but in a different order this year. This year, physical activity programs were offered by 53%, tobacco cessation by 49% and weight management 45%. Last year, weight management was first at 50%, tobacco remained at 49% and physical activity fell to third at 48%.

Incentives work and rewarding participation is still the most popular (32%) but more companies are combining a strategy of incenting participation and outcomes. The most common incentives are cash or gift cards and lower premiums. More employers are moving to progress-based incentives, which acknowledge incremental health improvement and point to an understanding of the need for long-term commitment and engagement. The amount that companies spend on incentives is increasing. The percentage of employers spending under $25 per employee fell, while the three higher categories grew. Most common tier is now $26-50 per employee for large employers, instead of the $11-25 category.

Many employers realize that programs will only succeed if people know about them. Some programs, like EAPs, are typically underutilized and employers may need to communicate beyond the open enrollment period. More employers are including the wellness program in their new hire packages. And reaching spouses is an increasing concern. The number of respondents indicating that reaching spouses/dependents is a significant concern rose from 27% last year to 42%.

Management support (42%) and internal leadership championing the programs (32%) are still the factors most often listed as essential to program success.

The most common barriers to measuring success reported this year were:

Hard to determine influence of wellness vs. other factors impacting health care costs (43%)

  • Insufficient data (41%)
  • Not enough staffing/time to dedicate to this (40%)
  • Too early to measure impact (37%)

Last year, insufficient data was first, insufficient staffing/time second, and “hard to determine influence of wellness vs. other factors” third. This change speaks to the increasingly sophisticated understanding of the complexity of wellness programs and of analyzing health costs. Overall, companies seem to be reconciled to the fact that implementing wellness programs, helping employees manage their work/life balance, and achieving the greater goals are not simple or immediate, but no less worthy of commitment and attention.