By Anne Rosivach
With health insurance expenses expected to continue to rise, employers are looking for wellness programs that can potentially reduce the cost of health care to both the employer and the employee. Employers benefit because healthy employees are more productive; employees gain because their out-of-pocket costs are reduced.
A recent Benefits Advisors Network (BAN) webinar emphasized the importance of comprehensive wellness programs. "A lot of us are very well meaning. For years, health risk assessments and biometrics screenings have been the core of wellness programs. Certainly, it's important to set some metrics we can track over time, BUT we have to make sure we're not putting all of our eggs into the assessment basket and not leaving anything for actual interventions."
Successful programs begin with a buy-in at the top and leverage all resources within a company. Success is dependent on the continuing commitment of the employer and employees. Regular screening, combined with intervention where appropriate; changes in culture and workplace policies; and small incentives all contribute to successful programs in both large and small companies.
Comprehensive, effective programs incorporate the following design features:
- Health advocacy
- Care coordination
- Case management
- Consumer-driven plans
- Health risk assessment
- Value-based benefit designs
Wellness programs should also include:
- Occupational health, such as health screenings and case management
- Employee counseling and assistance, with an emphasis on prevention as well as treatment
- Crisis intervention
- Ongoing support groups
- Aftercare treatment
- On-site health facilities
Following up on health risk screenings is an important feature of any wellness program. Health education, supportive environments, and linkage to other employee support services are all appropriate follow-up interventions. Programs should also determine the needs and interests of employees through surveys, focus groups, or a wellness advisory team.
Wellness involves behavior change, webinar speakers said. "We have to realize our limitations in the complex area of behavior change. We can lead a horse to water, or lead an employee to a program, but we really can't force behavior change upon him or her. The individual must be willing."
Among others, a supportive environment that encourages healthy behavior includes:
- A smoke-free policy
- On-site food resources
- On-site catering policies
- Quiet space or a stress-break station
- On-site medical clinics
- A release time policy
Cultural and behavioral changes can be set in motion by using some common incentive approaches. In fact, 46 percent of employees in companies that offer incentives complete health risk assessments versus 19 percent of employees who are not offered incentives.
Small financial incentives, in the range of $40-$60 per month, can generate short-term behavior changes in many participants. Behavior changes could be relatively simple, such as an employee completing a health risk assessment or biometric screening.
Financial incentives also appear to be effective in encouraging participation in health coaching and to engage in worksite activities and team challenges. Where major behavior changes are required, however, financial incentives show only a short-term effect.
Other common incentive approaches include special employee recognition programs or reduced health insurance deductibles or co-pays. Wellness-specific performance goals could be tied in with reviews and merit increases.
Incentives alone do not lead to internal changes, such as deciding to change one's diet or exercise more, and they may not be a practical tactic for sustained improvements in population health. Healthy behaviors result from a commitment to a comprehensive approach that balances screening, interventions, and a supportive environment.