Workplace Wellness Worries
The belief that some workplace wellness programs are worth the money hit a snag recently when researchers at University of Illinois at Urbana-Champaign released a study that found such programs show “limited evidence” that they actually work.
According to the researchers, such programs cover more than 50-million workers and are intended to reduce medical spending, increase productivity and improve well-being, but they found workplace-health programs such as health or fitness assessments, weight-control programs or disease-management classes, among others, don’t result in happier, healthier employees, medical cost reduction, lower absenteeism or higher productivity.
The trio of researchers—Damon Jones of the University of Chicago, and David Molitor and Julian Reif of the University of Illinois at Urbana-Champaign—created and deployed a comprehensive workplace wellness program study for a large employer, the University of Illinois. Employees were randomly assigned program eligibility and financial incentives individually. All told, about 5,000 (56 percent) of eligible employees participated.
Essentially, the study found zero benefits from this specific workplace wellness program in its first year. Health costs, sick days, productivity and even gym visits remained static. According to Reif, assistant professor of finance and economics at the University of Illinois Urbana-Champaign, the research sought to determine the causal impact of the program on health and employment outcomes. While 39 outcomes showed no improvement, two were positive: Workers who joined the wellness program did become likelier to be screened for health issues, and they thought their employer put a high priority on employee health.
While Reif says the study failed to find “significant effects” in the first year of the program for most of the outcomes it examined, researchers “are continuing to collect data in order to see if any effects will emerge in the second year.” He added that he and his colleagues haven’t yet analyzed data on biometric outcomes, such as blood pressure and cholesterol levels. “A subsequent analysis will investigate whether any effects are present in those data.”
While some employers might interpret these results as a reason to reconsider such programs, experts say the real issue is that measuring healthcare costs and health outcomes in a vacuum is no longer the most effective wellness strategy.
For example, LuAnn Heinen, vice president at the National Business Group on Health, calls the University of Illinois study “well done” and says it addresses issues employers have addressed in the past. However, she says, large employers today are interested in outcomes beyond healthcare costs alone.
“Strategically, health and well-being is part of a broader workforce strategy that seeks to impact business outcomes such as recruitment, retention, customer satisfaction, net-promoter score and employee engagement,” Heinen says. “With a focus on emotional health, financial security, social connectedness, purpose and job/career satisfaction, building a healthy culture and a positive employee experience are paramount.”
She says that a traditional wellness program that targets physical health risks and relies on individual behavior change—if it exists at all—is a relatively minor component of that larger strategy. That approach is characterized by attention to promoting physical, social and emotional well-being through work environments and changing corporate policies such as flexible schedules and family leave, combined with program offerings personalized to employee needs and preferences.
“In addition, many companies are reaching outside their own walls to understand and address social determinants of health and behavior in communities they serve,” Heinen says.
Stephanie Pronk, a senior vice president who leads Aon’s U.S. national health transformation team, says that, without healthy, fully functioning and resilient people, businesses cannot be successful. But she adds that the time has come to rethink how wellness programs are created and deployed, because lowering costs and boosting specific health outcomes alone are no longer enough.
“The literature shows studies concluding that some programs saved money and others did not,” Pronk says. “Given the reality that any successful workplace program needs to be tailored to the local situation and cannot be assumed to be effective without doing so, it’s not surprising that enormous variation in effectiveness is the result.”
Pronk says that today’s approach differs from the traditional wellness model because its focus is that a person’s well-being is experienced holistically and must be treated as such.
“By only focusing on individual indicators, such as exercise minutes, smoking, etc., it becomes difficult to improve, impact or sustain effective life changes,” she says. “This same holistic perspective must be infused into how we assess and value programs as well. Individual outcomes tell one side of the story, but they are indicators, not sources, of success and failure.”
Real value to an organization comes from moving from a “wellness program” to infusing well-being into every corner and fabric of the organization, Pronk notes, adding that it’s time to keep what is working, be willing to adapt and evolve, and recognize individuals holistically.
“Organizations that can empower well-being, not just entice compliance,” she says, “are going to be the organizations that shape the future through their attraction of talent, their productivity, their continued pursuit of collaborative optimization—the results of which are truly immeasurable.”
Reif agrees that while the University of Illinois research is dramatic in many ways, wellness programs like the one at University of Illinois certainly can have value. For example, they can attract a healthier talent pool because the study shows that healthy people are likely to find such programs desirable.
“Even if these programs alone don’t have a direct effect on the healthcare costs or behaviors of employees,” he says, “they may nevertheless make sense for employers to adopt because it may help them attract the types of workers they’re looking for in their firm.”