Do you remember the process of selecting the college/university you’d attend? Perhaps you’re in the season of life that I am in now, and you’re now helping your child(ren) find the perfect school. I recently toured several campuses with my son and it was amazing to see what occurred. We started with a list of what was really most important: alignment with his desired major, the school’s academic reputation, graduate employment rates, and course content. But as we toured the schools, guess what stood out? The country-club-like grounds, the Olympic size pools, the rec centers, fast food selections, and recreational activities. It took real discipline to remember the goal and not start to judge success by the level of social engagement he may enjoy. At least not only social engagement.
Of course you want to introduce a wellness program that is liked by your employees. But if you’re looking to truly transform lives and experience measurable cost reduction, the most liked program design may not align with the most effective approach.
Programs that were justified based on the power to attract employees, educate them about risky health behaviors, and inspire them to make radical changes to create greater wellbeing and cost savings, morph into beauty contests that compare the bells and whistles on a portal (or mobile app) that only appeal to tech savvy, highly virtual employees who tend to be on the younger side and fairly healthy. Employers start to celebrate small increases in participation and judge success by average time spent on a web page instead of by measurable health improvement. The occasional testimonial becomes the ray of hope used to rationalize the investment yet doesn’t carry much merit when the CFO starts asking for a more scientific analysis of results.
Yes, it was well liked. It was well liked by the handful of people who didn’t really need it. Nobody really pushed back. They didn’t have that much to gain and they didn’t have to actually do anything outside their comfort zone. Of course the goal of the tool was that they would actually do something. They would walk a mile after dinner, they would skip dessert for a week, they would schedule a dental exam, etc., but nobody required them to actually establish and achieve a meaningful goal.
Are these portals and gift programs bad? Of course not. They often help companies dazzle job applicants and they help with recruiting (remember that college visit). They even help with retention. Even employees who never use the fitness center or wear the free heart monitor will brag about having it as workplace perk. The sentiments are similar to those received from throwing a great holiday party, summer picnic, and casual Fridays. These things are great - just don’t expect their impact to be measured in chronic risk reductions or claims trend decreases. The RAND report and Pepsi Colas wellness research report, along with several articles in Health Affairs over the past few years, verify little if any return on investment in such designs.
A Different Approach:
So what’s the answer then? Poke and prod everyone to give you blood and personal information? For what purpose? I’ve seen several conference speakers cast a wide net suggesting that outcomes-based incentives don’t work or that biometric screenings are worthless. If these things alone are what you consider in your wellness program, I’m afraid these skeptics are correct. However, when these elements are ingredients in a thoughtfully designed wellness program and coupled with effective communication, realistic timelines, robust reporting and effective support for those who are ready and willing to take action, the results can be stunning. There is absolutely no evidence to support the claim that a design like this won’t produce strong health improvement and cost reduction. Do employees like it? Yes, many do because they have been eating well, exercising, keeping up with their preventative testing and avoiding tobacco but all they have received until now is an equal share of the cost increase.
It can be difficult in some cultures. Certain professions and certain geographies are well known for viewing rich health benefits at little or no cost as a birthright or entitlement they have somehow earned. This is especially true in government, education and large size legacy organizations where employees are often sheltered from the true cost of their benefit plans and the initiatives that suffer because of the size of the health plan.
In other organizations however, particularly those with a culture of “thinking like an owner” - problem solving, doing your fair share and contributing to the greater good above oneself - these programs are applauded and widely embraced. Remember, a results-based wellness program is not a way for an employer to perform “backdoor underwriting” or to cost-shift and avoid providing affordable plans that fully comply with the ACA design requirements. The wellness incentives tied to personal achievement and working toward your personal best represent a way to earn a lower cost or a richer benefit than is otherwise required from the employer. It’s a benefit that has been earned and it’s available to everyone. The catch is that you may need to do something that you know is good for you, but inconvenient or uncomfortable (which means that some people won’t like it). Sounds like most good things in life, right?
Bravo is proud of being a pioneer in this space. We’re embarrassed by things that others, and in the early days, even ourselves, designed that were compliant but ineffective. But as they say, “don’t throw the baby out with the bathwater.” Outcomes-based incentives are an incredibly effective component of a comprehensive health improvement and cost management strategy. And what about those portals, wearables and social platforms? They do help! For those who appreciate the technology, daily reminders, team and individual challenges, recipes and so on, this technology helps give them a place to start and a way to take ownership of their health. Bravo can provide our clients with resources that are second to none in these areas but remember, the goal isn’t to use a tool – the goal is to achieve a result and a tool is a way that might help you get there.