THE 6 GUIDING PRINCIPLES OF A TOP-PERFORMING WELLNESS PROGRAM

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1 THE 6 GUIDING PRINCIPLES OF A TOP-PERFORMING WELLNESS PROGRAM The critical elements needed to INCREASE PARTICIPATION and DRIVE EMPLOYEE ENGAGEMENT.

2 There is a popular misconception that wellness programs don t work. According to a recent Rand Corporation report, although 92% of employers with over 200 employees offer some sort of wellness program, most are ineffective at producing significant ROI and plagued with low levels of participation, averaging less than 25%. Such studies tend to support the notion 92% COMPANIES THAT OFFER A WELLNESS PROGRAM 25% AVERAGE PARTICIPATION RATES that investing in employee health may not be worthwhile. However, we believe that it is more accurate to say that the old wellness model doesn t work. Not all wellness programs are created equal. At WellnessRebates, we distinguish between successful programs and unsuccessful initiatives as Wellness 1.0 vs Wellness 2.0. The old wellness model, Wellness 1.0, offered various activities in an inconsistent, piecemeal manner and asked employees to improve their health without any accountability, established benchmarks, or limited incentives. Such initiatives were viewed as a fringe employee benefit, not an ingrained part of corporate culture. It is time for a new way of thinking about wellness, and the role employers play in promoting the health of their populations. Like players engaged in a sport, workers must be healthy to be most productive and productivity affects every organization s bottom line. Leaders must view the physical and emotional wellbeing of employees as critical to business success, and take a more active role in promoting health awareness and personal responsibility in their workforce. In other words, there must be a wholesale shift to a culture of wellness throughout the entire organization from the CEO on down. The new model of wellness what we call Wellness 2.0 is culturally-focused, outcome-based, tied to significant incentives, and constantly measured to promote accountability. Wellness 2.0 programs are strategically designed and administered as part of the company s vision and values. It is results-oriented programming that impacts a company s bottom line by delivering what it s 2

3 STRATEGIC PLANNING supposed to: containment of healthrelated costs (both direct and indirect costs, such as absenteeism) and more productive employees. Once you have achieved a broad consensus among your organization s leadership to promote wellness as a business strategy, it is then essential to incorporate 6 specific principles as you develop your own Wellness 2.0 program. While adopting these 6 principles may be difficult, and won t produce overnight success, their presence in your wellness program virtually guarantees that your organization is among the elite and most productive of your competitors. WELLNESS 2.0 PRINCIPLE I Strategic Planning To institute a successful wellness program, it is necessary to take a step back and assess your particular company s needs. This is the principle of strategic planning and it is crucial to the success of any program. If your organization is serious about implementing wellness as a business strategy, then it must be approached with the same level of dedication and deliberation that any other serious strategy decision would require. You can t know where you re going unless you know where you are. Therefore, the best place to begin your strategic planning is with a comprehensive needs assessment. This evaluation provides the necessary background information that informs the design and goals for your wellness program. The quality of information collected at this stage is critical. Consequently, verifiable data, like those from biometric screenings, are preferable to more subjective measures, like health risk assessments. But this doesn t mean that subjective assessments should be ignored. In fact, the planning process should include as much employee involvement and feedback as possible. Too often, wellness programs are designed without employee input; they are a top-down imposition vs a bottom- ASSESSMENT 3

4 up reflection of what employees want. Thus, it should be no surprise that employees fail to participate. To increase the likelihood of engagement, employee surveys should be used and strongly considered when designing the features of a successful wellness program. Another important way to include employees in the design and implementation of a successful program is by creating a wellness committee. The committee should be staffed with employees from different levels of the organization who are able to provide feedback on how considered initiatives will be received by the population. Members of the wellness committee, as champions of the wellness program, can help encourage participation and answer questions about the program s objectives. There are four critical steps in Strategic Planning: 1. Evaluate Population Health: Health Risks Assessments (HRAs) and biometric screenings can identify employee health problems and risk factors, and provide targets for improvement. There are numerous assessment tools available in both online and paper form; most health insurance carriers provide a confidential personal health assessment on their websites. For screenings, many insurers and vendors offer onsite services that include confidential reporting for participants. Employers can also encourage employees to visit their primary care doctor who can conduct required screenings and offer immediate advice on risk factors. It is important to work with a 3rd party vendor to collect and review personal 4

5 health data. This prevents the employer from reviewing individual health information, which builds trust with employees and ensures compliance with various state and federal privacy laws. 2. Determine Individual Needs and Interests of Employees: In addition to evaluating workforce health, it is important to assess the opinions of employees regarding their work experience and the types of wellness activities and features that should be offered. This is accomplished through conducting Employee Opinion and Interest Surveys. By involving employees in the design and implementation of the wellness program, and showing that their opinions matter, you are more likely to ensure engagement, enthusiasm, and participation. make the healthy choice the easy choice for employees. All policies that frustrate this objective must be heavily scrutinized. In addition, it makes sense to implement new policies and make changes to the work environment that promote healthier behaviors. 4. Determine Wellness Goals: In addition to improving employee health, there are many reasons to develop a worksite wellness program such as reducing health care costs; improving employee morale and engagement; reducing absenteeism and presenteeism; and improving workplace productivity. After reviewing collected data, a clearly defined and realistic set of goals for the program should be established. The success of the program should be judged by the organization s ability to achieve these goals within a specific time period. By setting and prioritizing specific goals and objectives 3. Review Workforce Policies and Environment Regarding Health: The culture and environment of a worksite can have a major impact on employee behaviors and health. The goal of such an evaluation is to 5

6 OUTCOME-BASED INCENTIVES for your organization, the wellness program design will be more focused. WELLNESS 2.0 PRINCIPLE II Incentives Tied to Benefit Plan and Outcome-Based Incentives There are two types of wellness incentive programs: participatory and health- contingent. Participatory programs are those that either do not provide a reward or do not include any conditions for obtaining a reward that is related to a health factor. For example, a participatory incentive may be given to an employee who engages in a health-related event, like attending a health fair or seminar, or reimburses an employee for the cost of a gym membership. As the name suggests, the reward is linked to participation ( showing up ), rather than achieving a specific health standard. Most wellness incentives are participatory. Alternatively, the second category, health-contingent wellness incentives, tie rewards to employees achieving a specified health-related standard. There are two subcategories of healthcontingent incentive programs: (1) activity-only; and (2) outcome-based programs. Activity-only programs require an employee to perform an activity related to a health factor, but do not require the individual to attain or maintain a specific health outcome. For example, an employee just has to complete a walking, diet, or exercise challenge to address a weight issue in order to receive the incentive. Outcome-based programs, on the other hand, meet the traditional health-contingent definition: to receive a reward, an employee must attain or maintain a specific health outcome (such as not smoking or achieving a certain BMI based on a biometric screening). Whether a participatory or health- 6

7 contingent program is best for your organization depends on your unique circumstances. Indeed, a mix of both types of incentives is often adopted. Regardless of which incentives structure you choose, it is imperative to incorporate wellness incentives into the employee benefit plan. Specifically, wellness participation and goals should be linked to employee health insurance premium contributions. This is advisable because it establishes the organization s seriousness about wellness, and promotes the natural connection between benefit costs and health. It s also an effective way of communicating the wellness program, since every organization has an open enrollment period where employees focus on health coverage. Indeed, firms that tie wellness program engagement to employee premium contributions typically see higher participation rates. While both participatory and healthcontingent incentives can serve useful goals, at WellnessRebates, we are strong advocates of the outcome-based approach. Outcome-based programs provide the best opportunity to reach the most at-risk employees. Most wellness programs suffer from low levels of participation and those who participate are often already health conscious. Under an outcome-based approach, healthy employees are rewarded for achieving or maintaining biometric standards (like healthy blood pressure, cholesterol, glucose, or BMI levels, or abstinence from smoking), while those at risk are given a significant incentive to make progress towards these goals. In fact, the Affordable Care Act allows employers to use incentives that are valued up to 30% of the cost of an individual health plan, or 50% for tobacco cessation. This is a significant wake-up call that # KNOW YOUR NUMBERS IDEAL YOURS Blood Pressure Waist Size Weight Cholesterol Fasting Blood Sugar 120/80 mm Hg women 32.5 /men lbs./5 ft.+5 lbs./inch above LDL>100/HDL<50 >100????? 7

8 CULTURE OF WELLNESS encourages all employees to know their numbers and work towards lowering their risk factors. Instead of simply awarding prizes to anyone who chooses to participate, without consequence to those who choose to ignore their health, outcome-based programs motivate the entire population to focus on the very risks that are precursors to most chronic (and costly) conditions in the United States. WELLNESS 2.0 PRINCIPLE III Build a Culture of Wellness Studies have shown that the use of extrinsic motivators alone, like financial incentives, are not enough to create the kind of lasting behavior change that s often required to maintain a successful wellness program and thereby live a healthier life. Programs should seek to promote intrinsic motivation as well, where the employee is striving for goals because they truly desire change, not simply to get a financial reward. The best way for an employer to produce such change is by creating a supportive culture of health and making wellness an ingrained part of the organization s values and practices. For example, an organization may implement a policy change that promotes wellness by encouraging employees to 8

9 TECHNOLOGY & GAMIFICATION take regular stretch breaks. A systemic change may include incorporating wellness participation standards into evaluations of middle management. Simple environmental changes can also have a big impact, such as establishing safe walking paths, setting up company quiet rooms, or offering healthy food options in company vending machines or the cafeteria. Together, these modifications to the policies and practices of an organization establish health promotion as a norm, thereby creating social pressures that positively impact in the decisions employees make regarding their health. It has been shown that promoting a healthy workplace culture translates into a more committed and happy workforce. In a survey by Workforce Management Magazine, 77% of employees confirmed that health and wellness programs positively impact the culture at work. The study found a strong link between the wellness and vitality of an organization and employee wellness. But in order to realize the potential benefits of worksite wellness, the culture of wellness must be embraced by the organization s leadership. Wellness values must come from the top down, and managers at all levels should vocally support and participate in wellness activities. Employees must believe that their employer cares about their total quality of life and is leading by example. Simply put, it is not enough to offer a wellness program: employees have to feel the company has embraced wellness as part of its culture. And unless there is a significant shift in the way employees think and behave, and in the way a company embraces and shares the wellness experience, these programs will not succeed. WELLNESS 2.0 PRINCIPLE IV Technology & Gamification At WellnessRebates, we believe that wellness shouldn t be viewed as an obligation imposed by the employer against the will of employees above all, it should be fun and engaging. This is reflected in the fourth principle of wellness: Technology & Gamification. 9

10 Technology is increasingly impacting many aspects of contemporary life, including the field of workplace wellness. Forward-looking companies seeking to engage employees and maximize the effectiveness of their wellness initiatives must be willing to incorporate new technologies and innovative program designs. Successful wellness programs often leverage state-of-the-art, interactive web-based information management and resource platforms, telecommunications, and mobile applications. These tools benefit both the employer and employee. Mobile technologies, for example, can expand the ability of employers to communicate with employee populations that are highly dispersed. For employees, wellness technology solutions make wellness more accessible and engaging, thereby increasing program participation. They also promote health knowledge and the personalization of wellness by granting employees on-demand access to health risk assessment tools and health information, and allowing them to track progress towards their health improvement goals. Finally, the best wellness technologies incorporate social media, allowing employees to encourage each other along their wellness journey. The social nature of wellness is also encouraged by gamification, which is the use of game-like features to intrinsically motivate behavior change. Employers incorporate gamification into their wellness programs by organizing health competitions, like a walking or weight loss challenge, or providing access to online games and health quizzes. Gamification taps into the competitive spirit and creates social pressure and encouragement to participate in wellness activities. Along with offering state-of-theart technology solutions, the use of health challenges can result in greater program participation and a feeling that wellness is fun: something the employer is doing for employees, rather than to them. 10

11 WELLBEING WELLNESS 2.0 PRINCIPLE V Wellbeing At WellnessRebates, we believe that the definition of wellness includes more than simply physical health or the absence of disease. To work at peak performance levels, employees must also have a strong sense of emotional, intellectual and social wellbeing. The Gallup organization, in collaboration with Healthways, Inc., defined wellbeing has having 6 dimensions: 1: Emotional Health 2: Physical Health 3: Work Environment 4: Basic Access 5: Healthy Behavior 6: Life Evaluation. Although it is impossible to expect an employer to address every employee issue, there are steps employers can take to encourage this more expansive notion of wellness. For example, to encourage wellbeing, your organization may provide access to an EAP service, or lower co-pays for psychiatric services. Through workforce surveys, you can measure the reporting of stress in your population, and use that information to evaluate aspects of your culture that contribute to the problem while providing education on stress reduction techniques. You can also measure job satisfaction among employees, and take steps to discover and encourage workers to use their strengths at work. As is often noted, employees tend to quit their managers, 11

12 M E T R I C S not their employers. Given the costs of rehiring and retraining new workers, an employer can potentially save considerable sums by simply tracking feedback provided by employees regarding their direct managers and intervening before a valued employee quits. The business justification for supporting employee wellbeing includes more than lower turnover. For example, studies have shown a direct link between depression and absenteeism, with some estimating an annual cost of $23 Billion a year. There are also links between emotional health, unhealthy behaviors, and worker productivity. For example, two Gallup surveys in January 2013 found that American workers who are engaged in their work and workplace are more likely than their counterparts to report healthier lifestyles. Another survey in June 2013 found higher incidence of emotional distress among smokers. By embracing and promoting all aspects of wellness, an employer can reap benefits beyond those typically associated with the absence of disease. WELLNESS 2.0 PRINCIPLE VI: Metrics As the saying goes, you can t manage what you can t measure. And if the goal is to effectively manage the health of a workforce, a constant focus on measuring and analyzing the impacts and results of a wellness program is crucial. There has been much discussion about the difficulty of measuring wellness ROI. Although numerous academic studies have shown a positive return on wellness dollars, the difficulty lies in accurately capturing the costs of a non-event, like preventing a heart attack or stroke. Frankly, there is no way to prove definitively that an individual who lost significant weight or lowered their cholesterol would have otherwise developed an expensive, chronic condition. However, the link between risk factors and chronic diseases is well established. Also, there are numerous strategies that allow employers to measure the impact of a wellness program on the health of the population. 12

13 13 For instance, an organization can evaluate trends in: 1: levels of program participation 2: health expenses per employee 3: the number of employees with specific risk factors or chronic conditions 4: the number of lost work days due to illness 5: other health-related expenses, like workman s compensation or disability claims 6: employee wellbeing metrics, like reported job satisfaction and stress levels These factors should all be studied over time (before and after the wellness initiative) and compared to similarlysituated firms in the industry to get an accurate assessment of success within the company as well as within the marketplace. Because the measurement of such data typically involves a collaborative effort with many divisions of a company as well as detailed analysis and information from third-party sources, the use of an outside wellness vendor to manage the process is typically necessary. CONCLUSION The guiding principles described above are designed to provide a greater understanding of the key factors necessary for a top-performing Wellness 2.0 program. The objective of Wellness 2.0 is to create a sustainable and accountable culture of wellness, thereby maximizing your organization s likelihood of success. We hope that this Ebook will be a valuable tool either to evaluate your current wellness initiative or to provide you with a starting point for developing your own Wellness 2.0 program. Be well, be successful, be happy. WellnessRebates was founded to help bring about a transformational shift to a culture that values and promotes good health. We welcome the opportunity to partner with your company and effect change by creating a successful wellness program based on the 6 principles outlined in this Ebook. Request your wellness program review WellnessRebates WellnessRebates.com 242 West 30th Street Suite #500 New York, NY [email protected]

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