Obtaining a clear view of the costs associated with implementing and managing a wellness program is a crucial step in determining the program's true value, according to several wellness experts and observers.

However, experts noted, it is a step that employers overlook with surprising frequency.

Apart from service fees for vendors and investment in financial incentives, certain promotional materials and on-site wellness equipment, there are a range of costs associated with comprehensive wellness and health management programming that often are not obvious to employers and, in some cases, may never reveal themselves as line-item expenses, experts said.

“The direct costs are the easy ones, but the indirect costs like staff time and program communications tend to be more difficult,” said Laurel Pickering, president and CEO of the New York-based Northeast Business Group on Health. “Everything that supports the wellness program — those are the costs that usually get left out.”

When support expenses go unaccounted for in employers' baseline cost estimates for their wellness programs, any demonstration of a net financial benefit generated likely would be skewed by inaccurate or incomplete program price assumptions, even if employers are able to illustrate their programs' positive effects on medical claims, lost productivity and other recurring cost drivers.

Primarily, experts said employers fail to account for the variety of labor-related costs associated with the planning, implementation and management of a wellness program. While third-party wellness vendors typically are responsible for a program's day-to-day administration, experts said successful wellness programs typically require months of strategic preparation in the form of steering committees and employee focus groups prior to implementation, as well as significant time commitments from department managers and senior-level executives designated to drive support and engagement in the program.

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“People don't realize how much effort it takes,” said Merry DeMartino, executive vice president of talent development at San Diego-based Event Network Inc. “You can't just roll out a new program without having people in place to champion it, to train other employees and develop a culture around the program. There's a cost tied to all of that, but it doesn't often get factored in.”

Employers' baseline wellness cost estimates also frequently omit expenses associated with ensuring regulatory compliance, which can inflate dramatically depending on a program's structure and targeted outcomes, experts said. For example, wellness programs designed in part to reduce costs associated with employee turnover often incorporate initiatives tied to an employer's recruiting and hiring practices, potentially increasing an employer's exposure to labor violations.

Even employers whose programs are focused entirely on reducing medical costs are likely to incur significant and recurring compliance expenses if their program includes incentives or penalties tied to employees' health statuses or outcomes, experts said.

“There could be legal implications with those strategies, so legal review for compliance for your wellness program is definitely going to have to be factored in, because involving risk managers or compliance officers is going to have a cost attached to it,” said Leah Malof, a Cincinnati-based health and productivity principal at Buck Consultants L.L.C.

Other wellness cost drivers employers often overlook include in-house IT costs associated with Web accessibility, population research and data analytics fees and — particularly among large employers spread out over multiple locations — redundancies in program planning and support structures, experts say.

“They don't realize that there may be grass-roots or localized wellness efforts already in place,” Ms. Malof said. “Adding a corporate initiative that could duplicate those efforts, or add compexities in terms of administration and integration, is likely going to affect the total return-on-investment of a program.”