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Few firms measure effectiveness of wellness offerings


Although the number of midsize and large companies using workplace wellness programs continues to grow, few employers use clinical measures to gauge the effectiveness of such efforts, new research shows.

Employers spent nearly 2% of their overall health care budgets on health-improvement activities in 2010—about the same as 2009, according to a survey conducted by Fidelity Investments in conjunction with the National Business Group on Health.

All of the 147 employers responding to the survey offered some type of wellness program, with the average number of programs offered by employers increasing to 23 in 2010 from 21 in 2009, the survey found.

In 2010, 74% of employers offered 19 or more types of wellness programs, including condition, lifestyle and health risk management as well as health education. In 2009, 60% of employers offered 19 or more types of wellness programs.

More employers—62%—provided financial incentives to employees to participate in these wellness activities in 2010, up from 57% in 2009. In addition, about half of all employers now offer financial incentives to encourage dependents to participate, according to the Fidelity/NBGH survey. This is a new question for 2010, so there is no comparative data for 2009.

The dollar value of financial incentives averaged $430 per employee in 2010 while dependent financial incentives averaged $420.

Sixty-four percent of respondents adjust plan contributions to ensure that the incentives are cost-neutral, another new question added to the 2010 survey.

Most incentives offered to employers were “carrots” rather than “sticks,” with only 12% using negative incentives, such as increasing premium contributions for nonparticipation in wellness programs.

Large employers, defined as those with 5,000 to 15,000 employees, are more likely to offer financial incentives than companies with fewer than 5,000 employees (78% vs. 38%, respectively). Jumbo employers, defined as those with 15,000 or more employees, are slightly less likely than large employers to offer such incentives, at 75%. 2009 results were not broken down by employer size.

Although most employers remain committed to investing in wellness, most are unsure about the returns they are realizing since only 46% measure their effectiveness using clinical outcomes as a gauge, the survey found.

Rather, the most popular metrics used to measure program success are participation levels, used by 77% of employers; engagement levels, such as program completion rates, 70%; employee feedback, 64%; and utilization of preventive services, 60%.

Additionally, 60% of employers use claims costs as a gauge of program effectiveness, while 50% use annual health care trend rates, 26% use compliance with evidence-based medicine and 10% use utilization of high-performing providers.

If an employer feels a health improvement program is not performing as well as it had expected, it is more likely to reassess all of its wellness programs (69%) or increase communication efforts (61%) than discontinue the program (25%), the survey found.

However, 56% of employers that use incentives said the efforts are increasing employee participation and engagement in wellness programs, according to the survey.

The survey results demonstrate that employers continue to invest in health improvement, said Karen O. Marlo, vp of benchmarking and analysis at the NBGH.

“We saw consistency in that employers are investing in a lot of different types of programs and are continuing to use incentives,” she said.

However, the survey also found that “employers are struggling with measurement and determining whether a program is successful; and if it isn't, whether they should invest those dollars elsewhere,” Ms. Marlo said.

The survey, “Employer Investments in Improving Health,” was conducted in September. To request a copy, e-mail