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Employers struggling to get wellness programs to stick


The vast majority of employers remain committed to worker wellness programs, yet they still struggle to engage employees in such programs that are intended to reduce costs and ensure a healthy workforce, experts say.

Numerous tactics are at work as employers look for ways to get employees more involved in behavior-changing programs, but cash incentives just for employee participation in wellness programs don't do much to keep employees engaged on a longer-term basis, said LuAnn Heinen, Minneapolis-based vp of the Washington-based National Business Group on Health.

In conjunction with Towers Watson & Co., the NBGH recently released findings of the 15th annual “Survey on Purchasing Value in Health Care,” which found that 37% of the 507 companies surveyed reward only employees who complete a wellness program and 29% reward only employees who complete several wellness-based activities, as opposed to providing incentives for merely signing up for such programs—a longtime practice that doesn't always succeed in keeping employees healthy, experts say.

“What employers are finding is that those initial incentives aren't everything,” said Ms. Heinen. “You still have the people who don't follow through (with programs) because they don't want to commit the time, they don't understand it or they don't want their employer interfering with their lives.”

Shelly Wolff, Stamford, Conn.-based leader of health and productivity for Towers Watson, said many employees find longer-term wellness programs to be difficult, such as smoking-cessation and weight-loss programs.

“Why aren't people engaging themselves in these? Because when it's difficult and it's something you have to work on every day, you'll have fewer people on board,” Ms. Wolff said. “Most people want to make changes, such as eating better and exercising more; it just has to be easier for them to follow.”

Barry Hall, Boston-based principal with Buck Consultants L.L.C., said companies that promote wellness programs as part of a change in the company's culture are bound to have more success in getting employees engaged.

“There's a lot of talk about creating a culture of health,” Mr. Hall said. “This goes beyond health assessments. Creating this culture is one of the most difficult things to achieve because (workers) are skeptical.”

Ms. Heinen said she suspects that many workers want wellness programs to go away altogether. “They have their issues with wellness initiatives. They want to know why their employer is getting involved in their health. They will say, "This is my business,'” she said.

That's why some employers are trying to push wellness from a self-empowerment standpoint, Ms. Heinen said. For example, IBM Corp. and GlaxoSmithKIine P.L.C. push wellness initiatives that promote the benefits of being healthy rather than dwelling on the rising costs of health care, she said (see stories, page 14).

Other tactics also are at work, experts say.

One example, cited by three experts, is the model utilized by Safeway Corp., a national supermarket chain that makes its employees “test out” of wellness programs and provides incentives, via premium deductions, only to workers who are proven to be healthy.

“This behavioral economics is a strategy more and more companies are considering,” said Ms. Wolff. “Programs that shift incentives to healthier workers are in the early stages and we are predicting more changes to come.”

Experts say employers plan to keep wellness on the table, but will continue to modify ways to reach employees.

For example, 93% of companies in the 2010 NBGH/Towers Watson survey said they plan to continue their health promotion programs. In addition, 83% said they have changed or plan to change their strategy this year, up sharply from 59% last year.

“Employers know that if people don't participate, you won't have an impact, no matter how strong your program is,” said Mr. Hall of Buck Consultants. “They aren't just looking at participation numbers. They need to see engagement for programs to work (to help reduce health care costs).”