Wp Ihr Employee Wellness 0305 (3)

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www.hr.com | 1-877-472-6648 copyright © HR.com March 2012

HR.COM Wellness Survey Study“Wellness: What Flavor Do You Prefer?”

Written by

Rod Reasen II, CEOHealthiest Employer, LLC

Employee Wellness

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Employee WellnessIn 2011, HR.com created a Wellness Advisory Board to assist the Institute for Human Resources: Employee Wellness certification program with content. The Board elected to measure the human resource community’s views on corporate wellness through a survey. This high-level survey generated several expected results, with some new notable points. This whitepaper addresses the respondents, questions and answers, and overall trends in the wellness market.

The 239 respondents were comprised of HR.com’s distribution list and the Advisory Board’s network, and took place from November 2011 to January 15th, 2012. The survey was created with 10 questions in multiple select, ranking, and yes/no answers. The respondents represented an employee base of 1.8 million employees worldwide.

Participating employers represented all sizes. No single employer size category dominated the response. As Exhibit 1 indicated, employers with fewer than 500 employees represented 49% of the respondent audience. It is promising to see this segment getting more involved.

Additional facts:Average age of wellness

program is 4.5 yearsAverage employee age is

40.13 years

Q1. What is your greatest challenge in getting results from your wellness program?Respondents were offered 15 choices to select their greatest challenge in getting results. When considering the average respondent’s wellness program has been in existence for 4.5 years, it is not surprising that engaging employees came in as the highest-rated challenge. This is a common topic on our travel and speaking circuit on corporate wellness. There are several stages of engagement that we need to understand.

Phase 1: Getting initial participationWhen establishing a wellness initiative you should look for “champions” within the organization who can influence others to participate. Additionally, offering some form of financial incentive can help create initial participation. Items like gift cards, cash, premium discounts, and drawings for large prizes draw interest. The obvious key, at this stage, is to get as much of your population engaged in participation as possible. Surveys are frequently used to gauge areas of interest along with motivating factors. It is important to understand what drives your population. Do you have a diverse workforce of men and women, age, social demographics? Is your population health minded, sedentary or obese? Make no assumptions. Whether referring to incentives or areas of needed health change, your individual interests will not be appealing to everyone. Sparking the attention and motivation of your team will involve a bit of investigative work on your part. Your efforts at the beginning will pay dividends if you take the time to start right.

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Employee WellnessPhase 2: Achieving on-going participationThis challenge can arise even in the first year. Personal interests or “what’s in it for me” drives participants. If your wellness program’s participation is solely driven by financial incentives, then you may need to continue offering these to keep your population’s attention. You may even need to increase the amount to encourage greater participation in the future. Educating your team members about the personal value of wellness may seem logical but many individuals need your assistance in showing them how. You are uniquely situated to be able to offer the support necessary for individuals to improve their own health. Developing a long-term strategy at the beginning will help you follow a path toward success.

Phase 3: Desire for lasting participationWhile all organizations hope their workforce will immediately understand the personal benefits of health, the reality is that most of us are stubborn and like to follow our own desires. As a wellness practitioner, it is important to understand that your enthusiasm for personal health is not always communicable. Getting lasting participation takes hard work, diligence, an understanding of behavioral psychology, and knowledge of your population. “Give a man a fish and you feed him for a day. Teach a man how to fish and you feed him for a lifetime.”

The personal benefits of being healthy far outweigh those of the employer; yet, so much of corporate wellness is focused on employer benefits. The employer, government, and society will ultimately benefit from individual personal health. To create lasting participation, employers must direct their attention toward personal accountability and intrinsic motivation.

Teamwork is also highly important. Studies have shown that you are highly likely to resemble the friends you spend time with. Thus, if your friends like to sit, eat potato chips, and watch television you will likely begin doing the same. Subsequently, if you find yourself around friends who exercise, eat right, and focus on health, you too will find yourself motivated to do the same. You can be a positive or negative influencer on your team. The applicable point is that teams can help each other by offering ideas, camaraderie, and a social dynamic that is very powerful.

GOOD SIGNS: The four lowest scoring items include lack of interest by the HR team, lack of c-suite interest, privacy and confidentiality concerns, and lack of energy/motivation. It was not too many years ago that privacy and confidentiality ranked as one of the highest concerns of employees. The cascade of information and perceived security of the data has softened the workforce to be open to more disclosure.

Another item is certainly clear: the HR professional is interested and motivated to take corporate wellness to the next level. They are now an advocate for the development and implementation of a strong plan.

Interest and engagement are the two broad areas to be addressed. We discussed the employee type above but cannot neglect one major constituent, leadership. Whenever you read about or discuss corporate wellness this topic becomes paramount. As leadership goes, so goes the organization. More than ever, employers see their strategic position evolving from a supporting role to a leading one. The idea behind creating a healthy workforce needs to move beyond a budget item. We need leaders who see the impact of health on society and not just their bottom line.

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Employee Wellness

Q2. Please rank the following statements that best describe the objective of your workplace wellness program.As corporate wellness initiatives grow in size and intensity, we wanted to discover what is motivating employers to dig deeper. There is an increasing understanding that wellness goes beyond offering a fitness center or bowl of fruit. There is also a newly discovered foundation and belief that wellness does not have to be tied directly to healthcare claims to show positive momentum and return. As you will see in this section, containing healthcare costs ranks 6th whereas the creation of a healthy worksite environment ranked first.

Employers intuitively see the link between corporate wellness and the personal health of their workforce. While certainly very important, claims reduction is now taking a backseat to the overall health of the employee. Bravo!

Although ranked last on this survey, the desire to use wellness for recruiting and retention benefits is moving up. We have had many discussions with employers who say this is one thing that younger workers are asking about during the interview process. Take note employers. Culture and environment are very important to this demographic.

There is also a growing trend to contemplate other outside effects on a population. Teamwork, education about healthy lifestyles, and dependent inclusion are now considered norms when establishing a corporate wellness program.

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Employee WellnessRanked only slightly behind healthcare costs is the idea of enhancing productivity. We see this as one of the key issues among employers worldwide. Many in the wellness industry see this as a national competitiveness issue. As a nation, we must concentrate on the health and productivity of our workforces to remain the premier supplier of talent, intelligence, and labor.

Q3. Which of the following do you offer at your organization? (Select all that apply)There’s no shortage of options for this question, so we included the top areas with the most relevance (which include some new items that are trending in the marketplace). The results are not overly surprising, but we do see some alarming tendencies.

ALARM BELLS RINGING:

Two of the areas we found most alarming are obesity education and tobacco cessation. By most studies, including those by the Centers for Disease Control, these are two of the most pertinent yet still aggressively out-of-control areas in American society. One in three US adults is obese, costing employers $1,000 to $5,000 per obese employee. Tobacco use is still the leading cause of preventable disease and illness in the United States. These are both controllable issues that demand immediate attention. The survey showed employers continuing to offer flu shots, wellness flyers, and other materials but the time has come for stronger solutions. To have a sustainable wellness initiative, employers must take action and move toward identification, mitigation, and prevention of health risk.

There were several positive areas showing encouraging results: nutritional education, weight loss initiatives, healthy vending, and biometric screening. Biometric screening has been on the rise for the last few years. This objective and statistically relevant information can be used to help identify many areas of risk including hypertension, diabetes, and cardiovascular disease. Like health risk appraisals, biometric screening provides actionable information on your population as a whole. We see biometric screening becoming the linchpin for other wellness initiatives.

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Nutritional education and weight loss initiatives should go hand in hand but they are often divorced of each other. Independently they are important but together they can become powerful. Most individuals do not understand the difference between a protein, carbohydrate, fiber or starch. The terms are familiar but ask one of your truck drivers if he is balancing his diet or if he knows how. You have an opportunity to inform, educate, and train your folks how to eat healthy. Experts agree that eating right and staying in motion are extremely important. Obviously there is a tie to obesity.

As we move on we find healthy vending options as a natural progression toward this endeavor. When it comes to vending, there are many good options to choose, including reducing the cost of a healthy alternative, dramatically increasing the cost of unhealthy options, or entirely removing the unhealthy ones. Don’t be afraid to make a bold move.

Q4. What incentive types do you find “most effective” in encouraging participation in your workplace wellness program? (Select all that apply)Our goal was to identify opinions from wellness: firsthand user and the HR community. There are many thoughts, theories and studies about how to best incentivize employees to participate in corporate wellness programming. Some folks believe financial incentives are THE best way, while others passionately believe in social or intrinsic motivation.

While 239 respondents is not a comprehensive study, the information is nonetheless valuable.

On the chart you will see that premium discounts rated ninth overall, while giveaways, gift cards and cash heavily outweighed the other options. One suggestion - know your population. As mentioned earlier, behavioral economics teach us that people are self-motivated. Not that they are motivated to get up and run three miles in 26 degree weather, but rather that they are motivated by their own self interests. These interests range dramatically by region, culture, social demographics and other environmental factors. To look at this chart and pick the highest rated incentive for use in your population could be a major disservice to you and your team.

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Let’s look at a few of these:

Giveaways, gift cards, cash, and merchandise have been the staples of wellness programs. What can we get someone to do for a ten-dollar gift card or t-shirt? Our society is riddled with free offers, coupons and deals. Although they may work for a while, studies show that we eventually become immune to their allure. Variety truly can be the spice of life when it comes to keeping your employees’ attention. The counter objective to the above is that we also have very short attention spans. With the average person losing focus after just 20 seconds it is no wonder these types of incentives are still being deployed today.

We heard of an auto manufacturer giving a new truck away to the winner of a weight loss challenge. The challenge drew a bevy of attention and many in the organization did lose weight. This type of offering can be effective when used to draw attention to the bigger strategic goal.

Lastly, additional vacation time or paid time off is a way to reward any and everyone in your organization. Drawings, big prizes, and contests draw upon our competitive spirit but limit the number of winners. For those less interested in competing, this incentive becomes very attractive.

Before choosing any incentives, employers should think through what behavior they are trying to elicit. They must also consider the potentially destructive behaviors being conditioned. For wellness to be sustainable, employers must work to create long-term motivation. Your incentives should be thought of as a way to introduce and draw attention towards your strategic objectives.

Q5. Have you had any internal discussions around how healthcare reform will impact your business?We wanted to learn if employers were discussing healthcare reform as it pertains to their business. More importantly, we were hoping to see how employers were looking at reform through the lens of wellness initiatives. Healthcare reform is certainly not a new talking point and one could argue that the market is overwhelmed with this subject, which is one reason we were surprised to find that close to half of the survey respondents answered that they have not discussed its impact. Much could be said about the need to plan, prioritize and research, but we will leave that for another day. As employers consider the changes ahead, we suggest seeking professional advice for legality, structure, and future financial ramifications.

Several changes that affect corporate wellness include:

1. Small employers may have federal and state grant money available to help establish or bolster wellness programming.

2. There are impending legal changes that would allow incentive amounts to grow by a significant amount. Currently set at 20% we have seen proposals to move this as high as 50%.

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Employee Wellness3. Copayment changes on preventive services in 2018 may facilitate the need to review benefit design and wellness programming.

4. “HIPAA’s five” standard based restrictions need to be adhered to legally.

Healthcare reform has already made its way into the health delivery system and benefit design. As incentive rules are modified, we suggest employers take a close look at how they can use the law to their advantage. The percentage of incentive will likely be increasing substantially thus allowing employers to create glaring choices for employees who elect to be healthy. For those employees who choose otherwise, the financial structure could be severe.

This area of the law is very favorable to the employer giving them more control to structure their health plan and wellness programming effectively. Overall, these are significant changes that should be considered when developing an employer wellness strategy. We hope that employers will take this to heart and begin having internal discussions within the year.

Q6. How do you anticipate healthcare reform affecting your business?

For those who answered, “yes” to considering the business effects of healthcare reform, we asked them to tell us how. We wanted to see if corporate wellness had finally moved beyond healthcare cost reduction to become a standalone program. The results were encouraging.

Before we get into the positive aspects of this chart, let’s discuss the red bar. As mentioned from question five, there is still a large extent of employers who have had little discussion. The above shows that of the 125 employers from the original 239, only 12.9% or 17 have still had minimal discussion around how this will affect their wellness programming.

Still, the majority suggest they will continue offering wellness programming. Another 11.11% say they could actually begin increasing wellness spending and programming. Only a handful of respondents suggested they may drop wellness altogether. A hopeful sign for both the wellness industry and society as a whole.

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Looking at this question by itself may cause some to ponder. After cross correlating question six with question two (Please rank the following statements that best describe the objective of your workplace wellness program) things become clear. The apparent link is not the expected relation to healthcare costs. It is the desire to create a healthy worksite. Furthermore, when the two questions are linked what you find is that the majority of employers are focused on individual health, education about being healthy, and the perpetuation of a culture of health. Notice I did not mention healthcare costs.

Certainly driving down healthcare costs is important but fortunately these survey respondents see the bigger picture. This is incredibly inspiring. Corporate wellness initiatives have existed for decades and there are many trailblazers who deserve our applause for laying the groundwork. Without these folks it is hard to believe that the above employers would have responded so favorably.

Corporate wellness is here to stay.

Q7. How do you measure the effectiveness of your wellness program? (Select all that apply)One of the touchiest subjects when dealing with corporate wellness programs is the discussion of metrics, tracking results, and return on investment. Some would argue that this is not something we should even be worried about. Others prefer key performance indicators signalling a program’s effectiveness.

As a data collector and metrics driven organization, Healthiest Employer is focused on the proof behind a theory. We understand that everyone calculates return differently, but see several common denominators that are far less subjective than objective. The survey responses were not all that encouraging. In fact, 27.84 percent of respondents say they don’t try to calculate a return and an additional 10.8 percent say they guess. Hmmm.

Much could be said about which methods of calculation to use or what specific data is relevant to calculate. We suggest starting. Most employers have access to three basic data sources: claims, biometric data and health risk assessments. For those employers who are blessed with additional access to information you may be seeing the aformentioned plus pharmacy, employee assistance programs, disease management, workers compensation, abesenteeism, and disability data.

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Employee WellnessCalculating ROI: As mentioned before, there are many theories about the correct path to calculate an accurate return on investment. Rudementary forms of calculation do exist. For instance, organizations can compare year to year claims and pharmacy usage or spending. Undoubtedly, it is nice to see these numbers drop from year to year. However, a cause and effect scenario is not necessarily being produced. The reduction could easily have been driven by the economic climate, turnover, eligibility or a host of other factors. Simply to state that a wellness program was effective by just viewing these two metrics is at best naive.

A more precise method would be to use multi-year specific biometric and risk stratification factoring across a specific static population. A mouthful and simply stated just means make sure you are comparing the same population set when looking at aggregate data. The issue with most employers when reviewing aggregated risk factors is that they literally change daily. Turnover is one of the biggest enemies to the calcualtion of corporate wellness return. By the time the employer gets his report, the population has already changed. The key is to make sure you understand this dynamic when building your hypothesis.

One should also consider which inputs to include. We believe there is enough core and pariphial data to show a fairly dynamic picture. Using biometrics, pharmacy, claims, and absenteeism data employers can get a snapshot of their current health status. By plugging in employee assistance, disability, workers compensation, and health risk assessment data employers have the ability to refine the picture. Think about it like putting the edge pieces around the puzzle. The hard part is done but you still have to fill in the middle.

The argument here is to start tracking. Begin with where there is access to information and build from there. The idea behind data collection is to find the story that the information is telling. Like a puzzle, data in silos can only show a piece of the picture. The more pieces that exist the more clear the story becomes.

As employers become more savvy about their data and what to look for in this arena we see exciting things happening.

Q8. Where do you turn first for corporate wellness advice? (Select only one)

The last five years have been a boon to the wellness community. Employers are adopting wellness initiatives at a higher rate than ever before and thus creating the need for resources to fulfill the demand. We asked respondents to tell us where they seek advice first. For the brokerage community, the results are very optimistic.

Respondents were asked several questions that advisors may find quite encouraging. For example, 63.18% say that engaging employees is the greatest challenge they

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Employee Wellnessface in getting results from their wellness program (Exhibit 2). Who better suited to assist the human resource professional than someone who already knows and understands how employees think? The most encouraging number for advisors came from the 25.94% who ranked the broker consultant as the “first place” they seek corporate wellness advice.

There is little question that healthcare reform has had its effect on the brokerage community, but it seems this group is also doing a good job at transitioning into a new era. Another question that showed renewed hope for the advisor was when we asked how healthcare reform would affect the business. Only 1.43% of respondents said they would drop health coverage while 11.11% said they would increase wellness spending (question 6). The overwhelming majority said they would continue to offer both insurance coverage and wellness programming to their workforce.

When asked this same question, 47.70% (question 5) said that they have not discussed the impact on healthcare reform. Additionally, respondents ranked “lack of time” as their third greatest challenge in implementing a wellness program.

An opportunity undoubtedly exists for those in the business of giving advice. As advisors continue to journey down these new roads of discovery, one thing is aptly apparent. Good advice is always welcome.

Insurers should also take note of this question. As respondents look for ways to build and improve their wellness programming they are seeking advice from you. One could argue that the insurer has a major interest in seeing wellness grow, as it could immediately affect their bottom line. Several insurers believe enough in this idea to offer guaranteed rates, with some up to three years. Of course the employer will be required to follow a strict protocol but it could be worth it.

Whatever the method, there are many resources on this topic. Information is available but it takes some time to weed through, analyze, and choose the best approach.

Q9. What do you see as the biggest hurdle for a corporate wellness program’s long-term sustainability? (Select one response)We addressed this previously under “incentives,” but it can’t be mentioned too often. For corporate wellness to remain effective it must have a sustainability strategy. Employers realize that short-term initiatives may get people moving initially, but they need them to keep doing so. Corporate wellness is more of a marathon than a sprint.

Keeping employees engaged is the biggest hurdle to sustainability. For this survey the average

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Employee Wellnessage of wellness programs came in at 4.5 years. These employers are also seeing a plateau effect. Many new employers are joining in and creating workplace initiatives but for those who have been doing this a while we see a real issue. What happens when you level out? Do you start from scratch? Hire a new wellness vendor? Start an onsite clinic? Go social or drop wellness altogether? These are the questions that many employers are asking. As the chart suggests, they don’t see healthcare reform or environmental factors getting in their way. Nevertheless, leadership and engagement remain focal points for the wellness industry.

Engagement is not only an issue from the beginning but it remains an issue throughout the life of a business. For an employer to stay moving it must consistently evaluate the effectiveness of current programming while predicting the areas to be addressed in the future. There is no set it and forget it trigger with corporate wellness. The minutiae of the population evolve and so must the programming.

We strongly believe that wellness works when individuals understand their role. Federal government, local government, employers, and individuals are all responsible but no one is more rewarded by good health than you and I.

Q10. Have you made any HR policy changes that support wellness? If so what?The role of HR in wellness is ever expanding. In fact, we see a new job function emerging in mid- to large-sized employers; that of the wellness manager, coordinator, educator. We like to call them “health promotion directors.” In recent years, the human resource professional has been tasked with the enormous undertaking of creating, implementing and sustaining a wellness initiative. Although many have performed remarkably, most have been doing so with little to no training or the necessary time needed to fulfill this responsibility adequately.

We see new institutes, colleges and universities establishing training for this growing field. Furthermore, we see a natural progression for wellness to appear in employee handbooks. Items such as tobacco-free work policies; volunteerism, increased pre-employment screenings and hiring practices are changing merging strategic wellness initiatives with policy.

Some employers have gone to the extreme of no longer hiring tobacco users. Others have created a “no sharing policy.” If you have the flu, a severe cold or other contagious illness, stay at home and don’t share. There is merit in understanding how to give flexibility to your workforce to preserve the health of the team. If you are serious about creating a culture of health, then you will inevitably make policy changes to support your goals. Make sure you seek appropriate legal advice and support with any change you see suitable for your organization.

The health and productivity field is by no means a new idea or an unproven one.

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Employee WellnessYet, new ideas are budding and the space is growing rapidly. As the landscape of national health continues to deteriorate, we see wellness, productivity and prevention rising. On behalf of the Institute for Human Resources Employee Wellness certification program, we offer our sincere congratulations to those of you who have entered the wellness journey and extend an invitation to those pondering. Let’s make a difference together.

About the author:

Rod R. Reasen IIChief Executive OfficerHealthiest Employer, LLC

Mr. Reasen is no stranger to the wellness community. For over ten years he has worked hand in hand with employers of all sizes to create unique trendsetting wellness programs. The Healthiest Employers® award program was created to show the innovation taking place in corporate wellness. The program has grown to nearly fifty U.S. cities and includes thousands of employers representing nearly thirty million employees.

Healthiest Employer, LLC is a research and analytics firm focused on behavioral health and wellness. They work directly with wellness vendors, brokers and insurers to assist with analytics in the workplace.

Mr. Reasen holds two bachelor degrees in Marketing and Finance from Bob Jones University in Greenville, SC and has been the featured speaker at multiple universities, wellness conferences, forums and webcasts.

He has authored over thirty articles in leading journals, including The Boston Business Journal, Employee Benefit Adviser Magazine and Inside the Minds – Employee Benefits Best Practices. His wellness research has been helping employers reconsider the way they develop, deploy and administer their initiatives.

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Wp Ihr Employee Wellness 0305 (3)

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