Front-Line Managers are Key to Wellness Program Participation

What’s the difference between a company with a high participation rate in wellness programs and a low one? As it turns out, front-line managers—the people who run the daily operations and work the most closely with their colleagues—are actually the ones who can have the most influence, and can best help improve their company’s wellness participation rates.

Finding the answer to increasing wellness participation has vexed employers for years. We’ve done a good job at getting younger, healthier employees to participate in wellness. And employers recognize and appreciate the benefits of comprehensive and integrated wellness programs.

But we haven’t quite found out how to motivate people who have tried and failed or those who have multiple conditions and don’t think anything can help; who think they are too busy; or who simply would rather go home and have a pizza, six pack and watch TV.

Unfortunately it’s individuals with poor lifestyle habits who are costing employers the most. On average, for every $1 of medical and pharmacy costs there is about $2.3 of health-related productivity costs that employers must pay—and that figure is much greater for some conditions. We must find ways to get these non-participants in wellness programs motivated and involved –- for our good—and theirs.

Back to the role of managers; we work with large employers and health plans nationwide. Several times a year we meet with employers at a Summit to share best practices as well as research and analysis we’ve conducted on outcomes from specific health and wellness programs. There’s a good cross section of employers at the Summit who struggle every day to find ways to hold down costs and help their workers become healthier and more productive.

At a recent meeting, we had an intense discussion about program design, incentives and what can really be done to encourage employee participation in wellness programs. Most attendees had participation well over industry averages of 40 to 50 percent. But we had a few with participation rates of 80 to 90 percent. “What the heck are you doing to achieve that level of success?” we asked. What they told us was that first, they were following the basic recommendations we make to all of our clients: 1) make the wellness programs relevant to employees; 2) engage employees at every level of the health continuum; 3) provide personal health support; and 4) offer really good and meaningful incentives –- not just gift cards -– like cash, extra vacation days, whatever motivates employees.

Our highest performing clients implemented the basics very well, but their secret was to make wellness participation part of their management performance reviews. The results were impressive to say the least –- not only in terms of participation –- but overall improved productivity and lower healthcare costs.

This approach worked for these employers for a number of reasons. First, it clearly motivates managers to encourage participation; managers want to get strong performance reviews so they can get promotions, raises, etc. But we found another reason this approach works so well. In successful programs, managers want their colleagues –- the people they worked with on a daily basis – to find ways to become healthier because they care. They found it easy to support programs that could provide meaningful benefits to their colleagues. And, they often found it was fun. Interoffice competitions for weight loss, exercise, even healthier eating created friendly competition and a sense of camaraderie.

It does take time to create a performance driven culture of health, but it is worth it. A recent study reports that for every dollar spent on wellness programs there are $3.37 dollars returned in reduced medical costs and $2.73 returned in reduced absenteeism.

Those are dollars every employer needs right now. Those are health benefits every employee deserves.

Tom Underwood is the CEO of Alere Health, the health management services division of Alere Inc.

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4 replies »

  1. Thanks for your post…agree with you 110%. It starts at the top – permeates down through the management level – then on to employees and colleagues. In fact, it is one of my personal objectives that we as a company walk the walk. In our most recent campaign, I’m delighted to report that 86% of our employees took the first step toward better health by completing our Health & Productivity Assessment.
    The C-suite plays a key role in creating the culture of health that sets the example and tone. By no means do I want to minimize their importance – just want to stress that while they play a key role in creating a culture of health – we can’t just look to the c-suite – we also must look at other people who can become “health champions” and lead their colleagues and peers toward a healthier life.
    Our advice based on research and experience? The best programs start at the top. Definitely make sure the c-suite believes in, supports, participates in wellness – then make sure you have the programs and systems to translate that enthusiasm and support to other influencers within the company.

  2. Having run such an employee program myself, it makes perfect sense that if you don’t involve the managers you won’t really change the culture. However, there is still a bit of elephant in the room that you didn’t mention: The C-Suite.
    Culture change needs to start from the top (or at least be enabled by the top).
    Without support from the top, you can’t get performance reviews to incorporate wellness goals. Without visible support from the top, it’s hard to get buy-in by the rank and file. Wellness will feel like just another box people have to check like the mandatory HIPAA or sexual harrassment video, and they will do the minimum necessary to meet the requirement without real enthusiasm. On the other hand, a CEO that requires his reports to participate and that participates himself in a weight loss challenge, or a walking challenge, etc., will get balls rolling.
    Or at least that’s what I think I know. Does your research say otherwise?

  3. Each organization’s needs and approach will be unique. We use Health and Productivity Assessments (similar to HRAs but more focused on productivity) as well as our own wellness strategists to help companies develop the program that will work best for their organization. In general, we believe that employees should be rewarded and acknowledged for participation in any wellness program. Our research has shown us that if an employee has even a small success in a program, they are much more willing to set higher goals and participate in other programs. Our goal is not to turn employees off from wellness – to make employees feel like it is intrusive or overly demanding – we have to encourage, support and provide a range of programs that will get employees engaged in wellness. You don’t do that with penalties – you do that with incentives that acknowledge participation.

  4. can you be more specific about how you made participating in the program a part of the performance review process? Did they get a higher rating by cutting their mile times or increasing the number of pushups they could do, or was it OK to simply participate?