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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Aditya PathakJoe SweetTom UnderwoodAlta whitetouchingsoulsintl Recent comment authors
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Tom Underwood

Aditya, thanks for your comment. I’m so glad that I could help. If you would like additional guidance as you evaluate your wellness strategy, I’d like to invite you to contact Rhonda Willingham at Alere. You can reach her by emailing rhonda.willingham@alere.com or calling 770-767-8855. Good luck.

Tom Underwood

To answer Joe Sweet’s question about the legalities of discussing wellness goals during performance appraisals, this is an important discussion worthy of further exploration with your health and wellness plan consultants and team, as well as your legal counsel. As stated in the article, participation in wellness programs is what managers should encourage. Do note that personal health information (PHI) should not be part of the performance appraisal. Involving managers in setting goals is important – charging them with encouraging their team – and of course actively encouraging them to participate in the overall wellness program themselves – is also… Read more »

Aditya Pathak
Aditya Pathak

Tom – thank you for the detailed response – very insightful.
I certainly think that our organization needs to seriously evaluate our strategy around enabling wellness maintenance.

Joe Sweet

Are there legal concerns on discussing and setting wellness goals with individuals during performance reviews?

Tom Underwood

In answer to Aditya Pathek, good question. I believe one of the more interesting and promising trends we’ve seen over the last 5 to 10 years is a definite increase in programs focused on the “healthier” segments of the workforce to maintain wellness and increase productivity. The idea is to prevent individuals in this “low-risk” population from developing unhealthy habits that could lead to a costly chronic disease. Wellness programs also work with those in the medium- and high-risk segments to help them lower their risk with a long-term vision of increasing the low-risk segment over time. We work with… Read more »

Alta white

Thanks for sharing. I recently read your article and found interesting. Yes I too agree with Tom’s. Offering employee wellness program may lower the level of absenteeism that goes hand in hand with a healthful workforce. It may also reduce the number of injuries that occur in the workplace.
This wellness program will turn to more reliable workforce and will inevitably translate into a smoother work cycle and a more comprehensive bottom line.


I agree with Tom. Life always makes things happen to people to show them the true importance of their need for action in any situation. 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, can motivate them the most

Aditya Pathak
Aditya Pathak

Good insights Tom. Thanks.
Have you come across any organization that is putting at least as much emphasis on keeping their employee base healthy, as they do on managing chronic segments? I belong to an organization where the average population is relatively young, and consequently healthier than average organizations that typically engage in active management of health. Is there any evidence that proactive management of health helps bottom-line/ productivity/ employee satisfaction etc. Etc.?