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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8 replies »

  1. 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.

  2. 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 vital to the success of the program. However, employers should focus on participation, and not specific PHI data. Alere helps employers to safeguard PHI, and provides assurances to employees by ensuring that PHI is not provided to the employer – they only typically receive aggregate, de-identified information.

  3. 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.

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

  5. 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 a large global high tech company that conducted our version of an HRA – the Health & Productivity Assessment (HPA)– not long ago. Most of this company’s workforce is younger and highly educated. Yet . . . the HPA, which includes questions about absenteeism and presenteeism, as well as about nutrition, physical activity and other risk factors – showed that even in this younger population, many were at risk for chronic illness.
    The company has a range of programs but started focusing more on programs that would engage and KEEP all employees involved in wellness. There’s more emphasis on personal health coaching – reaching employees by mobile devices and the internet. You can’t neglect any segment of your population. The goal is to keep healthy employees healthy, keep those at risk from getting a chronic illness and lowering the risk of those with a chronic illness. That’s why we think programs that are tailored for unique employer groups and the populations within those groups are so important – off-the-shelf programs aren’t going to cut it.
    I would like to recommend some articles that may shed more light for you:
    A recently published meta-analysis of the literature on costs and savings associated with such programs found that medical costs fall by about $3.27 for every dollar spent on wellness programs and that absenteeism costs fall by about $2.73 for every dollar spent.
    Baicker K, Cutler D, Song Z. Workplace wellness programs can generate savings. Health Aff. 2010;29: 304-311.
    A recent study in the Journal of Occupational and Environmental Medicine (JOEM) showed that health-related presenteeism has a larger impact on lost productivity than absenteeism. Such presenteeism may occur when an employee has a chronic illness that saps energy or focus making him/her less efficient. The JOEM research showed that every dollar of medical pharmacy costs is matched by $2.30 of health-related productivity costs.
    Loeppke R, Taitel M, Haufle V, Parry T, Kessler RC, Jinnett K. Health and productivity as a business strategy: a multiemployer study. J Occup Environ Med. 2009;51(4):411-28.
    In terms of satisfaction, when we poll clients’ employees before and after wellness programs are initiated, the level of increase in participant satisfaction is significant – to the extent that many employers end up expanding and building programs after just the first year or two because of that increase. Last year, the Atlanta Business Chronicle ran an article on employers who, despite being in the midst of a recession and under pressure to cut extra programs, were holding onto their wellness programs and making cuts in other areas because they viewed their wellness programs as essential. Comprehensive, integrated wellness programs remain one of the best ways to lower benefit costs and improve employee satisfaction.

  6. 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.

  7. 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

  8. 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.?