A recent blog on HBR.org proposed to deliver “The Cure for the Common Corporate Wellness Program.” But as with any prescription, you really shouldn’t swallow this one unless all your questions about it have been answered. As a physician, a patient, and a businessman, I see plenty to question in Al Lewis and Vik Khanna’s critique of workplace wellness initiatives.
With their opening generalization that “many wellness programs” are deeply flawed, the authors dismiss a benefit enjoyed by a healthy majority of America’s workers. Today, nearly 80% of people who work for organizations with 50 or more employees have access to a wellness program, according to a 2013 RAND study commissioned by the U.S. Department of Labor and the U.S. Department of Health and Human Services.
It’s not clear whether the authors are intentionally dismissing or simply misunderstanding the wealth of data that shows how wellness programs benefit participating employees. The RAND study summarizes it this way: “Consistent with prior research, we find that lifestyle management interventions as part of workplace wellness programs can reduce risk factors, such as smoking, and increase healthy behaviors, such as exercise. We find that these effects are sustainable over time and clinically meaningful.”
Lewis and Khanna, however, don’t focus on such findings. Instead, they question the motives of a company for even offering a wellness program, which they slam as an “employee control tool” and “a marketing tool for health plans.” And, in perhaps the most baffling statement of all, the authors suggest that workplace wellness initiatives are “trying to manipulate health behaviors that are largely unrelated to enterprise success” (emphasis mine).
Let’s consider that piece by piece. What are the behaviors that corporate wellness initiatives are trying to influence? According to the RAND study, the most common offerings — available in roughly 75% of all wellness initiatives — are on-site vaccinations and “lifestyle management” programs for smoking cessation, weight loss, good nutrition, and fitness. In short, companies want to reduce the risk that their workers will get the flu, develop lung cancer, or suffer from the many debilitating conditions linked to overweight and a sedentary lifestyle. How could these initiatives be deemed “largely unrelated” to the company’s success?
I beg to differ, and there’s plenty of data to back me up. Many companies may have instituted workplace wellness programs initially as a way to reduce health care costs. However, a growing body of research suggests that nurturing employee health and wellness has a significant impact on productivity — which, as we all know, has a direct bearing on company profitability. Consider this paper by Harvard researchers who reviewed 36 studies of corporate wellness programs. The researchers reported that for every dollar large employers spent on wellness programs, they saw company medical costs fall about $3.27. But even beyond that payoff in health, the study found a comparable payoff in productivity: For every dollar spent on wellness programs, the companies’ absenteeism-related costs fell about $2.73.
Good health “plays a large role in employee productivity,” says a research study by the Milken Institute, an economic think tank. The institute’s researchers concluded that common chronic diseases (including cancer, diabetes, and heart disease) are responsible for $1.1 trillion in lost productivity annually in the U.S. economy. They attributed those losses both to absenteeism and to “presenteeism,” when employees come to work too unwell to do their jobs.
The RAND report says its research “confirms that workplace wellness programs can help contain the current epidemic of lifestyle-related diseases, the main driver of premature morbidity and mortality as well as health care cost in the United States.” If Lewis and Khanna think that such achievements don’t having bearing on enterprise success, we’ll just have to agree to disagree.
What I do agree with are the authors’ recommendations that employers follow the USPSTF screening guidelines for generally healthy adults and their advice to tread lightly on promoting annual physical exams. Over-screening drives up health care costs, increases the likelihood of unnecessary treatment, and can even do more harm than good. And I certainly can’t quibble with their recommendation to ask employees what they want: Some of the best wellness programs I’ve seen stem from tight feedback loops between management and employees that lead to popular and effective wellness programming.
But I’m profoundly troubled by the authors’ intimation that corporate wellness programs are more about control or manipulation than about enhancing employees’ health. After working on wellness programs with hundreds of business leaders for the past eight years, I’m convinced that most of them truly want to support their workers’ well-being for three overarching reasons:
Humanity. Yes, it exists in the C-suite, despite what cynics say. Executives at America’s largest companies believe investing in the health and wellness of their employees is simply the right thing to do.
Fiscal responsibility. These leaders are under great pressure to rein in soaring health care costs, and they rightfully see wellness programs as one way to do that.
Perspicacity. Insightful executives look for every competitive advantage they can harness, and that’s what healthier employees represent. “Employers are recognizing that good health is a total business issue, and a lack of it affects workforce performance,” says a recent Towers Watson study. “Most now point to establishing a culture of health as their top priority and an essential factor for success.”
It may sound clever to ask executives the question that Lewis and Khanna pose: “Are you doing wellness to your employees or for your employees?” But neither choice seems ideal. In the many well-run companies that I work with, I see conscientious leaders doing wellness with their employees — a shared mission to cultivate a healthier workforce for everyone’s benefit.