By Laura Putnam and Mari Ryan
Every HR professional has a full plate of responsibilities – and workplace wellness has become a standard item on the menu. Especially in light of the Supreme Court’s recent ruling to uphold the Affordable Care Act, it is likely that workplace wellness is here to stay. Meanwhile, workplace wellness is a field that has more questions than answers, and HR professionals are often left trying to sort out the pieces.
What seems like a rather straightforward proposition – a company investing in the health and well-being of its employees – has become a source of conflict. On one end of the spectrum, critics are lambasting workplace wellness, calling it an invasion of individual privacy and a waste of valuable resources. On the other end of the spectrum, proponents tout its many benefits – from savings on health care costs to enhanced employee engagement to improved retention – arguing that workplace wellness is indeed money well spent.
Why is there is so much disagreement on the topic – and how do we move forward from here?
We’re spending a lot on health care.The United States leads the world in health care expenditures, which is 20% higher than any other country– and more than double the average. We are on a path to fiscal insolvency if we don’t find out a way to reduce this spending.
Employers – and employees – are feeling the pain of these increases. Employers are continuing to spend more on health care costs, and meanwhile, an increasing percentage of these costs are being transferred to employees. According to Aon Hewitt’s analysis, the employee’s share of spending on health care costs has escalated by almost 150% over a ten-year period (between 2004 and 2014).
All of this spending isn’t getting us any healthier.Despite all this money going toward health care, we’re not any healthier – by a long shot. Already, over a third of Americans are obese and another third are overweight. If trends continue, a recent study indicates that almost half of us will be obese by 2030. Meanwhile, heart disease continues to be the number one killer and it’s projected that one third of us will be diabetic by 2050.
The vast majority of these “lifestyle” diseases and conditions are avoidable
Frustratingly, the vast majority of these diseases and conditions are preventable – and in some cases even reversible. Turning around our current trajectory of poor health requires that we drastically change our lifestyle, which requires making changes in our behaviors – and this is where we get stuck.
Behavior change is hard. By and large, all of us already know what to do to improve our health: Eat better, move more, avoid smoking.However, collectively, we just can’t seem to “get” ourselves to put this knowledge into practice. Workplace wellness boils down to changing behaviors from unhealthy to healthy ones – and this seemingly simple proposition is actually very difficult to carry out.
Return On Investment (ROI) is a worthwhile pursuit and is achievable – or is it? Most organizations in the US are counting on workplace wellness to help curb the onslaught of health care costs. The question is – is it realistic to think that wellness programs truly can render a savings on medical expenses?
Some argue yes. A heavily cited 2010 review showed that companies can save $3.27 in medical costs and another $2.73 in absenteeism costs for every dollar spent on wellness.
Others argue no. Meanwhile, the largest study to date on the impact of worksite wellness conducted by the RAND Corporation, found that while workplace wellness programs can positively impact some health outcomes, they do not appear to lead toward meaningful savings in health care costs.
Incentives work – or do they? Perhaps, the most contentious point of debate is the use of incentives and penalties, aka, “carrots and sticks.” Both are used to motivate employees to participate in programs, and increasingly, they are used to activate specific health outcomes. Employers have doubled their spending on incentives over the past four years to the tune of almost $600 per employee on incentives alone, according to recent surveys conducted by the NBGH and Fidelity Investments. The Affordable Care Act includes provisions to increase allowable incentives from 20 percent of total cost of overall health care coverage to 30 percent, and in the case of tobacco-related programming, up to 50 percent.
While considered a “best practice” by many, a growing body of experts and practitioners caution against the use of incentives. Researchers like Alfie Kohn, author of Punished By Rewards, argue that incentives and penalties can diminish intrinsic motivation and do nothing more than drive short-term compliance.
Penn State’s controversial wellness initiative exemplifies the risks of taking a heavy-handed approach. In July of 2013, the university introduced a wellness program that applied stiff penalties to drive participation rates.Any faculty or staff member who opted out of the required health assessment and screening would be penalized $100 a month! Instead of encouraging employees to join in, the overly coercive tactic generated an outcry and the faculty rebelled. The news went viral, and ultimately, the university withdrew the program.
Workplace wellness is money well spent.Some critics question whether worksite wellness industry is worthwhile at all, citing the fact that it is now estimated to be a $6 billion industry. Let’s put some perspective to this figure. Consider, for example, that the equally difficult-to-measure field of learning and development is a $164 billion industry, with an average per employee expenditure of $1,200 per year.
Overall, workplace wellness is working – or is it? What we know is that simply having a wellness program is not enough; it needs to be a program that is worth taking part in. While companies like Johnson & Johnson and Dow Chemical are successfully engaging over 80% of their employees, the research shows that in most cases, 80 percent of eligible employees are choosing not to participate in their company’s wellness programming. So, while there are certainly bright spots of workplace wellness, we can fairly say that overall, workplace wellness is in dire need of a tune up.
Where Do We Go From Here?
So, now what? Below are key elements to creating a workplace wellness program that is more likely to work:
1. Reframe how you define “success”
2. Emphasize intrinsic over extrinsic motivation
3. Move from wellness to well-being
4. Consider “going stealth”
5. Shift the focus from changing individuals to changing cultures
Reframe how you define “success.” As long as you are in the mindset of demonstrating a reduction in medical costs alone, you will always be stuck trying to demonstrate the worth of workplace wellness. It’s time to share the bigger picture with leaders – and employees, helping them to understand the value of workplace wellness – beyond cost containment. Workplace wellness done well can help to build a thriving, vibrant workplace that boosts morale, fosters employee engagement, enhances human performance, and attracts and retains top talent.
These are the opportunities for savings that lie beneath the surface. The research suggests that lost productivity associated with low levels of employee well-being add up to three times the costs associated with direct medical expenditures.
Emphasize intrinsic over extrinsic motivation. Sustainable behavior change is only possible when it is intrinsically based. This means that the best that you can do to spark long-lasting change in employees is by creating the conditions in which they are more likely to motivate themselves.
According to long-standing research in the field of social psychology, creating these conditions begins with appealing to the inherent, human need for:
1.Competency or sense of mastery;
2. Autonomy or sense of control and choice;
3. Relatedness or being socially connected with others;
4. Purpose or sense of deep meaning; and
5. Play or sense of fun and enjoyment.
These elements of intrinsic motivation should be taken into account in the design of every workplace wellness program.
Move from wellness to well-being.The primary focus of workplace wellness up to this point has centered on identifying and mitigating physical risk factors, such as weight, blood pressure, and cholesterol. What we know now is that a broad range of ingredients, such as one’s financial state, career satisfaction, social bonds, and even zip code factor heavily into one’s health and well-being. Furthermore, there is extensive evidence that people are much more likely to be motivated by the prospect of improved quality of life as opposed to improved health (which can feel too far off in the future to be immediately relevant).
Focusing on these multiple dimensions of well-being can lead to real bottom-line results. According to a recent Healthways’ study, a well-being strategy in lieu of a wellness strategy (that focuses only on physical health), can double the savings in productivity losses. Their findings suggest that enhancing an individual’s well-being by 10 percent can lead to 5 percent reduction in absenteeism, 24 percent reduction in presenteeism, and even a 2.2 percent reduced likelihood of hospital admission.
Consider going stealth. A small study at Stanford revealed that students are more likely to make changes in their diets when motivated by reasons beyond health, such as protecting the environment or supporting human rights. Based on these results, the researchers concluded that a “stealth” strategy will likely yield greater returns on any behavior-change effort.
Applying these findings to the workplace,it is likely that you will achieve higher levels of engagement by going stealth, “sneaking” wellness into non-wellness initiatives, such as safety trainings, leadership development programs, or team engagement efforts. You can follow the lead of Schindler Elevator Corporation, a forward-thinking organization that integrates well-being into its management, safety, and even HR training programs.
Shift the focus from changing individuals to changing cultures and environments. Ultimately, all of us are creatures of culture and products of our surrounding environment. Therefore, to maximize the impact of any wellness initiative, focus your efforts on making the healthy choice the easy choice and the normal choice. This calls for a shift from focusing so much on personal responsibility and individual accountability, to finding ways to optimize the environment and change the culture to create a “new normal.” To do so, you’ll need to engage leaders at all levels and deliberately design a built environment of wellness. Your goal should be to create an organizational entity that lives and breathes well-being.B&W
About the Author(s):
Laura Putnam, is the author of Workplace Wellness That Works and founder and CEO of Motion Infusion, a well-being consulting and training firm that provides creative solutions in the areas of engagement, behavior change, human performance improvement, and building healthier, happier, and more innovative organizations.
Mari Ryan is CEO and founder of AdvancingWellness, where she consults on worksite health promotion and well-being, and directs the delivery of worksite well-being services to clients.
This article was originally published on August 2015 Employee Benefits and Wellness - HR.com