Effective wellness programs must be customized, supported by top managers

WASHINGTON – Employers’ adoption of wellness programs has been growing rapidly, but few companies are implementing comprehensive programs likely to make a meaningful difference in their workers’ health, a new study by the Center for Studying Health System Change says.
The study, conducted by HSC for the nonprofit National Institute for Health Care Reform, included a review of research on wellness programs and 45 interviews with industry experts and representatives of benefits consulting firms, health plans, wellness companies and employers.
To make a real difference, the study found, firms need to implement customized, integrated, comprehensive, diversified programs strongly linked to their business strategy and championed by senior leadership and managers throughout the company.
“Many experts told us that employers that lack the ability and commitment to support a comprehensive wellness program may be wiser to stay on the sidelines,” said Ha T. Tu, a senior HSC health researcher and coauthor of the study.
In general, the study found, “off-the-shelf” programs are less effective, and providing online health risk assessments and Web-based educational tools, but no individualized follow-up to engage employees, is the approach least likely to make an impact.
Programs are also less likely to succeed if wellness is promoted on its own, in isolation from the company’s priorities, or if it’s sold in an environment of discord or financial turmoil, the study found.
Mutual trust was found to be crucial, and communication, the study says, must be ongoing and kept fresh and up to date; it also works best when done in house rather than by a vendor.
The authors also recommend comprehensive, integrated and diversified efforts, rather than isolated initiatives such as a smoking cessation program. And most experts believe financial incentives are essential to achieve strong participation, but they need to be designed to incrementally reward activities to improve or maintain health. However, there are also strong examples of employers who offer minimal or no cash rewards but are successful.
Regarding return on investment, the study found it’s uncertain and hard to measure. Employers should expect to invest in wellness for several years before seeing a positive ROI, if at all, the authors warned, and anyone looking to wellness as a quick fix will be disappointed.