How to Finally Fix the Flawed Corporate Wellness Model

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Today’s model for workplace wellness is to offer a program of dazzling options, but studies show such programs are not producing the outcomes they promised and that employees and companies deserve.

Here are four major changes for employers who want to improve their employees’ health and wellness and realize a return on their investment in wellness programs.

1. Get real about outcomes

A recently published study by The RAND Corporation revealed that wellness programs are not getting the intended results. One reason programs were failing was that fewer than 37 percent of U.S. employers even measure the effectiveness of their wellness programs.

Measurement is a critical part of adjusting and tailoring a program to create meaningful results. If you aren’t measuring, how do you know what works? Or as Dr. W. Edwards Deming, the total quality management (TQM) expert said: “You can’t manage what you don’t measure.”

Another reason programs failed was that employers were not looking at outcome data with a critical eye.

For example, recently Highmark (a large Blue Cross and Blue Shield plan) showcased the results of the wellness program it offered its 19,600 employees. The results were given a shiny gloss when they should have set off loud alarms.

Fewer than half of its employees participated and fewer than half of that pool reported feeling more productive at work as a result of participating.

Another indicator was weight loss: The average loss was 5.6 pounds.

That’s a good start, but not near the modest 5-7 percent weight loss (an average of just 11 pounds), needed to reduce the risk of heart disease, diabetes, and other chronic diseases.

Only 163 employees lowered their Body Measurement Index (BMI) status from obese to overweight or from overweight to healthy weight. That’s less than one percent (.86 percent.)

If you accounted only for the two-thirds of Hallmark employees who are likely overweight or obese, the success rates rises to only 1.3 percent.

The bottom line: Highmark spent a lot on a well-intended program for weight loss. But they didn’t get enough participation or weight loss to significantly impact health and wellness. Highmark deserved a better result – and all of us need to look at our numbers and do an honest accounting to ensure program success.

2. Start with where people are “at”

Many wellness programs start with what seems like a logical place to begin: a health risk assessment (HRA). Unfortunately, many employees don’t participate because of fears about:

  • How the information may be used by their employersWill my insurance rates go up?
  • What the results may revealWill there be bad news?
  • What changes they should make but aren’t ready to makeBetter that I don’t know than feel guilty for not changing.

Pushing HRAs on people who aren’t asking for them is a recipe for failure – and often forms a barrier to attracting employees into committing to a program. Wellness programs should start with where people are “at” and what they want; and offer multiple pathways to entry.

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By helping employees achieve goals that are important to them, and what they are ready for, opens up a pathway for ongoing wellness. By creating a welcoming entry-space, wellness programs will have more success engaging employees in tackling the difficult health and wellness challenges that drive up costs and reduce productivity.

And, when people feel understood, respected, and supported, they begin to invest emotionally and gain confidence in their ability to make changes. This emotional investment and confidence are what drive long-term health success.

3. Make health and wellness the social norm

Changing the corporate culture to make health and wellness the social norm is a key factor in achieving an organization’s wellness goals. That means:

  • Establishing policies that help health and wellness flourish.
  • Making healthy food available in the cafeteria, in vending machines, and at events.
  • Encouraging physical activity throughout the day instead of just subsidizing gym memberships or installing an onsite gym.
  • Viewing vacations as something that everyone is encouraged to take instead of only rewarding people for working long hours.
  • Encouraging and celebrating all the little things (and the big ones) that people do to stay at the top of their game at work and at home.

Successful wellness programs become part of the corporate culture and the social norm, not something that each employee does on their own in isolation.

4. Promote organizational wellness

Current wellness programs too often narrowly define wellness as the absence of disease and offer quick fixes to lower blood pressure, decrease weight or diabetes.

But, wellness isn’t a tactic.

Organizational wellness, like individual wellness, addresses all the factors that affect the organization’s capacity to thrive – how can each person be the best they can be physically, mentally, socially and spiritually? Individual employees are part of an organizational ecosystem – and that ecosystem should be healthy as well.

Creating a truly high-performance organization depends on engaging everyone at all levels of the organization and developing wellness leadership from the grassroots to the C-suite, from the cubicle all the way to the boardroom.

Dr. Deborah Teplow is CEO and co-founder of the Institute for Wellness Education. Previously, she was founder and CEO of Health Focus, a medical publishing company that produced continuing medical education for a national audience of physicians and other clinical professionals. Dr. Teplow has served on an expert panel for the U.S. Department of Health and Human Services, as a director on the board for the Global Alliance for Medical Education, and a subcommittee chair for the Alliance for Continuing Medical Education.


10 Comments on “How to Finally Fix the Flawed Corporate Wellness Model

  1. Great content. I 100% agree with the need to measure progress / outcomes. It’s not about wellness activity and programs but measuring progress to make a meaningful difference in peoples’ lives.

    The other main problem is trying to develop a culture of wellness or a corporate wellness model that’s separate from the core of the organizations – it’s purpose and values. The support structure of systems, communication, management and other areas should be, in many ways, the same support structure that reinforces the purpose, values and strategy of the organizations. I focused on wellness because we cared about our employees and their lives so they could make the maximum contribution at work (and in their personal live). Don’t build a wellness culture but integrate it as a cornerstone of your overall culture.

    1. Absolutely right! We define wellness as doing and being the best you can physically, psychologically, socially, and spiritually; and contributing to your community (home, work, etc.) to make it the norm. This means that wellness is a value and process that imbues everything a company does. It is holistic and
      person-centered so even staff meetings to decide who cleans out the fridge on Fridays reflects an approach that affirms and celebrates individuals’
      contributions and capacity.

  2. Lots of good ideas in that article – but still so missing the boat – the Highmark study was indeed a disaster – but for a fundamentally more important reason than just bad math – If wellness programs want to be taken seriously they need to be at the very least, evidence-based – given that there is no evidence base for weight loss programs – in this case both no evidence of efficacy and lots of evidence of lack of efficacy – offering them at the workplace makes no sense either from a health or cost perspective – companies need to stop harping about how many people lost weight – because we know that most will gain the weight back and many will gain more back as well – Like forcing HRA’s, promoting weight loss programs will not save money and will not improve health for the overwhelming majority of folks who participate and it will cause additional problems for many – as Dee Edington said – “Weight Loss Money is Money Down the toilet” – as long as we are addressing the need to change what we do – this would be a perfect place to start! – Jon

    1. Whatever the wellness program, the key to achieving the physical,
      mental, social or spiritual outcomes each person wants depends on behavior change. In terms of behavior change, the evidence base demonstrates the importance of starting where each person is at in their particular stage of change related to their goals. This is followed by working through the change process at a pace that makes sense to the person, using methods and strategies that align with their values, culture, preferences, and style.

      Further evidence indicates the need for real-time measurement of progress, which includes assessing whether the strategies being employed are a good fit for the person. In short, is the intervention working and does it fit? These are the “proximal” outcomes. If a person is not making progress, and the strategies and methods don’t fit for the person, change won’t be sustained, the desired long-range goals (ie, the “distal” outcomes) won’t be achieved, and no ROI will be gained. We don’t have to wait until all the research and evidence is in on each wellness program before getting started. We can get started with what we already know about behavior change in general and the effectiveness of measuring proximal outcomes.

      Another issue related to current wellness programs is that they focus too much on deficits and put the full burden on the individual without marshaling existing strengths and resources, and community initiative. We are inspired by Isaac Prilleltensky’s work and his conceptualization of the two predominant approaches to change. A lot of traditional wellness program use too much of what Prilleltensky calls the “DRAIN” approach, which is Deficit-oriented (pick out the overweight, smokers, etc), Reactive (throw a bunch of wellness programming at employees), Alienating (coercive HRAs and biometric testing), and INdividual focused (tell me to get more exercise, but don’t give
      me breaks during the day to let me get moving, tell me to cut back on calories, but don’t provide adequate options to standard cafeteria food). We clearly need a lot more of what he calls “SPEC”: Strength-based, Preventive, Empowerment, Community change.

  3. Agree with the other comments that this is great content, but wellness alone often misses the bigger opportunity. The greatest group healthcare dollars are spent on the smaller segments that fall in to chronic and pre-disease conditions. Focus on that smaller segment who are most at risk for digressing in their health into more and more expensive medical care needs and you’ll see the biggest bang for the buck. We work with groups to ID earlier their risk group members and then help engage more pro-active resources with those members to hold them steady and improve their conditions; or at minimum better manage and delay the progression to more expensive care (like pre-diabetic to diabetic to dialysis). Keeping healthier group members healthy is important, but biggest ROI is still to be found in those at risk group members. Glad to discuss with anyone off line.

    1. What it sounds like you’re talking about is prevention, not just preventing
      inception of new problems, but preventing their progression of existing
      conditions. I totally agree. Unfortunately, considering that over 1/3 of
      American youth are overweight or obese, they enter into the workforce at
      high-risk. So, preventing the employees of all weight categories and conditions from getting worse is a big deal. As long as we’re looking at reducing risk, take employees who are entering middle age, when the average weight gain over those years (approximately 16 lbs) is enough to greatly increase the risk of diabetes. As you suggest, help them simply maintain whatever weight they’re at and it will be a big ROI.

  4. Wellness initiatives should include improving the quality of workplace relationships. Since most of us spend a majority of our waking hours interacting with work colleagues, those interactions greatly impact our well being. Instead of only treating the symptoms of toxic work climates, diagnose and cure the underlying conditions.

    1. Great point that’s too often overlooked in the drive for measuring
      calories ingested and steps taken. What you’re talking about is social wellness (and not social media, which doesn’t necessarily address social wellness at all.)

      It’s up to all of us who appreciate that there are far more factors driving wellness than just a healthy diet and adequate exercise. Unfortunately,
      BMI, blood pressure, and cholesterol are easy to measure. And, we recognize the concrete behaviors that contribute to their being out of whack. We can point to high BMI, BP, etc. and draw a straight line to poor health and high healthcare costs. Unfortunately, it’s harder to measure workplace toxicity and its effect. A first step, as you suggest, is to get social wellness on the wellness agenda. It’s not about being 1970’s loosey-goosey peace-love-and-brown-rice, but it is about taking a holistic approach so we recognize all the factors that contribute to overall wellness.

  5. I’m just seeing this now–a very thoughtful article (not saying I agree with all of it but it is indeed very thoughtful) with an excellent discussion and I like that you as the author respond to all the comments. You were nice not to name ShapeUp as the perp for the Highmark debacle but seeing as they list it right on their webite (which is how we found it) it seems like it’s fair game to call them out.

    Thanks for elevating the discussion of this topic and for attracting thoughtful comments too.

  6. While I applaud the argument here by Ms. Teplow, I do believe her presentation of herself as “Dr. Teplow” to a healthcare audience is unethical at the worst and at a minimum highly misleading at the best.

    According to online records, Ms. Teplow doctorate was conferred in Music in 1983 by Stanford, not in any healthcare-oriented field. While Ph.D. graduates are certainly colloquially referred to as “Dr.”, I believe it’s highly unethical for her to apply that credential in an industry where it would be naturally assumed that her doctorate was in a health-related field.

    Ms. Teplow, the strength of your argument itself can stand on its own.

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