Are traditional wellness programs improving employees’ health and lowering costs?
A new study finds that the answer is no.
The results of a well-designed study of a traditional wellness program are just what we would expect. Researchers Zirui Song and Kate Baicker (of Harvard and the University of Chicago) recently published their findings in the Journal of the American Medical Association (JAMA). The study found no change in health metrics and no decrease in cost at the sites that were offered wellness programs. It reports results similar to those from the University of Illinois published by the National Bureau of Economic Research last year.
Interestingly, Song and Baicker were coauthors of a seminal 2010 Health Affairs meta-analysis suggesting $3.27 in savings for every dollar spent on wellness programs — so they did not come to this study as critics of wellness programs.
A strong study
This is a strong study. There were more than 4,000 employees in the group exposed to the wellness program and almost 29,000 in the sites that served as controls. The workers at the wellness sites self-reported more exercise and more active weight management. The wellness program included modules on nutrition, exercise, stress reduction and other related topics administered by registered dieticians. Experimental sites were chosen randomly, and the employees were well matched.
This was an “intention to treat” study — so that the researchers looked at all the employees who could have participated in the wellness program, avoiding the selection bias that often makes wellness programs appear more effective than they actually are.
The authors acknowledge potential criticisms:
- The employer, a large warehouse club chain, has low-wage workers with short job tenure.
- The study was for only 18 months.
- It’s possible that there will be some improved health or some lower cost in the future.
The stakes are high
With considerable spending on wellness programs, it’s important that they become more effective. Willis Towers Watson research shows an employee Net Promoter Score (NPS — a customer satisfaction measure) of -51 for employer-sponsored wellness programs. NPS scores under 0 are strongly negative; world class companies can sometimes achieve NPS scores of 70. This suggests that employers need to find better approaches than conventional programs to teach employees about healthy behaviors.
While traditional wellness programs don’t appear to move the dial, employers have alternative means to improve the health and health behavior of their employees. For example, employers can make their workplace as conducive to healthy behaviors as possible (better nutrition, more exercise, clean air, decreased stress). Employers can also get substantial value from investing in integrated wellbeing – providing employees and their families with valued resources that address their physical, emotional, financial and social wellbeing. And, even if these programs do not directly lower medical claims costs, employers will gain a competitive edge by creating healthier and happier employees.