Depending on the viewpoint of whether you’re a buyer or a seller, the perspective held by anyone reviewing a wellness plan for any organization is largely based on just a handful of factors: cost to implement, engagement by management and employees, length of time to implement the program, tracking utilization and involvement by employees, and return on investment.
Does all the hype about wellness live up to expectations, or is it just another gimmick? And what about the end results? At the end of the day, are your employees going to be healthier and your company more profitable?
These questions require significant thought and consideration before going headlong into any wellness program. Also, all the studies to date by various surveys that have been done indicate that wellness works. When evaluating a plan to help your employees lose weight, control high blood pressure or diabetes, get fit, eat healthier, stop smoking, or the myriad of other life changing needs they may have, as an employer, you should consider all options before moving forward.
From the legal perspective, there are certain HIPAA regs you must adhere to when introducing a wellness program to employees. According to Martha Jo Wagner at the legal firm of Cohen & Grigsby in Pittsburgh, wellness programs that provide a reward without requiring an individual to satisfy a standard related to a health factor—such as programs reimbursing the cost of health club membership whether or not an employee loses weight—must satisfy only one requirement. The program must be made available to all similarly situated individuals.
Such programs are relatively simple to design and implement, but employers pay the cost even if the individual's health does not improve. In contrast, programs that provide rewards only if individuals satisfy a standard related to a health factor such as losing weight—programs that will be referred to as standards-based programs—must meet more numerous requirements.
- How high a reward? Currently, a standards-based program may provide a reward of no more than 20 percent of the cost of group health plan coverage. The cost of coverage may vary depending upon several factors, including which individuals may participate in the wellness program and what benefit package has been elected under the group health plan. Under the health care reform law, this limit will be increased to 30 percent in 2014 and could be increased to as much as 50 percent by agency action.
- Does it "smell" right? A standards-based program must have a reasonable chance of improving health or preventing disease, must not be overly burdensome, must not be a mechanism for discrimination based on a health factor, and must not be highly suspect in the method chosen to promote health or prevent disease.
- Is it frequent enough? A standards-based program must allow individuals the opportunity to qualify for the reward at least once a year.
- Is there an out? If it is unreasonably difficult for an individual to meet the standard for obtaining a reward because of the individual's medical condition, a standards-based program must waive the reward requirements or provide a reasonable alternative standard for the reward.
Given the trajectory of health care premiums, the adoption of wellness programs is quickly becoming the preferred long-term strategy for controlling costs for many companies. Organizations that have successfully adopted such programs have seen a reduction in everything from absenteeism to medical claims to workers compensation expenses. Essentially, wellness works.
Pick the program that works best for your company. You may want a streamline version or a Cadillac plan with all the bells and whistles. However, you need to realize that any commitment you make is for the long haul. Most wellness programs need 3-5 years before you’ll see a reasonable ROI. That’s a long time to float money for a promised positive yield on your investment. Yet, the possibilities exist for as much as a 5 or 6 to 1 return.
Additionally, your executive management needs to buy into the concept, especially the chief financial officer, who is primarily responsible for counting the cost. According to Health Sprocket, consider these eight points before rolling out your wellness program conversation with your CFO:
- Make CFO a partner. Invite your CFO to participate in health care benefits decisions.
- Tie benefits, bottom line. Clarify the relationship between benefits and the organization’s financial well-being.
- Quantify the link. The direct costs of poor employee health can be persuasive when making the financial case for improving employee health.
- Measure everything. Collect every possible kind of numerical evidence. Compile claims costs. Conduct employee surveys.
- Go beyond the obvious. While it’s important to tally costs of paying an absent employee or overtime or temps, it is equally important to understand the opportunity costs of each lost day of work.
- Package the numbers. Make your stats and other information readily available to the CFO.
- Get to know your CFO. If you can put your goals for the wellness initiative into a context that resonates with the executive’s own views, you’re more likely to get the money you need.
- Learn CFO-speak. Likewise, if you present your case using the same accurate financial terms your CFO relies on for precision and clarity, he or she will find you and your data more credible.
Wellness programs have proven overall that companies can improve their bottom line and the health of their employees. There are struggles with participation and implementation, but that is true of any new initiative. Although wellness has been a major buzzword over the past year in HR circles, the concept is not new. And it makes sense.
Whenever individuals are proactive with preventive health measures, their health does improve even if it happens gradually over time. In some cases, people can see positive results right away. But typically, improvement takes time largely because it requires behavioral changes. Altering your lifestyle to lose weight is tough to do, especially if your habits are deeply ingrained over many years. Yet, if your goal is to not die young, then a wellness program is a good way to start making those changes that lead to better health. Individuals, and companies, can win big with wellness.