If you Google the phrase “Why Wellness Programs Don’t Work” you will return 455 million results in 0.59 seconds (go ahead, try it). The list of publications telling you why such programs don’t work include Wharton’s Knowledge at Wharton, the New York Times, The Harvard Business Review, Resources for Employers, The Wall Street Journal, Inc. and even LinkedIn.
If we define “work” to mean these programs are lowering healthcare costs, improving employee’s physical and mental health assessments and making employees better users of the healthcare system, they definitely are not working.
Here’s why:
Not enough emphasis on mental health programming
I once read an advertisement from a wellness vendor. To paraphrase, the ad said if “…your employees are feeling stressed, call us. We’ll send a therapist over.” As if it is that easy to overcome feelings of detachment, depression and despair. Maybe when the therapist comes over, they can bring a bowl of fruit.
The wrong vendors are being utilized
Having Tiffany or Chad from the gym come over and tell the employees what days of the week to work adductor muscles and which days to work the abductor muscles is a poor use of time and money (except for Tiffany and Chad!). Would be better if Tiffany and Chad could provide education on how to incorporate physical activity in one’s schedule without becoming Exercise Bulimic (EB).
The programming is not making participants better users of the system
The United States Preventive Services Task Force (USPSTF) is “an independent panel of experts in primary care and prevention that systematically reviews the evidence of effectiveness and develops recommendations for clinical services.” (Wikipedia). They provide one of five letter grades (A, B, C, D, or I) to preventive services. A=a recommended service, I=insufficient evidence to assess the balance of benefits and harms. Hypertension screening in adults? A. Tobacco smoking cessation? Definitely an A. Mass screening for atrial fibrillation gets a I. As does screening for Vitamin D deficiency in adults.
I once had an intern stand in Market Square holding a laminated sign with USPSTF printed on it. His job was to ask 100 employed or retired adults if they knew what the letters stood for. The result? 39%. An effective wellness program would have that number up to 93%. Tiffany and Chad may not know what those letters stand for but they probably know how to “superset” pecs and triceps.
No independence from the wellness vendor
It’s inefficient to pay a health insurance company for company healthcare (or a TPA for a self-insured entity) and then to pay extra money for wellness services. The same thought goes to the bundling of health insurance with wellness services.
The wellness vendor should be separate from the health insurer. Administering claims is a low margin enterprise. Offering wellness services is high margin. Improve the health assessments of the workforce (which includes improving knowledge of the system) and put your company in a better negotiating position to lower overall costs.
Paying an insurance company for healthcare coverage and then paying again for wellness programs would be the equivalent of buying a bike at a bike shop and then paying the bike shop owner some more money to ride the bike for you. (If there was a Hall of Fame for Great Analogies, that one would be in it.)
And if there was a Hall of Fame for bad wellness ideas, the program described HERE would be in it.
