• Andrew Stephenson

Flipping the Focus Towards Prevention in Corporate Wellness

For decades, the promise of corporate wellness programs has been to promote positive health and control health and associated corporate performance costs. In reality, the majority of the wellness industry has failed to achieve the levels of engagement necessary to achieve that promise.

HBD recently hosted a webinar with Shortlister to discuss the gap between this promise and what is widely being delivered, and subsequently presented an overview of the pathway that's required to close that gap. You can view notes and a video of that webinar here.

Given the ongoing pandemic and the knowledge that pre-existing conditions make people more susceptible to significant illness, the case for prevention and indeed the benefits realized for those who were already ahead of the curve prior to the pandemic has never been more compelling.

The biggest barrier to reaching the benefits of prevention is engagement. As most vendors provide niche products in the wellness space, most companies are forced to try to build a comprehensive program from a group of individual pieces. They end up with programs that compete for employee attention and dilute total population engagement across multiple sub-programs. Employees end up with a bunch of puzzle pieces, but rarely a clear picture.

In recognition of companies struggling to properly reach across their total population, most companies fall back on trying to target the low-hanging fruit of identifying and managing their high risk and highest cost employees. Ah, the rise of "disease management" programs. While we totally get the appeal and quick-wins associated with cost efficiencies in this very high-cost group, it's an unsustainable approach, as it doesn't prevent the next wave of people within your population from becoming high risk. Established literature indicates that only around 3% of the U.S. population is currently "healthy", and most populations, without intervention, will have an annual 2-3% migration towards high risk. If you can't more effectively engage more people and stem that flow, you will never get ahead. For every high-risk person whose costs you improve, another person drops into that high-risk and high-cost bucket to replace them.

A far more sustainable cost management strategy is to still identify and aim for efficiencies in the high-risk and high-cost group, but concurrently seek early, proactive intervention across the remainder of the population, that is, the entire population. Avoid or slow their progression towards high-risk and high-cost. Data from Dee Edington during his time at the University of Michigan (refer to his exceptional book, Zero Trends, 2009) established that you actually save 40% more by preventing a health risk than you can save by reducing or properly managing that health risk once it's reached. 40% more!

The added benefit of being able to more successfully engage the total workforce in a more proactive wellness program is that you get other benefits in workforce performance (like absence management, job engagement, productivity, and injury prevention), adding to the value proposition and sustainable workforce cost management. While many people tout these as added benefits of wellness programs, most programs don't achieve the reach necessary to properly realize these benefits. It is estimated by leading researchers (Goetzel, Edington etc) that to achieve the greatest financial returns from wellness programs, you need to achieve sustained engagement from at least 60% or more of your total population.

Across our book of business, HBD averages sustained engagement from over 95% of the total workforce annually (over 85% of the total workforce in a sustained and routine nature), without major participation incentives. With that captive audience, the door opens to significant group behavior change and measurable shifts in group health and performance.

Average Workplace Health Outcomes Across our Book of Business:

With these outcomes, the conversation can truly flip towards prevention. With this consistent reach across the population, you still identify and help manage those already at high risk, but you concurrently intervene and stem the flow of the rest of the population towards high risk.

The Pathway to Prevention:

How do you get there? Instead of trying to "best fit" a bunch of independent programs to your people, we start from your people, your unique culture, and operational logistics, and then build a program to fit them.

Interventions must be structured in a way that makes engagement EASY and ROUTINE. Whenever you put programs in the periphery and wait or try to nudge people to seek them out, you will immediately reduce your reach and begin to limit the programs to those who specifically know they need them, or who have an existing interest in them. That immediately erodes your opportunity to achieve prevention.

Secondly, the content is critical. It must be RELEVANT and ACTIONABLE. Most people have a basic sense of what they're "supposed" to do to be healthy (eat better, exercise more, etc), and yet so few people actually do it. It's not a lack of information or incentives, it's a lack of compelling actionable knowledge. People don't know how to fit the generic recommendations to their personal routines or they don't have a compelling personal value proposition to bother. However, for behavior change to occur and stick, they need both.

Finally, the program must be nimble and adaptive. Employees need to keep getting personal value from the program long-term, even as their health, needs, or interests change. If the program is stagnant and generic then attrition becomes the rule rather than the exception.

The real value of corporate wellness isn't unattainable, but it's also not quite as simple as selecting a few flashy plug-and-play solutions and trying to nudge people towards them with gift cards. It requires purposeful structure and adaptive content that can truly reach and engage your entire population - regardless of their existing risk or stage of readiness.

To learn more about our global best practice methodology, or if you are interested in truly starting to get ahead of the cost curve with your people's health and performance management, then we encourage you to hit "contact us", reach out - no obligation - to at least learn about the type of program we could build for you.

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