Don’t Forget About Your Healthy Employees

The problem with employee wellness programs is that only people who are already healthy usually participate.

WEA Trust Health Promoter, Chris Ceniti, has heard versions of this idea from benefits professionals throughout his 20-plus years in the employee health promotions field.

They'd say, "People who are already in good shape show up for a pat on the back, and these other people - who I know are at high risk - aren't there, Ceniti recalls. "But that's looking at wellness backward."

Yes, an important goal of wellness programs is to help high-risk employees improve, Ceniti acknowledges. The wellness movement, however, was created to move what he calls the predominant "sick-care' paradigm toward more of a true health-care paradigm.

"The U.S. may be the best in the world at treating symptoms and disease. But the art of a wellness program is to reach people before they get sick, when they're still at low risk, and keep them there," Ceniti says. "That's how employers get the best value from a wellness program."

Research: Preserving good health has highest value to employers

Seminal wellness research in the 1990s, led by Dr. Dee Edington as director of the University of Michigan's Health Management Research Center, showed that helping employees preserve good health saves employers more benefit dollars than reversing poor health.

In measuring a population of employees who had participated in Health Risk Assessments (HRAs) for two consecutive years, Edington's team confirmed what you'd expect: The employer's medical costs increased for employees whose risk factors (obesity, high blood pressure, smoking, etc.) increased from one year to the next; and the costs decreased for employees whose risk factors decreased.

But here's what you might not expect: The mean increase in an employer's medical cost for each risk factor an employee added during the year was $350; while the mean decrease for each risk factor an employee eliminated was only $150.

"Keep in mind these dollar values are from the early 2000s," Ceniti says, "but the concept this research quantified has remained valid over the years." He cites another study led by Edington in 2010 that showed just how quickly your employee population can move from low risk to higher risk.

Avoid the natural flow toward poorer health

Again, measuring an employee population through HRA data from consecutive years, the research yielded the average annual "natural flow" of employees from low or medium risk to a higher risk category:

5% of low-risk employees increased to high risk 25% of low-risk employees increased to moderate risk 20% of moderate-risk employees increased to high risk

Think of Edington's natural flow as a river your employees are floating in, naturally tending to go downstream to poorer health as they get older. Ceniti says, "A strong wellness program can help employees move back upstream, but it's at least as important to help folks stay where they are, so they don't just flow along with the current unnoticed until they show up on your medical claims list."

Getting healthy employees involved

To interest low- and moderate-risk employees in a wellness program, Ceniti recommends volunteer events that get people moving, such as runs, walks, and volunteer community clean-up or construction campaigns.

He stresses that these activities should accompany the basic elements of a holistic wellness program, including: annual HRAs and biometric screenings, printed and online resources on fitness, nutrition, mental health, etc., visible leadership and communication championed by top management, and incentives.

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