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Research Questions

  1. How prevalent are workplace wellness programs?
  2. What behaviors do they target?
  3. How well do the programs work?

This paper describes the current state of workplace wellness programs in the United States, including typical program components; assesses current uptake among U.S. employers; reviews the evidence for program impact; and evaluates the current use and the impact of incentives to promote employee engagement. Wellness programs have become very common, as 92 percent of employers with 200 or more employees reported offering them in 2009. Survey data indicate that the most frequently targeted behaviors are exercise (addressed by 63 percent of employers with programs), smoking (60 percent), and weight loss (53 percent). In spite of widespread availability, the actual participation of employees in such programs remains limited. A 2010 survey suggests that typically less than 20 percent of eligible employees participate in wellness interventions.

At this time, it is difficult to definitively assess the impact of workplace wellness on health outcomes and cost. While employer sponsors are mostly satisfied with the results, more than half stated in a recent survey that they did not know their program's return on investment. The peer-reviewed literature, while predominately positive, covers only a tiny percentage of the universe of programs. Evaluating such complex interventions is difficult and poses substantial methodological challenges that can invalidate findings. The use of incentives, such as cash, cash equivalents, and variances in health plan costs, to promote employee engagement, while increasingly popular, remains poorly understood. Future research should focus on finding out which wellness approaches deliver which results under which conditions to give much-needed guidance on best practices.

Key Findings

Ninety-two percent of larger employers offer workplace wellness programs.

  • The most frequently targeted behaviors are exercise, smoking, and weight loss.
  • But typically less than 20% of those eligible participate in the programs.

Recommendation

Information is sorely needed about which approaches produce which results under which conditions.

Table of Contents

  • Chapter One

    Introduction

  • Chapter Two

    The Current State of Workplace Wellness Programs

  • Chapter Three

    Program Impact

  • Chapter Four

    The Role of Incentives

  • Chapter Five

    Conclusions

  • Chapter Six

    References

The research described in this report was sponsored by the U.S. Department of Labor and the U.S. Department of Health and Human Services. The work was conducted in RAND Health, a division of the RAND Corporation.

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