The report investigates the characteristics of workplace wellness programs, their prevalence and impact on employee health and medical cost, facilitators of their success, and the role of incentives in such programs. The authors employ four data collection and analysis streams: a literature review, a survey of employers, a longitudinal analysis of medical claims and wellness program data from a sample of employers, and five employer case studies.

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Workplace Wellness Programs Study

Final Report

by Soeren Mattke, Harry H. Liu, John P. Caloyeras, Christina Y. Huang, Kristin R. Van Busum, Dmitry Khodyakov, Victoria Shier

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Research Questions

  1. What are the characteristics and prevalence of current workplace wellness programs?
  2. What is the evidence for program impact?
  3. What is the role of incentives under wellness programs?
  4. What are key facilitators of successful wellness programs?

The report investigates the characteristics of workplace wellness programs, their prevalence, their impact on employee health and medical cost, facilitators of their success, and the role of incentives in such programs. The authors employ four data collection and analysis streams: a review of the scientific and trade literature, a national survey of employers, a longitudinal analysis of medical claims and wellness program data from a sample of employers, and five case studies of existing wellness programs in a diverse set of employers to gauge the effectiveness of wellness programs and employees' and employers' experiences.

Key Findings

Characteristics and Prevalence

  • Approximately half of U.S. employers offer wellness promotion initiatives, and larger employers are more likely to have more complex programs.
  • Programs often include wellness screening activities to identify health risks and interventions to reduce risks and promote healthy lifestyles.

Impact

  • Employee uptake of worksite wellness programs remains limited. Fewer than half of employees (46 percent) in the firms surveyed undergo clinical screening or complete a health risk assessment (HRA), which is used to identify employees for interventions.
  • We found statistically significant and clinically meaningful improvements among program participants in exercise frequency, smoking behavior, and weight control, but not cholesterol control.
  • Participation in a wellness program over five years is associated with lower health care costs and decreasing health care use. The average annual difference is an estimated $157, but the change is not statistically significant.

The Role of Financial Incentives

  • Incentives for completing an HRA are effective, particularly above a threshold of $50. On average, an increase in the HRA incentive by $10 is associated with a 1.6 percentage point increase in the HRA completion rate for incentives in the range of $0-$100.
  • Smoking cessation is also the only health behavior for which achieving the goal earned a greater reward than participating in a program.
  • "High-powered" incentives that tie as much as 20% of the cost of coverage to achieving a health goal remain rare.

Key Facilitators

  • Broad outreach and clear messaging from organizational leaders.
  • Making wellness activities convenient and accessible for all employees.
  • Making wellness an organizational priority among senior leaders.
  • Leveraging existing resources and building relationships with health plans to expand offerings at little to no cost.
  • Approaching wellness with a continuous quality improvement attitude, and solicit feedback from employees to improve programs.

Table of Contents

  • Chapter One

    Introduction

  • Chapter Two

    Methods

  • Chapter Three

    Employer-Based Wellness Program Characteristics and Prevalence

  • Chapter Four

    Program Impact

  • Chapter Five

    The Role of Incentives

  • Chapter Six

    Lessons from Case Studies for Program Implementation

  • Chapter Seven

    Conclusions

  • Appendix A

    Employer Survey Sampling Methods

  • Appendix B

    CCA Data Analysis Methods

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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