by Alex Palmer | March 17, 2014

OpenSymmetry offers wellness incentives and challenges to employees interested in a wide array of health issues, from stress relief to competing in a triathlon 
Sales consulting firm OpenSymmetry had taken steps to encourage its approximately 120 employees to get healthier, offering information sessions and creating awareness campaigns at its various offices. But in March 2013, the company’s leaders, looking to develop a more comprehensive on-site wellness program, hired registered dietician Tracy Beeman to create a new position at the Austin-based company: wellness director. 

“We really focused on laying the foundation, finding out what were the staff’s goals for the program,” says Beeman. 

As she worked with the company’s executives and surveyed its staff about their wellness priorities, it became clear that they were looking for a healthy incentive program that would go beyond asking workers to fill out a health-risk assessment (HRA) and attend a workshop on smoking cessation. 

Beeman began scheduling a weekly meeting for employees interested in weight management, one for those looking to boost their fitness efforts, and several others, turning each into an audio podcast that remote workers from as far as London and Singapore could access. She created rotating monthly programs, each with its own appropriate incentive: One month, workers were encouraged to pack healthy lunches instead of buying them each day, and the person who did so the most consistently won a nice set of lunch bags and containers. Another month focused on staying hydrated, with the prize of a high-end water bottle. This February, Beeman oversaw a healthy-food recipe contest.

“A big goal of ours in the program is to have a variety of different activities for different people,” says Beeman. “We want to encourage those who are already being healthy to continue those behaviors, but also reward people who need to make lifestyle changes for doing so.”

This approach has been a success, with high engagement across the company. OpenSymmetry even earned recognition as one of the “Healthiest Employers of Central Texas” by the Austin Business Journal this year. But OpenSymmetry’s approach also points to an overall evolution taking place in corporate wellness programs. 

As wellness incentives have matured over the past decade, employers have broadened their approaches as far as types of healthy behaviors encouraged. At the same time, wellness has moved beyond just controlling healthcare costs to tracking more expansive concerns, including worker satisfaction and retention. These shifts have been accelerated by leaps in activity-tracking technology as well as the passage of the Affordable Care Act (ACA).

“Historically, health and wellness has focused mostly on physical parameters such as exercise, diet, nutrition, or smoking,” says Mark Nyquist, vice president of product for health and wellness for Connexions Loyalty, a Richmond, VA-based incentive firm that expanded into wellness incentives earlier this year. 

Pointing out that well-being programs now “look at the whole individual,” taking into account aspects such as financial, spiritual, work, family, friends, and physical well being, Nyquist concludes: “We now realize there is more to being healthy than just exercising and eating right.“

More Holistic 
Amy Kramer, solution design strategist at Maritz Motivation Solutions, who oversees the St. Louis-based company’s health and wellness programs, agrees. She says that while wellness activities have been anchored in prevention — measuring biometrics and assessing health risks — organizations have begun adopting what she calls a “more holistic” approach that does more than look at the raw health data.

“It ties into the whole person — being preventive with your exams, disease state management — but beyond that, it also looks at how you can promote physical activity, and how you can focus on nutrition in corporate wellness,” says Kramer.

This also incorporates stress management, work-life balance, and even spiritual health.

Kramer points to a large healthcare organization that had been using cash incentives for its health program with middling results. Working with Maritz Motivation, it created a comprehensive strategy that touched on nutrition, physical activity, and preventive behaviors, even encouraging wellness through the company’s on-site cafeteria by using points and discounts for healthy food choices.

“From these tools, the company saw a dramatic increase in participation,” she says.

As OpenSymmetry demonstrates, a holistic approach offers a bigger tent, whether for the active person who may feel unmotivated by a “Biggest Loser” type competition, or the individual who might shy away from testing such personal statistics as their weight and blood pressure. The worker who is nervous about filling out an HRA may feel comfortable wearing a pedometer or attending a workshop about healthy eating, and having a variety of entry points raises the likelihood of broad participation.

“By making a choice, it impacts my health, and that can spill into other areas of wellness,” says Kramer, adding that by taking the first steps, she has seen many participants quickly dig deeper into their health habits. “That ownership piece is huge, so when you offer just one aspect of wellness, you are actually restricting people.”

Susan Piglia, AVP of corporate wellness for Jefferson, LA-based Ochsner Health System, has seen the value of widely appealing health incentives firsthand. Her company has been working with wellness company Virgin Pulse to enhance workers’ wellbeing in a program that currently boasts a 90-percent engagement rate, which she credits to Virgin’s comprehensive approach to health goals.

“You can have the best wellness program in the world, but if the culture isn’t changed, you’re not going to be able to change their habits on an ongoing basis,” says Piglia.

Virgin Pulse CEO Chris Boyce explains that Virgin Pulse’s offerings not only encourage physical activity and eating right, but also seek to improve employees’ energy, ensure they are getting enough sleep, and help them manage workplace stress.

“Traditional wellness programs haven’t delivered as they promised they would. More often than not, the companies offering them were focusing on whether employees have completed an HRA or had their biometric screening,” says Boyce. “This approach doesn’t do much to actually change people’s behaviors or make them healthier, and employees weren’t engaging with these types of programs.”

Nutrition Emphasis
A sign of how wellness is changing can be seen in how nutrition is being more widely tracked and rewarded. Last year, the company NutriSavings was launched, which works with employers to provide incentives to workers who make healthy grocery purchases. The joint venture of employee benefit company Edenred and digital grocery saving service SavingStar, NutriSavings boasts partnerships with more than 100 supermarket chains throughout the country. 

Workers who sign up for the program register their frequent-shopper card through NutriSavings’ platform, which analyzes their food purchases line by line, providing an overall score, and giving workers employer-determined benefits such as grocery gift cards or discounts. At the same time, the company’s partnerships with supermarkets allow it to offer special discounts on healthy foods not available elsewhere.

“For example, you can incentivize team members to purchase fresh fruit and vegetables by providing a 20 percent discount up to $30 a month, or if your basket score goes up by 10 percent, the employer gives you $10,” says Gerard Bridi, CEO of NutriSavings. “This is really very new. The reality is that it was very difficult to capture all this data — no one had access to it unless an employee brought in their receipts.” 
Bridi emphasizes that only the overall score is reported to employers, not individual food purchases, which allows the program to balance privacy concerns of workers while providing a deeper understanding of their habits to employers. 

“It is long overdue for a health plan to develop a robust program like ‘Eat Right Rewards,’ and we are proud to partner with NutriSavings,” says Vincent Capozzi, senior vice president of sales and marketing for Wellesley, MA-based Harvard Pilgrim Health Care, an early adopter of the NutriSavings program. Capozzi adds that the company is especially pleased to “introduce a nutrition lifestyle behavior member reward program that will educate and reward our members to buy healthier foods at their supermarkets or other outlets.”

Rewards Remain Central
Rewarding employees for healthy behaviors still remains key. A recent study by Workplace Options, which provides support programs to organizations that encourage employee work-life balance, found that 58 percent of employees said they would commit to some type of wellness goal if there were an incentive.

“Incentives can take on various forms — cash rewards or gift cards and merchandise rewards or health insurance discounts, to intrinsic rewards like virtual badges and recognition,” says Hiran Perera, CEO of Walkingspree, a Boerne, TX-based wellness company focused on tracking workers’ physical activity.

The spending on these incentives has gone up, according to Perera. “Five years ago, the average incentive was no more than $100 per person per year,” he says. “Now, it goes up to $500.” 

The reason for the greater spending on rewards, according to Perera, is that employers are seeing the value of wellness programs. Perera points to one client that reduced its health insurance costs by $1,200 per year per employee.

“That compares to the cost of the program being less than $80 per year per employee,” he adds.

That is not to say every company can immediately offer all the bells and whistles. Those organizations just beginning to offer a wellness program should still begin with a few basic metrics. 

“We’ve seen workplaces that go all out and have incredibly robust and detailed incentive programs, and companies that start small,” says Jennifer Patel, leader of Hallmark Business Connections’ health and wellness team. “A lot of companies can’t afford to have someone manage their program full time, so they rely on vendors or have people internally manage the programs — that’s where we step in, providing a vision and counsel on how to develop a program that will not only be effective but worth its value.”

Hallmark has been in the wellness business for over a decade, working with businesses of all sizes. “We know that the impact of healthy and engaged employees on the workplace is not only good for the employee, but for the workplace and the customer,” says Patel. 

In these early stages, Patel emphasizes that awareness of health issues should be the top priority — encouraging participants to take health risk assessments or understand what their current levels of exercise actually are.
“When people start using a pedometer or tracker, they suddenly realize ‘I sit a lot all day. My goal is 10,000 steps, but I’m usually getting four — I thought I was doing well!’ That awareness is a great motivator,” says Patel. 

“We encourage our clients to lead with the positive and develop forward-thinking, encouraging environments. It’s awareness of where you’re at that will help give people a sense of what they need to do and the program helps empower them to make changes,” says Patel.

ACA Impact 
The debate and subsequent implementation of the Affordable Care Act (ACA) has spotlighted the costs of healthcare for both employee and employer, and given a renewed push for finding ways to cut those costs.

“The ACA domestically has put a real financial incentive not just for large employers, but small ones as well, to focus on wellness,” says Alan King, president of Raleigh, NC-based Workplace Options. “The publicity and awareness raised by the ACA from the consumer standpoint has been significant — the idea that you are receiving this benefit and can be awarded for the cost of that benefit.”

For example, if an employer offers a 10-percent discount on insurance costs each month, they are now more aware than ever of the savings this provides.
He adds that the ACA also puts a focus on employees to manage their healthcare costs, helping raise individual awareness of the financial impact of their wellness decisions and the importance of preventive measures. It also means that more companies will be moving to consumer-style healthcare plans with high deductibles that may keep employees from visiting a physician until they are actually sick.

But the rise of remote or freelance workers who can now afford healthcare coverage under the ACA means that workplaces will need to think beyond their internal health benefits program. 

“For so long, people have aligned wellness with benefits and healthcare, but a lot of companies are doing it a disservice to focus only on that because when you do that, it is only servicing the people in your health program,” says Kramer. 

Focusing only on employer-provided healthcare costs may also not be sufficient in determining the ROI of a wellness program. Kramer points to a recent study of PepsiCo’s company-wide wellness program by the company’s wellness executives and RAND Corporation researchers, published in the January 2014 edition of the journal Health Affairs. The authors found that for every dollar invested, PepsiCo only saw a $0.48 savings, concluding that “employers and policy makers should not take for granted that the lifestyle management component of such programs can reduce healthcare costs or even lead to net savings.”

But Kramer counters that this study used reduction in healthcare spending as its primary metric for success.

“Yes, you want to see claims go down, but you want people to be preventative,” says Kramer. “When a wellness program is directly tied to healthcare costs, it overlooks benefits like a better customer or client experience, and higher employee satisfaction.”

Hallmark’s Patel agrees, emphasizing that holistic wellness programs must be gauged by more holistic metrics; shifting from ROI to ROV, or “return on value.” “Value can be seen in a reduction in absenteeism, in a company’s engagement scores, and increased productivity,” she says. “We are hearing more people say that their wellness programs help retain and recruit talent — aspects beyond cost-containment issues.”