Wellness incentives: how well do they work? Companies are offering everything from Green Stamps to days off in order to get participation

Business & Health, April, 1991 by Nancy Madlin

Wellness incentives: How well do they work?

The logic behind corporate wellness programs is simple and indisputable: employees who are in better health spend less on healthcare. "The dollar savings derived from wellness can be higher than most companies realize," says Tom Sawyer, president and CEO of Health Advancement Services, a consulting company in Tempe, Ariz. One of Sawyer's clients, the city of Glendale, Ariz., has had a wellness program for nine years. The city estimates it gets $10 back for every dollar spent on the program.

It's no surprise, then, that the number of companies starting up wellness programs of one kind or another is growing. Or that these companies are exploring new ways to improve results by increasing employee participation. "Clearly, people are watching this kind of initiative with great interest," says Margaret Beckham, information manager at the National Resource Center on Worksite Health Promotion in Washington, D.C.

The more employees who participate in a wellness program, the more potential savings. That's why companies have tried a variety of methods to increase employee participation, some of which have proven more effective than others. Mandatory employee participation, for example, is not recommended. When a railroad company tried to require its track maintenance employees to do warm-up exercises, the workers threatened to strike unless the program was halted immediately.

Accentuate the positive

Systems that use "disincentives" to penalize those deemed unhealthy also are questioned by many. "Disincentives can create employee relations problems, leading to charges of unfair discrimination or accusations of management interference in private matters," says Lynn Gilfillan, a wellness coordinator at Coors Brewing Co. of Golden, Colo. "It's much better to create incentives that put employees in a position to gain something."

Since 1984, Coors has run a health assessment program, mailing out surveys with over 100 questions for employees and spouses. Along with routine health and safety matters like smoking and seatbelt use, the survey asks about such personal matters as whether, in the last year, the employee has had sexual difficulties or a "stressful Christmas." Survey results allow Coors to appraise the health status and lifestyle of each employee and spouse, and to direct him or her to appropriate programs.

Filling out the appraisal form is voluntary and the results are confidential. "We felt employees would resent a wellness program that mandates participation," says Gilfillan. "From the beginning, we wanted the appraisal to have a low profile, so it wouldn't be a case of management meddling in personal affairs." And there is an incentive to participate: If the employee's appraisal shows that his "health age" is the same or less than his chronological age, Coors will increase its health insurance contribution from 85 to 90 percent.

Crossing the 'goals' line

"A well-designed incentive program can make significant contributions to wellness success," says Sandra J. Wendel, editor of Worksite Wellness Works, the newsletter of the Wellness Councils of America (WELCOA) in Omaha, Neb. "Frequently, the presence of an incentive will increase participation, increase adherence to a specific behavior, and increase follow-through by 10 to 20 percent."

Companies with wellness programs offer employees incentives to reach a number of different goals. The most frequent goal, by far, is to have employees quit smoking, but other common goals include better health via aerobics, biking, jogging, walking, or swimming; and losing weight.

Some companies go beyond even these activities, usually basing program goals on the specific medical risks of their employee populations. A company with a lot of men over 40, for instance, might reward proper diet and exercise; one with a lot of women under 40, obtaining pre-natal care during pregnancy; and one whose employees do a lot of driving on the job, wearing their seat belts.

Time off for well behavior

The incentives are even more various. Companies are using all manner of things to reward employees who participate in wellness programs--fee rebates for completing a weight-loss or smoking-cessation classes; a day off after a year of no smoking; and eligibility for a raffle offering a weekend getawat after one has reachsd weight loss goals.

One of the most effective incentives of all may also be one of the simplest: "I think the most powerful incentive to participation in wellness programs is to offer the program during work hours," says Roger Reed, vice president of product development at Keycare Health Resources in Indianapolis (formerly part of Blue Cross of Indiana). "That really increases participation; during work hours, you can even reach the unmotivated."

But, according to Healthy, Wealthy & Wise, the managers' guide published by WELCOA, time off from work is just the beginning; as a reward for reaching a fitness goal, companies are also awarding T-shirts, gym bags, sun visors, pens, thermometers, relaxation tapes, water jugs, beverage mugs, car safety kits, videos, books, blood pressure monitors, coolers, magazine subscriptions, jackets, sports clothing, and gift certificates to stores and restaurants. ("People will do anything for a T-shirt," says the WELCOA guide. "And they'll do even more for paid days off, cash, and praise in the company newsletter.")