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Published on : January 15, 2014

The Missing Ingredient to your Wellness Recipe

The Missing Ingredient to your Wellness Recipe

The days when employers wondered if it made good business, sense engages in worksite wellness are long gone. The evidence  in favor of wellness programming has mounted to such overwhelming significance that CFOs no longer ask if there will be a positive ROI for “doing wellness”. They see it reported in financial magazines and study after study. Now, however, they should change their question to “Why isn’t our wellness program returning a positive ROI?” Obviously, it works elsewhere. What is missing in our program?

After more than twenty-five years of consulting, designing and managing wellness programs, our experience is that there is a common denominator; a missing ingredient to be found in those programs that are failing. That missing ingredient is strategy. Consider this composite discussion as a company looks to introduce worksite wellness.

CFO:    “I checked around and my peers at other organizations confirm that we should do this – they report getting about a 3:1 ROI”

HR Manager:        “I know. That is what my HR magazines say, too. We need to do this soon, because I just got the renewal for our HMO and rates have gone up 10%.”

CFO:    “Ok, I approve the concept. How much will it cost?”

HR Manager:        “It seems that costs are all over the map. I will prepare an RFP and we will get proposals to start a program here. I’ll let you know as soon as I get the proposals from wellness vendors.”

[Some time later]

CFO:    “Wow. That is more than I thought it would be. But, with a 3:1 return, it seems a good investment. Go for it.”

[A year, or two later]

CFO:    “What’s going on with that wellness program? We have been doing it for a while and our health insurance rates are still going up. I thought it was supposed to lower costs. I cannot see any ROI. Why did we fail when others succeed?”

Therefore, what was missing, beyond a fundamental understanding of how employers realize a return on investment from introducing wellness programming (Hint:  it is about a lot more than health insurance premiums)? Alternatively, flip the question and ask what is the key ingredient in highly successful worksite wellness programs? Strategy.

All too often, employers think of wellness as a “product” that can be bought. I often describe this as “wellness in a box.” There are a number of reasons for this:

•    Vendors sell that idea. As the marketplace has blossomed, many wellness providers promote their product as “turnkey” and “one size fits all.”
•    Less qualified insurance brokers are used to the idea of shopping for a product and then having the vendor of that product implement a “solution.”
•    Employers look for a quick fix.
•    Seminars, magazines and web forums love to talk about the idea that worked for one employer and focus on the programming idea, incentive or communication method as if that particular idea was magic.
Let us review each of these failings and then consider a different approach.
It is no surprise that vendors need to sell their service or product. Without selling, they would not garner new customers and would quickly go out of business. However, it is vital that employers recognize that, as with any product, wellness programmers want you to buy and their marketing efforts are focused on emphasizing the positive aspects of their product. This is not a question of dishonesty, either. While there are some less than trustworthy vendors, as in any marketplace, most wellness vendors truly believe their approach is better than others are and that it will work for your organization. They had an idea for starting their business – maybe they worked elsewhere and saw opportunities to improve on what their former employer was doing. Regardless, the important thing to remember is that no single vendor has the perfect solution for all organizations.
Insurance Brokers.
Few insurance brokers have extensive experience in wellness & productivity planning. For most, wellness is a product they sell- like dental or vision insurance. Their business model is predicated on the idea that they can solicit quotes, compare offerings and then have a vendor deliver a product or service. Only the most specialized benefits firms have trained staff, medical directors or a true wellness practice. For the rest, wellness is another opportunity to earn commission and they are just as easily swayed by the “wellness in a box” idea as an uninformed employer is. It fits the model by which they have been working for years. After all, most insurance brokers do not deliver service themselves, they broker a deal for someone else to do so. Over the past several decades, the very best insurance brokers have expanded beyond the “broker only” model and have begun true specialized wellness consulting practices.

The conversation that began this essay is, far too often, a real-life experience. Too many employers make numerous mistakes when considering wellness programming. They:
•    Take a shortsighted view, thinking that introducing a wellness program will have immediate effect. At the core of successful programs is the difficult task of human behavior change. Anyone who has tried to start an exercise or weight loss program understands how difficult change can be.
•    Ignore the impact of culture. Every organization is unique and, even those who celebrate and promote how their unique approach differs from competitors in their space, ignore how important culture is in effectively designing, implementing and successfully managing a wellness program. Just because a particular idea worked for another company does not mean that same idea will work as well when transplanted to yours. For example, some companies have great success with challenges that pit employees against one another. They do so because their culture embraces competition and the behavior of their employees reflects that. However, a company whose culture is more collegial and less competitive will not find the same success with that sort of challenge…but may with team-oriented activities.
•    Assume, or expect, that the vendor(s) will do it all and the wellness program will require little or no ongoing involvement from the employer. Again, consider how a dental insurance program works…HR has very little impact. Once the RFP has been sent, competing insurers are evaluated – price, provider networks, claims operations and perceived quality are evaluated. A contract is signed, enrollment is completed and, from that moment on, the insurer deals with employee’s needs directly. Unless there is a problem, the employer is hands off until time comes for the renewal or replacement of that contract. Wellness programming is a far different model.
Those of us who speak, write or publish on wellness programming find that listeners and readers much prefer to hear about success stories. The typical request from a seminar or conference to speakers is for a detailed explanation of what worked at company X. The audience loves to hear the details of the plan and how it solved a problem, with good reason. We all can learn from each other and there is often application at my organization for an idea that proved successful at yours. However, we often ignore the – vitally important – preamble and analysis. What factors contributed to the particular decisions, initially and through implementation? What cultural distinctions contributed to the success? Those discussions are not as “sexy” as the promotion of the walking campaign that worked so well, or the stories of individual employees who improved their biometrics, quit smoking, or can now walk the golf course. Nevertheless, without analysis of the “why” and “what,” often the discussion of “how” a plan accomplished its goals falls short of what the audience needs to replicate the success.
A Better Way
The last sentence foreshadows a better way when it comes to successful wellness programming. Goals. The word alone brings joy to the heart of strategic planners. Unless an employer invests the time and effort to create a considered and comprehensive strategy for their wellness program, success is as much as matter of luck as anything else is. At first reading, that may seem harsh. Luck? After developing a detailed RFP, wading through the many proposals, negotiating with the chosen vendor, sending out communications, how can success be a matter of luck? 
No matter how thorough the vetting of a vendor might be, if an employer has not developed a set of Guiding Principles for their wellness plan –then success is as much due to luck that the vendor happened to match up with your culture as it is due to the specifics of the programming offered. You might be choosing between two equally excellent and proven wellness vendors, only to have great success with one and failure with the other – for reasons dealing more with your cultural fit than what that vendor does.
With that understanding, here is a brief outline of how to avoid the pitfalls outlined above:

  • Conduct some self-evaluation. Just as self-awareness is a critical part of a successful life, a fair and honest evaluation of your organization is an important place to start when creating a strategic plan. You cannot figure out how to get to where you want to be without knowing your starting point.
  • Establish success metrics. How will you define success? The answer will differ between organizations and across time within a single organization. Gaze into your crystal ball and say, “if X happens in 1, 2, 3, 5, 10 years, our wellness efforts will have been successful.” Knowing your goals will help you every step along the way.
  • Use the long-term goals to help establish some guiding principles by which you will make your decisions. Having a framework against which you will measure competing opportunities will save you headache and keep your plan on track towards your goals. Using an earlier comparison, if you determine that your culture is a collegial one, then having a guiding principle that “we won’t set employees against each other in competition” may help you to say no to the flashy vendor who has a beautifully packaged and often effective system of competitive challenges.
  • Get some help. Find someone within your benefits team who can help you to establish your goals and guiding principles, and then help with implementation and management of your plan. If your benefits broker has proven experience in this area, great. If not, consider replacing that broker with someone who does – as the truly successful programs are those that canintegrate artfully and effectively. Integrate wellness & benefits; benefits & workers compensation; HR practices and wellness programming; company-wide and benefits messaging. Experience and expertise in wellness programming are not commonly found within an HR department, and, unfortunately, not even within brokerage teams.
  • Resist temptation. Do not get excited about the newest flashy vendor offering. Just because someone uses words like “social network,” “the cloud”, “mobile platform,” “gamification,”does not mean their program is a good one. Alternatively, even if it is, one that will work with your company’s unique culture. A parallel can be seen in restaurants in recent years as chefs look for constantly more innovative ways to display food on your plate. Caught up in a desire to create a “wow” moment when the dishes are delivered to the table, many chefs have created wonderful-to-look-at displays, but forgot taste. Beautiful, flashy, exciting are all good descriptions of your programming – but not if they come at the expense of quality, effectiveness, and results.

One final thought in considering the importance of including strategic planning in your wellness recipe. Some employers feel that creating a plan will hinder their ability to recognize opportunity and change direction. They fear rigidity. In fact, properly done, having a strategic plan gives increases flexibility. You know what you are trying to accomplish, you have guiding principles against which to measure your decision making and a structure that provides life and scope to your plan. Then, when a new opportunity arises, you have a process for decision-making and a structure onto which you can attach the new programming.

About the Author

A sought after speaker and writer, Matt has 33 years consulting experience, including more than 25 years in worksite wellness.  Matt is the author of the critically acclaimed book, The Benefits Performance Processand he is one of a national team of experts who contributed to the successful Nolo Press book, Healthy Employees, Healthy Business, now in its second printing.