Few employers targeting risk areas, measuring ROI or taking strategic approach
In looking at health and wellness in the workplace, there appear to be a few disconnects or missed opportunities when it comes to employer initiatives, measurement and strategy, according to a survey by Sun Life.
Work-related stress is the most important health risk affecting employees (56 per cent), followed by smoking, mental health issues and high blood pressure (35 per cent each) and diabetes (31 per cent), found the survey of 677 Canadian employers. However, the nine most popular wellness initiatives offered are employee assistance programs (EAPs), flu vaccine programs, first aid or CPR courses, employee recognition, work station assessments, time off, flexible work, staff appreciation events and newsletters with wellness information.
“There are disconnects regarding respondent-identified health concerns and wellness initiatives offered,” said the 2011 Buffett National Wellness Survey. “For instance, the majority of the top 10 health concerns are direct risk factors for a number of chronic diseases, yet most of the top 10 initiatives identified do not address these risk factors.”
The key health concerns around work-related stress and mental health issues are being addressed by some of the initiatives, such as EAPs, employee recognition and flexible work, said Lori Casselman, associate vice-president of health and productivity solutions at Sun Life Financial in Toronto.
However, there could be a lack of recognition around the impact these types of workplace-driven programs can have on managing risk.
“We do see that there’s some opportunity as it relates to some of the more physical health concerns — things like smoking and diabetes, high cholesterol, obesity — identified as being key health concerns by employers. The programs that are being offered that specifically speak to those types of risks and issues for chronic disease are falling lower on the list of initiatives.”
Employers are starting with what they can easily address, for immediate results, such as flu shot clinics or EAPs, said Catherine Connelly, associate professor at the DeGroote School of Business at McMaster University in Hamilton.
“So maybe they don’t have a program specifically tailored to some of those most common issues, but some of the things they’re offering, they’re still beneficial… under the same umbrella.”
In fact, there is no disconnect, said JudithPlotkin, vice-president of strategic growth at Homewood Human Solutions in Toronto. Many EAP programs provide nutritional education, health awareness, a wellness website and smoking cessation or stress management programs.
“It’s actually perfectly aligned,” she said. “The fact that (an) EAP incorporates many of the other wellness initiatives may have caused some misleading results.”
Another potential disconnect concerns the return on investment.Only 36 per cent of employers continuously evaluate and record the outcomes of wellness efforts while just 31 per cent calculate and record the ROI associated with wellness efforts (though this is up from 19 per cent in 2006 and 25 per cent in 2009), found Sun Life.
This is an evolving area and employers are taking steps in the right direction, said Casselman. But there is a lack of understanding of exactly how to assess and quantify the results.
“For many employers, it’s a big area to try and tackle.”
But there are small steps organizations can take, such as looking at claims information — around prescription drugs usage, long-term disability (LTD), short-term absences and attendance — or health-risk assessments and engagement scores.
“Often, participation rates are a good indicator of success,” said Casselman. “Also, there’s certainly a strong case being built here in Canada for the value of these programs, so many more employers are recognizing it’s the right thing to do — it’s becoming more of a norm.”
Many employers say the results are more about the impact on culture or employee commitment, said Plotkin.
“For some companies, once they’ve fully embraced it, it’s become such a game-changer that it would seem minute to say, ‘We’ve paid 75 cents on the dollar’ because it’s actually impacted the way they operate.”
And a lot of things that impact the employee experience aren’t specifically related to wellness initiatives, said Plotkin, such as a change in schedules.
“It’s a tricky place to do research if you’re looking for an absolute result.”
Employers want to offer these initiatives for the right reasons — to help employees, said Connelly.
“They’re not necessarily going into it solely with the view of reducing their health-related costs or reducing absenteeism,” she said. “The employee reactions to some of these is quite positive and it’s immediate — people are grateful.”
To even consider quantifying and demonstrating ROI figures, it’s essential a foundation for baseline data collection and measurement is in place, according to Sun Life’s report. But while many employers (52 per cent) analyze claims data, fewer consistently evaluate wellness initiatives (23 per cent), conduct a needs assessment (21 per cent) or record baseline data (18 per cent). And only 21 per cent measure the health of full-time employees.
“Doing a needs assessment and capturing that baseline data is critical to both an employer’s success within a program but also to the marketplace acknowledgement of the value of workplace wellness programs,” said Casselman.
“Without capturing that baseline data, you don’t necessarily understand the needs within the organization, you don’t know where you’re starting from so it’s difficult to gauge progress year over year and to really demonstrate any successful outcome or any returns on the investment that’s being made around workplace wellness.”
And cost is an issue, said Connelly. Either an employer allocates all its resources to getting this baseline or it assumes all employees can probably improve their health.
“At the very basic level, even if they’re not assessing each individual employee’s health, they should be tracking things like use of EAP and prescription drug costs, things like that that they’re probably collecting anyway at a high level. So why not connect those dots?”
A lack of time could also be part of the problem, said Plotkin. But employers shouldn’t consider engagement or health benchmarking surveys unless they’re sure they’re going forward with some initiatives.
“When you survey or benchmark, you raise an expectation amongst employees that something is going to happen.”