Workplace Wellness programs can reduce healthcare costs, reduce absenteeism and increase worker productivity and quality of life. The return on investment (ROI) for employers can be significant. To date, US employers have not embraced the implementation of workplace wellness programs, especially small businesses which are defined as companies with less than 100 employees. The Affordable Care Act mandates that employers offer healthcare to their employees and to change our collective healthcare mindset from the treatment of disease to the prevention of disease in order to keep rising health care costs down. The challenges of changing this mindset are best handled by American employers as they provide 60% of the health insurance in the U.S and their employees spend the majority of their time inside their facilities. Selling this idea to small businesses and aiding them in implementing effective programs will be the key to stemming the tide of rising healthcare costs.
There have been a substantial number of studies investigating the return on investment (ROI) on dollars spent by employers on employee wellness. These studies show there is a clear benefit to the employer in terms of reduced healthcare costs and a healthier workforce with greater productivity and less absenteeism. The average ROI was $3.37.1 It should be noted that these studies have their limitations due to selection bias and publication bias. Selection bias means healthy employees are more likely to participate in wellness programs than unhealthy employees and this could cast a more positive light on the results. Publication bias means that studies with positive results are more likely to be published creating a surplus of studies indicating a positive result.
It can be argued that employers are in a unique position to be able to impact public health. They are perhaps in a better position than health care professionals. The majority of Americans (60%) receive health insurance through their employers. In addition, the average worker spends more time at work than they do with their health care providers, who they see on an as needed basis. There is hard evidence that would suggest that workplace wellness programs can save employers money. A review of wellness programs at 47 companies showed positive results in 73 % of the cases.2 However, to date, wellness programs have not been widely adopted. This could be due to the fact the expected ROI does not justify the hard cost of putting a program in place. The Affordable Care Act offers some incentives for employers to implement evidence based wellness programs. In 2011 the Department of Health and Human Services (HHS) distributed $10 million in worksite wellness grants.
To be effective programs must well be designed, consistent with evidence based practices, effectively executed and properly evaluated. Many programs, however well meaning, do not meet these standards and do not work. In order to evaluate the effectiveness of a wellness program you must determine the expected outcomes. Reviewing of a variety of expected outcomes such as ROI or decreased absenteeism and then examining the framework for measuring the effectiveness of a wellness program based on expected outcomes is key. Top management buy-in and a direct tie in to the company’s culture are also essential for success.
Although workplace wellness programs have been proven to be effective at reducing health care costs and improving employee health, productivity and quality of life, employers have been slow to adopt wellness programs. Healthy People is a program of nationwide health-promotion and disease-prevention goals set by the United States Department of Health and Human Services (DHHS). Healthy People 2010 had a goal of 75% of all U.S. companies having a robust wellness program in place.3 U.S. employers did not meet that goal.
There is very little research regarding the successful implementation of workplace wellness programs at firms of less than 100 employees. Small businesses provide 55% of all jobs.4 Firms with less than 100 employees will be key in reducing healthcare costs in the U.S. and stemming the rising tide of chronic health issues like obesity, type 2 diabetes, hypertension and heart disease.
What is the impact of the Affordable Care Act (ACA) on businesses with less than 100 employees? ACA offers grants for small businesses who have not previously had a wellness program. The law is designed to promote preventative care rather than the treatment of disease. A workplace wellness program provides a framework for employees to take preventative care beyond a yearly physical exam. There are some program components such as health education and creating a supportive environment that must be complied with to receive the grant. There are HIPAA requirements that must be complied with as well.
So what does all of this have to do with students pursuing a degree in Human Nutrition-Dietetics at MSU Denver? Workplace Wellness is an important and emerging field chock full of opportunity for people who understand the relationship between chronic disease and nutrition. This may be an option for students who cannot or don’t want to follow the Registered Dietitian career path. There could be opportunities in state and local government, within major corporations, under the umbrella of a major health insurance provider or with an independent company that offers workplace wellness as an outsourced service. Workplace Wellness is a growth area in the healthcare field. Get out there and find out what is going on. This could be your niche.
1. Baicker K, Cutler D, Song, Z. Workplace wellness programs can generate savings. Health Aff. 2010; 29(2): 304-311, doi:10.1377/hlthaff.2009.0626
2. Anderko L, Roffenbender J, Goetzel R, et al. Promoting prevention through the Affordable Care Act: workplace wellness. Prev Chronic Dis. 2012; 9: doi: 10.5888/pcd9.120092
3. Healthy People 2020. Centers for Disease Control Prevention web site. http://www.cdc.gov/nchs/healthy_people/hp2020.htm, Published October 14, 2011. Accessed March 29, 2015
4. Small Business Trends. The United States Small Business Administration web site.
http://www.sba.gov/offices/headquarters/ocpl/resources/13493, Accessed March 29, 2015