Prevent your wellness program from turning into an epic failure

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If your corporate wellness program has turned into an epic failure, you’re not alone. A 2014 Gallup poll found that while 85% of the big companies in the US offer a corporate wellness program, only 24% of employees are actually engaged in them. Wondering why your program hasn’t taken off quite like you’d initially imagined? Take a look at a few of the potential reasons things aren’t working like they should.

  • Your wellness program appeals mainly to the healthy. If your wellness program components attract mainly healthy employees who want to stay healthy, you’re missing the boat. These people are likely already living healthy lifestyles, so they don’t really need your help. If you really want to move the needle, you need to offer solutions that appeal to the rest of your workforce. The truth is that many employees who need to improve their health are turned off by being ‘forced’ to use the gym, wear a fitness tracker or eat certain foods in order to earn rewards. But those same people are quite open to the idea of doing things like watching videos that show them how to get rid of unhealthy behaviors that have been plaguing them for years.
  • It’s not accessible. You need a convenient wellness solution that can be used by your employees at all times. Make certain that they can take advantage of it both in the workplace and outside of it to create healthier lifestyles, not just at certain times or only in the office. At SelfHelpWorks, our secure online video delivery system is the perfect way to reach even the busiest or most private employees.
  • You’re not offering an incentive. People often need to be rewarded to try out new things, and that’s as true in a wellness program as it is anywhere else. It doesn’t have to be a complex incentive either — you could even offer something as simple as a nice coffee mug. But beware — incentives can be a double-edged sword. Use them to drive participation in a one-time activity like a health screening, or couple them with solutions containing cognitive training components that create intrinsic motivation. This is critical, because unless a new mindset is developed the employee will simply go right back to the same old unhealthy behavior as soon as you stop rewarding them.

Looking for more help with your corporate wellness program? Contact us today.

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Do incentives really make a difference?

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Corporate wellness programs are commonplace these days as employers strive to create a healthier, happier, more productive workforce. According to a research report from RAND Corporation, about 33% of smaller US firms and 80% of larger firms offer wellness programs. And most of them – about 60% of the smallest employers and 90% of other employers – use incentives to encourage participation in the wellness program. The big question is – do these incentives really make a difference?

When it comes to participation, the answer is yes. The report showed that overall the participation rate was about 40% when there was an incentive. This was double the rate that non-incentivized programs achieved. Not surprising really – after all, most of us were trained by our parents to react to incentives: “Finish your homework and I’ll give you a treat,” etc.

But the real question is, do these incentives really work to create healthier, happier, more productive employees? This question has caused much debate and controversy.

On one side of the argument are those who point to the detection of previously un-diagnosed health problems as a result of increased participation in health screening; and there are those who believe that if you simply get someone to do something for three weeks it becomes a habit. On the other side are those who point to the evidence that external (or extrinsic) motivators do not result in sustained behavior change and may in fact encourage negative behaviors such as cheating. The Internet is filled with stories about wellness program participants tying exercise trackers to their dog or ceiling fan, and in one case a lawsuit revealed that Kansas City employees defrauded their health insurance program of more than $300,000 in cash incentives by falsely claiming to have run marathons and competed in triathlons.

It’s easy to see that incentives are a double-edged sword and need to be used wisely. Ideally, they should be used as a catalyst… a sparkling lure to entice people into participating in a one-time activity such as a screening, or into trying a new wellness activity. However, achieving a lasting benefit is unlikely unless the activity cultivates an inner sense of motivation (known as intrinsic motivation) that gradually replaces the extrinsic motivation created by the incentive.

At SelfHelpWorks, our behavior change programs focus keenly on creating true, intrinsic motivation. While many of our participants register for one of our cognitive-based courses partially (or wholly) because their corporate wellness program has lured them with an attractive extrinsic incentive, they soon discover a new sense of purpose, a vision and motivation that is deeply personal and enduring. It is this intrinsic motivation that keeps them engaged and drives genuine, lasting behavior change.

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Macy's lawsuit: Reasonable Alternative Standards for wellness programs

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Properly structured wellness programs are of tremendous value to employers and employees alike, as they can improve the health, wellbeing and productivity of workers. As a result, employers with wellness programs usually incentivize employees in a bid to improve participation and outcomes.

However, as witnessed at a recent legal workshop we attended, many employers are still not clear on some of the nondiscrimination rules that apply when offering wellness program incentives — or when levying health plan surcharges (typically for tobacco users). Just ask Macy’s and their third-party administrators (TPAs), who are currently being sued by the Department of Labor. Among the allegations: they failed to properly apply the Reasonable Alternative Standard (RAS) rules allowing their smokers to avoid a health insurance surcharge.

The important thing to note here is that Macy’s did in fact offer their smokers a tobacco cessation program that would allow them to qualify for the tobacco-free health insurance rates. Cutting through the complexities of the case, the program was allegedly non-compliant in three areas:

  • The availability of the Reasonable Alternative Standard was not properly disclosed.
  • The smoking cessation program was unreasonably difficult for some individuals to complete for medical reasons, meaning that these people were not in fact offered a “reasonable” alternative given their particular circumstances.
  • The plan continued charging the tobacco surcharge to individuals who didn’t remain tobacco-free for at least 6 consecutive months during the year — even though they had done the tobacco cessation program. This is definitely a no-no if true… the whole purpose of the Reasonable Alternative is to allow certain employees to earn incentives or avoid surcharges even if they cannot achieve a particular health standard.

SelfHelpWorks is more familiar with the ins and outs of the Reasonable Alternative Standard (RAS) requirements than most, because our targeted online interventions are often used as a Reasonable Alternative — particularly in the areas of tobacco, BMI and blood sugar levels. So we thought you might find the following overview useful — although please bear in mind that this is nothing more than a brief, watered-down synopsis and should in no way be construed as legal advice.

Basically, there are two types of incentivized wellness programs — participation-based and contingency-based. In participation-based programs the participants are rewarded for simply “showing up” — the incentives are not tied to a health-related achievement. On the other hand, in contingency-based programs the reward is contingent on achieving a health goal of some sort. It’s the contingency-based incentive programs that require you to offer participants a Reasonable Alternative.

There are two types of contingency-based programs: activity-based and outcome-based.  Activity-based programs require completing an activity to earn the incentive, but do not require any particular health outcome. On the other hand, outcome-based programs require achieving or maintaining a specific health standard or outcome to earn the incentive. So rewarding employees for walking 10,000 steps a day would be considered activity-based, while rewarding them for having a BMI of less than 30 or being tobacco-free is outcome-based.

For activity-based programs, a Reasonable Alternative must be provided for someone who is physically incapable of participating in or completing the activity, or for whom it is medically inadvisable. For outcome-based programs, a Reasonable Alternative must be provided for someone who is not able to achieve the required health standard.

It’s important to be aware that in 2013 the Reasonable Alternative requirement was expanded for tobacco and other outcome-based programs. Prior to then, a Reasonable Alternative only had to be provided if a medical condition made it unreasonably difficult or medically inadvisable for an employee to satisfy the health standard. However the 2013 regulations required that a Reasonable Alternative be provided to anyone who failed to meet the initial standard, regardless of medical reason.

The general requirements for a Reasonable Alternative Standard are:

  • At least one suitable RAS must be provided at no cost to the employee. Suitability is judged on a case-by-case basis. So if an employer offers a default RAS but an employee cannot be reasonably expected to complete it due to their particular circumstances, it is the company’s responsibility to provide another.
  • Employees completing the RAS must receive the reward for the entire year. So a smoker who completes a tobacco cessation program 6 months after the start of the plan year still needs to receive non-smoker rates for the entire year.
  • The time commitment required of the participant must be reasonable.
  • The RAS must be available every year, regardless of the employee’s outcome in prior years.
  • The availability of a RAS (or the possibility of having the standard waived, if applicable) must be properly disclosed where applicable.

Reasonable alternatives come in various forms, some more likely to produce positive outcomes than others. That’s why the SelfHelpWorks online video-based courses are such a popular Reasonable Alternative: in addition to being suitable for virtually any employee regardless of health status, our successful rates are extremely high. Simply put, when a participant begins a SelfHelpWorks program, chances are very good they will soon be making a positive and long-lasting lifestyle change.

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