Rand Report on Wellness Programs

Wellness programs are now widespread and encouraged by the reform law.  The Rand group was contracted to evaluate the characteristics and prevalence of these programs, the evidence for impact, the role of incentives and what are factors leading to success.   (Rand Report)   Rand reviewed the literature, did a survey of employers, analyzed a claims database for wellness impact and did five case studies of employer wellness programs.  At least half of employers have at least one wellness effort, either health promotion, or primary or secondary disease prevention.  The focus is on diet, weight, exercise, smoking, stress management and the usual litany of chronic diseases.  A surprisingly small number of employees, about 46%, take advantage of these programs in some way and only about 20% participate in an intervention recommended based on HRA or screening results.  That may change as more employers put higher incentives or penalties in place in regard to wellness participation.  The literature suggests positive health effects on an employee population and on individual participants from wellness programs, but not as large as would be hoped.  While employers strongly believe that their wellness programs reduce medical costs, absenteeism and health-related productivity, many have not actually done an evaluation.  Rand’s analysis suggests a lowering of health utilization and costs for employees who do participate, a trend that appears to grow with increasing years in a wellness program.   The Rand survey found the use of incentives is widespread and growing, most commonly for HRA completion and participation in a lifestyle intervention.  Incentives appear to be effective in changing behavior, at least in the short term.  Communication strategies, employee and leadership engagement and continuous evaluation were listed as factors in a successful wellness offering.