The International Foundation of Employee Benefit Plans surveyed 479 companies, 372 in the United States and 107 in Canada, regarding wellness initiatives. (IFEBP Survey) The primary differences between employers in the two countries is a more intensive focus in Canada on mental health issues, as that is a primary driver of costs in that country. 80% have some wellness initiative and the average time these have been in place is 7 years. About 60% are doing this primarily to increase worker productivity and engagement and about 40% mostly to control health spending. As might be expected, given the different nature of the health systems, Canadian firms are less concerned about controlling health spending. Most companies expect their wellness budgets to increase in future years and, probably just for US businesses, the reform law is encouraging greater use of wellness efforts. About 80% currently use some incentive related to wellness programs, with the incentive most commonly being attached to completion of a health risk assessment, completion of health screening or participation in a smoking cessation program. The incentives are increasingly attached to actual health measurement as opposed to just participation and US companies expressed an intent to increase their use of this type of incentive, up to the full amount permitted by the reform law.
The most popular wellness efforts are flu shots, with 71% of companies offering these, smoking cessation with 54%, health risk assessments with 51% and health screenings with 50%. In terms of programs aimed at fitness and nutrition, health coaching is used by 39% of respondents, promoting healthy food choices by 38%, weight loss initiatives by 38% and wellness competitions by 42%. For mental health improvement, employee assistance programs are used at 80% of the businesses and stress management programs at 24%. The highest worker participation rates are in health assessments, health screenings and flu shots, all with mid-40% participation rates. Future areas of emphasis for this group of firms include improving and increasing wellness communications at 58%, more use of incentives at 45% and improving health literacy of employees at 45%. About a third of the companies survey workers about what they would like to see in wellness programs and 29% include spouses and/or families in the programs. Only about a fourth of respondents calculate a return-on-investment for wellness, but for those that do, 93% say it is positive, which an average $3 return on a $1 investment. But a larger group tracks other outcomes, and most feel that wellness has improved health assessment and health screening results, reduced absenteeism and increased productivity. In general, business appears to have solidly endorsed the value of wellness initiatives.