More Carrot Than Stick

Yet with most insurance programs today, he says, “If I make all the right choices, I’m going to pay the same as someone who makes all the wrong choices. The opportunity is, ‘Let’s change the financial aspect in a rational and appropriate way that reinforces behavior over time.’”

Rolfing does not advocate an outcome-based approach, but rather one that rewards employees for reducing risky behavior or maintaining good behavior. The key, he says, is not to rely exclusively on short-term monetary rewards such as gift cards, but to also offer employees ongoing discounts on health insurance.

St. Paul–based civil engineering and planning firm Bonestroo chose that dual approach. Through a program developed with the help of SimplyWell, Bonestroo employees and their spouses receive $25 gift cards for completing a health risk assessment. In addition, employees get a discount on insurance costs, as long as they earn a certain number of points throughout the year. Points can be earned for exercising, participating in health education programs, going to Weight Watchers, going to a doctor at recommended intervals, and for other healthy behaviors. The insurance discount amounts to 7 percent off the single-person cost, plus an additional 3 percent discount for a spouse who earns sufficient points.

Last year, “over 70 percent of employees participated and earned their full points, and only a few dropped off on renewals,” says Maureen O’Malley Rehfuss, Bonestroo’s vice president of human resources.

A wellness program’s success also depends, in part, on how well the work environment supports it. “It forces you to look at what you’re serving in the employee cafeteria and what’s available in your vending machine,” Stevens says.

How a wellness incentive program is communicated to employees also can be critical to the program’s success. “You have to tap into what speaks to the employees if you want to have a prayer,” says Rosie Ward, a health management consultant for RJF Agencies, a Minneapolis-based risk management consultancy.

Ward offers several rules that an organization should follow in communicating an employee wellness program:

• Take it from the top down. “The first message needs to come from a senior leader,” she says. If, instead, it comes from human resources, employees will not take the program as seriously, she says.

• It’s not just about work. “The first message needs to be ‘We care about you as a person and secondly, as an employee of the company,’” Ward says. She advises companies to say: “Because we care, we recognize that your health and having a high quality of life is valuable to you no matter what you do.”

• In it for the long haul. The organization should want to work with employees to help them achieve a high quality of life from the time they are hired until they retire.

• Practice privacy. Of course, it must be made clear to employees that all personal information will be kept confidential and will not be shared with the employer, Ward notes.

If an employee wellness program is not introduced appropriately, employees will perceive it simply as a cost-cutting measure, Ward says, adding that if morale already is bad for some reason, the program may be perceived negatively no matter how an organization communicates it. In some cases, it may be useful for human resources to conduct an employee survey prior to implementing a wellness program so that any negative issues uncovered can be addressed first.

Like Pronk, Ward says organizations should start with an incentive-based approach to employee wellness, but she stops short of ruling out a stick-based approach. After three to five years, she says, an organization may find that its wellness program is losing momentum and may need to go to an outcome-based approach. “But you can’t go in at ground zero with an outcome-based program or it will backfire,” she says.