Companies have long embraced workplace wellness programs as a way to improve workers’ health and reduce overall medical spending, but a new study may prompt employers to rethink those efforts.
The study, published Tuesday in JAMA, a medical journal, looked at the experience of 33,000 workers at BJ’s Wholesale Club, a retailer, over a year and a half.
While workers who enrolled in the wellness program reported that they learned to exercise more and watch their weight, the research found no significant differences in outcomes like lower blood pressure or sugar levels and other health measures. And it found no significant reduction in workers’ health care costs.
“These findings may temper expectations about the financial return on investment that wellness programs can deliver in the short term,” concluded the study’s authors, Dr. Zirui Song, a health policy researcher at Harvard Medical School, and Katherine Baicker, dean of the University of Chicago Harris School of Public Policy.
Most employers – 82 per cent of companies with more than 200 workers – offer some sort of wellness program like smoking cessation or weight management, according to the latest survey by the Kaiser Family Foundation. Companies often encourage participation in these programs by dangling some sort of financial carrot, ranging from a gift card if you track your steps to a significant discount off what you pay toward your health insurance.
“Wellness is this multibillion-dollar industry where there has been a really weak evidence base of what these programs do,” Baicker said.
Some programs have prompted concerns over employees’ privacy and the use of health data by third parties, like vendors selling these workplace plans. Lawsuits have been filed that forced employers to retreat from offering incentives for reaching specific goals.
Nearly all the studies to date had been observational and have largely concluded that the programs save some money for employers. But this study randomly assigned employees to a wellness program and compared their results with those of employees who were not enrolled in such efforts.
Employers looking for a quick reduction in their health care spending will be disappointed, Baicker said.
But there were some encouraging notes among those who adopted healthier behaviours. “We’ve seen that necessary first step,” she said. And those alterations could later lead to better overall health and lower medical expenses.
“It is not the final verdict on workplace wellness programs,” Song cautioned, calling the research “still a young field.” The authors are now analyzing three years of data from the wellness program to see if there are any longer-term effects.
BJ’s Wholesale Club referred all questions to the researchers.
There has been a shift in emphasis in what companies offer, including addressing broader issues like emotional well-being, said Brian Marcotte, chief executive of the National Business Group on Health, which represents large employers that offer insurance coverage to their workers.
More recent programs provide a variety of techniques aimed at reducing stress or helping employees better manage their finances, tools that are aimed at increasing workers’ productivity, he said.
In a departure from previous wellness program policies, employers are now less likely to dictate what their work force should do in favour of offering workers a range of programs aimed at addressing their individual needs. “It’s really hard to engage someone on their physical health” if the person is depressed or struggling with debt, Marcotte said.
But wellness has also raised concerns that employers are pressuring workers to participate in these programs and that the private health data being gathered could be inappropriately shared with employers.
AARP, the consumer advocacy group for older Americans, sued the federal government in 2016, arguing that the rules governing the programs violated anti-discrimination laws aimed at protecting workers’ medical information. The group won its lawsuit, and the government has not yet issued new rules that would govern these programs.