Why Do Traditional Wellness Programs Fail?

HR Policies & Procedures
by Stephen Bruce, PhD, PHR

Many wellness programs fail, say experts Lynda F. Jeppesen & Travis Dent, but there is a way to design a program that gets maximum involvement, great payback, and widespread employee appreciation.

Jeppesen and Dent made their comments at the SHRM Annual Conference and Exhibition held recently in Las Vegas, Nevada. Jeppesen, who is SPHR certified, serves as Senior VP, Human Resources of Larry H. Miller Group of Companies; Dent is a senior consultant for ACAP Health in Dallas, Texas.

Has traditional wellness failed? Jeppesen notes that 71% of employers offering wellness initiatives say their programs are not very effective at lowering costs.

Why? Part of the problem is participation. Typically, only small percentages participate fully.

Our “Healthcare System”

Then there’s the healthcare system itself. Jeppesen says that the bottom line with the healthcare system is this: employers benefit from healthy people, but the healthcare system benefits from sick people. The current trend is treating people who are sick, rather than focusing on preventative care. The result is that more than 95% of the nation’s health expenditures are for the diagnosis and treatment of diseases.

Furthermore, more than 70% of those costs are attributed to preventable illness. Certain lifestyle challenges make it hard to reduce these costs:

  • Lack of physical activity (More than 60% do not exercise regularly)
  • Rampant obesity (More than 73% of adults are overweight)
  • Diet and nutrition (Sugar & caloric consumption are at record levels)
  • Alcohol abuse and tobacco usage remains high
  • Stress (More than 60% of absenteeism is due to psychological issues and job stress)
  • Chronic illness (More than 90 million Americans have chronic conditions)

Although some wellness programs may be working, says Jeppesen, the facts are that:

  • Employee’s average weight has increased each of the past 4 yrs
  • The average employee Body Mass Index (BMI) is rising steadily and is considered obese as defined by the Centers for Disease Control

So what’s an employer to do? Is it better to abandon wellness programs altogether? Jeppesen prevents a positive alternative that can make a big difference.

In building a wellness program for the Larry H. Miller Group of Companies, Jeppesen says she wanted a program that would:

  • Encourage behavior change
  • Result in a reduction in medical claims risk and cost
  • Provide quantifiable, sustainable results
  • Increase employee engagement
  • Be easy to use
  • Contribute to a quality work environment
  • Help us be an employer of choice

Dent says the company chose to align with ACAP Health, a healthcare consulting firm that helps to engage major healthcare stakeholders including employers, insurers, medical providers, pharmaceutical companies and others to bring new & innovative solutions that deliver measurable results.

The company was founded on the belief that slowing the “production” of disease is the only sustainable way to flatten the trajectory of healthcare trends.


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Developing a program

In looking at the realm of healthcare costs, Dent says that it’s important to note that in a given year, only 4 % of claimants submit claims for more than $10,000; however, claims for more than $10,000 account for 60 percent of expenditures.

The challenge is to get the 4% who spend most of the money, healthier, and keep the vast majority who haven’t made expensive claims from becoming ones who do.

Metabolic Syndrome as the Target

The Larry H. Miller Group of Companies chose metabolic syndrome as the target for their efforts. Employees with the syndrome have three or more of a list of conditions that collectively may lead to heart disease, diabetes, or other problems.

One source lists the following as having increased risk associated with metabolic syndrome:

Alzheimer’s

Depression

Cataracts

Esophagus Cancer

Sleep Apnea

Retinopathy

Breast Cancer

Stroke

Heart Attack

Cardiovascular Disease

Gall Bladder Disease

Congestive Heart Failure

Nonalcoholic Fatty Hypertension

Liver Disease

Pancreatitis

Pulmonary Disease

Pancreas Cancer

Colorectal Cancer

Diabetes

Kidney Disease/Cancer

Erectile Dysfunction

Ovarian Cancer

Gynecological Abnormalities

Urinary Tract Cancer

Psoriasis

Endometrial Cancer

Arthritis

Non-Hodgkins Lymphoma

Gout

Leukemia

Typical risk levels for metabolic syndrome factors:
(different sources define these factors somewhat differently).

 

Man’s Risk Factors

Women’s Risk Factors

HDL cholesterol

<40

<50

Triglycerides

≥150

≥150

Waist circumference (Not pants size)

≥40 inches

≥35 inches

Blood pressure

≥130/85

≥130/85

Fasting glucose

≥100

≥100


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Measurable Factors

One of the key factors for Jeppesen was to base the program on measurable factors. Some results that have been observed:

Reductions in the incidence of specific metabolic syndrome factors:

Elevated waist circumference

19%

Elevated triglicerides

41%

Reduced HDL (“Good cholesterol”)

11%

Elevated blood pressure

39%

Elevated Fasting glucose

29%

Percents of participants who showed improvement:


Elevated waist circumference

77%

Elevated triglicerides

66%

Reduced HJDL (“Good cholesterol”)

48%

Elevated blood pressure

71%

Elevated Fasting glucose

55%

Impact of diabetic risk


Number with normal glucose (<100)

up 14%

Number with prediabetic gluscose (110-125)

dropped 18%

Number with diabetic risk glucose (>125)

dropped 30%

The program also showed similar improvements in weight, body mass index, and other measures.

In tomorrow’s Advisor, how the program works, what it costs, and what it’s saved, plus an introduction to the “Wellness Bible.”

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