Like many a Fitbit owner, I spend excessive amounts of time tracking my steps on the Fitbit dashboard. One day, I wandered over to the corporate wellness section of the website, and saw an interesting statistic: Companies with worksite wellness programs experience an 8% increase in employee productivity.
It sounds impressive, but this stat (attributed to a 2005 National Business Group on Health report), raised questions. Any wellness program? Any company? Productivity is tricky.
Many salaried workers don’t know how many hours they work; many people don’t directly generate revenue. Years ago, while writing a piece on telecommuting, I kept hearing secondhand that at X company, telecommuters are 25% (or 30% or 40%) more productive than other employees. Then I’d call X company, and they’d deny it. As one spokeswoman told me, if they knew some employees were 25% more productive than others, don’t you think they’d act on that?
So I wondered: Is the usual assertion—that wellness programs boost productivity—true or not? Here’s what we do know:
Healthy weight people take fewer sick days. According to the Centers for Disease Control and Prevention, a healthy weight man misses about three days of work for illness or injury each year. An overweight or obese man misses approximately five days. Someone working 237 days a year can do more than someone working 235 days per year — though not orders of magnitude more. In theory, if a wellness program could help someone achieve a healty weight, that could reduce absenteeism.
Further, a 2007 analysis from Duke University Medical Center found that obese workers filed twice the number of workers’ compensation claims, had seven times higher medical costs from the claims, and lost 13 times more days of work from work injury or work illness than other workers.
Risk factors correspond with higher medical costs. ConAgra, the packaged foods company, has run a wellness program for six years. According to VP of Human Resources Charlie Salter, in its current iteration, employees get a bonus Health Savings Account contribution for participating (taking a health assessment and doing a finger prick blood test). Then they get insurance premium reductions for achieving normal ranges (or achieving major progress) on five health factors including body mass index (BMI), cholesterol, blood pressure, smoking, and blood glucose.
The company found that "people with at least four of these health risks are 2.5 times more costly than people with two risks or less," Salter says.
People like wellness programs. Good ones offer access to exercise advice and convenient health screenings, which busy people appreciate. Regardless of outcomes, these make people feel like their employers care, which can boost engagement and, potentially, productivity.
Some studies find measurable benefits. One meta-analysis of 42 corporate wellness studies found a 25% reduction in absenteeism and sick leave, a 25% reduction in health costs, and a 32% reduction in workers compensation and disability costs.
A recent report from the National Business Group on Health and Towers Watson found that organizations with strong wellness programs had lower rates of obesity than "low-effectiveness" companies, and had lower unplanned absence rates (3.3 vs. 4.0 days/year).
However, a lot is still unknown. "What happens in the wellness industry is that logic is applied in a reverse fashion," says Rod Reason, CEO of Healthiest Employers, a tech firm that focuses on population health. It makes sense that healthier employees are more productive; ergo, we believe a wellness program boosts productivity.
"I believe there’s more than just fanfare out there," he says. But if you ask him to show an exact link between a dollar spent on wellness and productivity, "we’re very quiet. That’s the journey we are on right now. We have several publicly traded customers right now tracking that exact question." The complications?
First, losing weight—the factor driving a lot of potential productivity stats—is really hard. People already try valiantly and fail. If a corporate wellness program found a way to ensure that most participants would achieve a reasonable BMI, that company should exit whatever business it’s in currently and start marketing its new plan instead. The good news is that losing even a few pounds is helpful—one reason ConAgra rewards losing 5% of body weight—but if big cost reductions require achieving a healthy weight, that probably won’t happen.
Programs can be designed well or not-so-well. Originally, says ConAgra’s Salter, people got points for specific actions, like participating in a local fun run. But "We found that was probably not a real smart design. There are 1,000 ways to lose weight," he says. Eventually the company decided not to police how people achieved results.
Figuring the right rewards for those results, however, is also tricky. ConAgra gives single employees who do the original health screen $900 for their HSAs, and families $1,800. Achieving results lands you a premium reduction of $750 for singles and $1,500 for families.
The company wanted participation; "It’s probably one of the highest incentives I’ve ever heard," Salter says. But you need large reductions in medical costs to offset a $1,650-$3,300 outlay. Reductions may not be immediate; sometimes a health screen reveals that someone needs to be on medication, which raises costs in the short term. People change jobs, too. It’s possible someone could lower their risk factors—and then go work for a competitor, meaning you never reap the productivity benefits.
That doesn’t mean companies shouldn’t try. "It’s really rewarding to see people literally improve their lives," says Salter. Quantifying a productivity dividend, though, is something else. "We are still trying to look for empirical data that would absolutely prove the efficacy of what I’d call modifiable risk reduction," he says. "We are very close to that," and more data will roll in over the next few years. But right now, it’s still "a big question."