Evolution of Workplace and Corporate Wellness Programs

Over the last 2 decades, employers have increasingly implemented corporate wellness programs in an attempt to improve the health of, increase the productivity of, and reduce the health care costs of their employees. These programs have been highly variable, but many of these initiatives have focused on physical health through the encouragement of healthy eating habits, increased exercise and physical activity, and stress management. Throughout the pandemic, businesses and their workforces have been forced to respond to an unpredictable economy and meet unprecedented challenges along the way. The effects of the pandemic on the health and well-being of society are still largely unknown, but strong influences have already been exerted on the labor market with increased burnout, the “Great Resignation” and “quiet quitting” trends. The pandemic has magnified disparities and inequities in vulnerable populations, and employers will again be faced with how to best respond to and address the needs of their employees.

A comprehensive approach to employee health and wellness must go beyond mental and physical health. Health Risk Assessments (HRA) are cornerstones of many wellness programs and have allowed employers to identify the prevalence of disease burdens and risk behaviors of their workforce through self-reported questionnaires. Some employers compliment the HRAs with biometric screenings, providing objective clinical readings on blood pressure, body mass index, lipids, and blood glucose, perhaps identifying previously undiagnosed chronic conditions like diabetes, hypertension, and hyperlipidemia. Aggregate reporting on the HRA and biometric results can also provide meaningful programmatic insight to assess the effectiveness and inform strategic direction. But these traditional wellness programs have largely failed to consistently deliver on the promised value of cost savings and clinical outcome improvement. Lack of engaged participation, incomplete support for follow-up actions, poor alignment of programmatic design, and failure to address root cause factors are some reasons for inconsistent program outcomes. The health and wellness strategies must expand to include social drivers of health (SDOH), those non-medical factors that influence upwards of 50-75% of health outcomes. Without understanding the prevalence of these risk factors within a workforce (like food insecurity, transportation, housing, or social isolation), programmatic design may miss the upstream contributing elements that may make improved health and wellness unattainable. This is especially important in industries where workforces are comprised of socially and economically diverse populations.

Successful wellness programs enable action. Participation and engagement empower action, which can produce results. Thoughtful and meaningful incentives must be deployed to motivate employee engagement. But once the employee becomes engaged, there must be continued support to produce action.

For example, if an employee participates in a biometric event and an abnormal value is discovered, what is the subsequent action for the employee? Discussing this value with their physician may seem like a logical next step. But how are employees supported to take that action? Is the employer-sponsored health plan designed to remove financial barriers (copays, coinsurance) that may otherwise discourage seeking care? What if they do not have a primary care provider? Is the program offering support to schedule appointments and link to providers in a timely fashion? The biometric result produced an opportunity for action, but a successful program must foster the execution of the action.

The lessons learned in this example must also be deployed as screening for social drivers is considered in the evolution of corporate health and wellness strategies. Aggregate reporting of the results from SDOH screens can provide programmatic insight, but infrastructure must be in enacted to facilitate meaningful connections to resources designed to address those needs. Failure to act and address root causes will not produce results. How can an employer expect their employees to exhibit healthy eating behaviors if employees have food insecurity?

The goals and objectives of corporate wellness programs remain unchanged - improve the health of, increase the productivity of and reduce the health care costs of their employees. But post-pandemic, after disparities and inequities have been exacerbated through the unprecedented stress and strain of our social networks, employer health, and wellness programs will be best positioned to maximize value and impact on their workforce if strategies are developed to screen, and subsequently, integrate social care services into the core program design. Employers must seek out stronger relationships with healthcare providers, vendor partners, and community support service organizations to develop a network of resources and care delivery pathways that enable action by their employees to improve their health. The growing and compelling evidence showing the influence of social risk factors on health and health inequity demonstrates the necessity of mitigating these social needs if consistent and meaningful health outcomes are to be realized at a population level.