GRAND RAPIDS — Cash and success stories motivate people. Fear and punishment: not so much.
So experts say that employers trying to drive participation in their workplace wellness programs may want to focus more on rewarding employees for good behavior that improves their health, rather than imposes penalties on those who opt not to participate or don’t achieve health goals.
Kimberly Mitchell, an employee benefits attorney at Varnum, suggests that using the proverbial carrot rather than the stick is more likely to get employees involved in workplace wellness. Offering an employee a financial reward for completing a smoking cessation class and kicking the habit may work better than charging them extra on the health premium if they smoke, she said.
“I would just try to frame it positively to get buy-in, and that will ultimately lead to reduced costs,” Mitchell said during the recent Shape Michigan Expo in Grand Rapids.
Sponsored by Priority Health, Spectrum Health and Mercy Health, ShapeMichigan focused on the burgeoning obesity rate among Michigan residents, more than 31 percent of whom were obese in 2011, according to data from the Trust for America’s Health. That’s up from 17.2 percent in 1995 and that obesity rate, under present trends, will grow to 59.4 percent by 2030, Trust for America’s Health projects.
Many employers over the year have adopted workplace wellness as a way to improve and maintain the health of employees to reduce rising medical claims that drive up health premiums. Survey data shows employers are increasingly using incentives such a gift cards at local retail stores or a small reduction in premiums to drive employee participation and reward individuals who achieve personal health goals. Some are also penalizing those who don’t participate.
Federal law does limit rewards to 20 percent of the cost of providing health coverage, an amount that increases to 30 percent next year under the Affordable Care Act, Mitchell said.
Employers involved in wellness also need to follow requirements that allow for all employees to earn a reward, Mitchell said. If a company has a walking club and offers a financial reward for walking so many miles a week or in a month, for instance, it must offer an option to employees who are medically unable to participate to still earn the reward, she said.
In the panel discussion on workplace wellness, Mitchell and others said the key for driving participation is to make it easy for employees to take part.
How much of a carrot to offer to encourage participation is the question for many employers.
The “sweet spot” amount of any wellness reward an employee can earn in a year is between $250 and $600, said Kristine Sapak, a senior wellness account representative at Priority Health. To maximize what they decide to offer, employers need to first find out what works with their staff, Sapak said.
Sapak told the stories of two companies she’s worked with that offered their employees $50 gift cards as participation rewards. At one company, employees “jumped” at the opportunity to earn a gift card. At the other, they “just didn’t do a darned thing.”
“The best thing you can do is understand your employees,” Sapak said. “Know you employee base and keep trying. See what works.”
Sometimes the incentive isn’t financial.
Mercy Health has a system to reward employees who participate in wellness but also seeks to link an employee’s health with their lifestyle. Making an individual’s motivation the ability to play with the grandchildren or their ability to still enjoy the outdoors if they like to hike or fish is a powerful emotional link that can get people to better care for themselves, said Kay Beebe, a nurse practitioner at Mercy Health’s Center for Health Enhancement and Rehabilitative Therapy in Muskegon.
“Humans like pleasure. If exercise means punishment, why would any of us keep doing it?” Beebe said. “If you can connect your associates with pleasure, that may bring more long-term behavior change than fear.”
Panelists at ShapeMichigan also suggested starting with the usual steps such as serving only healthy snacks in the employee cafeteria or vending machines.
Saint Mary’s Health Care in Grand Rapids now only serves whole-grain breads and pastas in the cafeteria and this year eliminated fried foods, said Sheryl Lozicki, director of wellness and nutrition for Mercy Health. Incremental steps are the best way to drive change, Lozicki said.
If an employer decides to offer workplace education such as weight-loss or exercise classes, Beebe suggests that they charge a small fee of maybe $4 or so. If they offer it for free, employees may not see it as a value, Beebe said.
“A lot of people sign up. But do they show up?” Beebe said.
Sharing the success of co-workers who lost weight or got their blood pressure under control will also motivate others, Lozicki said.
“There is a lot of positive in storytelling,” she said.
Dr. David Folkmeir of Mercy Health said the key to ultimate success is embedding a culture of wellness throughout the company, starting with ownership and senior management. Leadership also needs to make a long-term commitment to wellness to drive the cultural change toward healthier lifestyles.
“It just has to be the way it is and that just takes a period of time to do,” Folkmeir said. “The behavior needs to become the reward. If that’s just the way it is, everyone will get on board.”
Recent data from the Trust for America’s Health put the obesity rate in Michigan at 31.3 percent in 2011, up from 17.2 percent as recently as 1995. Under present conditions, the obesity rate will balloon to 59.4 percent by 2030, according to the Trust for America’s Health.
The Trust estimates that obesity-related medical conditions cost more than $18.5 billion to treat in 2010. That amount could exceed $22 billion by 2030 if nothing changes.
On top of the obesity surge, one in 10 Michigan residents is now a diabetic.
Over the years, many employers have implemented wellness-based health plans that data shows work in changing behavior and health risks.
Priority Health estimates that employers over the last three years that use its HealthbyChoice wellness-based plan saved $2.7 million from medical claims that were avoided and lower absenteeism rates. Of people enrolled in HealthbyChoice, 38 percent reduced their body mass index, 50 percent reduced their blood pressure and nearly half quit smoking.
At Blue Cross Blue Shield of Michigan, more than half of enrollees in the Healthy Blue Living wellness plan who promised to quit smoking have done so and nearly three-quarters have lowered their blood pressure to an acceptable level, West Michigan President Jeff Connolly said. Sixty-one percent achieved a goal of lowering their blood sugar.