Many workplace wellness programs focus, rather unwisely, on altering unhealthy employee lifestyles. Examples of such programs include weight-loss contests and smoking cessation campaigns, just to name a few.
While these efforts are certainly admirable, anyone who has tried to lose weight or quit smoking will tell you that changing ingrained behaviors and habits is extremely difficult – even when there are significant incentives involved. To us, it seems that the focus on lifestyle and behavioral changes as a starting point misses the mark.
Rather, we recommend that employers almost always start with age appropriate screenings and immunizations. This approach is a simple and effective way to care for employees and prevent and/or treat developing conditions. And because most of the recommended screenings and immunizations are covered at 100% by most health plans, there’s less pushback from a participation standpoint.
From there, we often recommend that wellness programs tackle targeted disease management, and only after that, in most cases, should employers attempt to change employee lifestyles and behaviors.
Many basic screenings can occur during an employee's routine annual checkup. Physical exams, BMI (Body Mass Index) screenings, and blood pressure readings are all routine tests that can be early predictors of more serious problems. For those at risk for STDs, annual screenings are recommended after age 25. Every five years, employees should have their cholesterol checked, and every three years, beginning at age 45, they should be screened for diabetes. Doctors may also suggest screenings for glaucoma as well as other vision or hearing problems, especially as employees age.
In addition to tests for general health, employees should be encouraged to seek out recommended cancer screenings. Colonoscopies or other physician-recommended tests for colon cancer should begin at age 50 – earlier if they’re deemed high risk – and repeated every ten years. After age 40, skin cancer screenings should become annual. Women should be getting a pap test for cervical cancer every 1-3 years, and should begin annual mammograms to screen for breast cancer at age 40-50 (as advised by a physician). Men should have a testicular exam during their regular check-ups and take an annual Digital Rectal Exam (DRE) or prostate-specific antigen (PSA) blood test at age 50 (40 if identified as high risk).
Adult immunizations also need to be emphasized as an essential part of health maintenance, just like screenings and tests. If not previously immunized, employees need 3 doses of Tetanus and Diphtheria vaccine, with a booster every 10 years. Also, non-immunized employees will need a Pneumococcal vaccine if they meet risk factors, and the CDC recently updated their recommendations regarding the HPV and Meningitis vaccines. Employees who never had chicken pox and haven’t been previously immunized should receive two doses of chicken pox (Varicella) vaccine. High risk employees or those over 65 should receive Influenza immunizations yearly.
The evidence clearly shows that asking employees to lose weight or quite smoking is usually a misplaced priority. A terrific article in the New York Times indicated that while workplace wellness programs aimed at modifying behavior are popular with employers, they’re largely ineffective and shift the burden of cost onto the employee.
Good research on wellness programs is scarce, but one study did show that programs that focus on effectively managing specific diseases like asthma, diabetes, and coronary artery disease could lower costs when implemented over several years. But research on health outcomes in general consistently finds that an ounce of prevention is indeed worth a pound of cure.
A 2014 article in the Journal of Occupation and Environmental Medicine found that companies with “well-designed and well-executed programs that are founded on evidence-based principles can achieve positive health and financial outcomes.” By focusing on age-appropriate screenings and immunizations as an initial step, companies can maximize the benefits of their wellness programs using proven, controllable data to minimize future health issues for their employees. After these basic goals are met, programs can expand into other wellness areas such as managing chronic conditions and modifying difficult behaviors such as weight gain and smoking. We’ve found that it’s much easier to get buy-in from the entire organization when the focus is on simple preventative measures.
For help with understanding or managing your business’s wellness plan, contact the JP Griffin Group. Our underwriting and actuarial team is highly trained in performing the kind of deep-dive data analysis required to identify an employer’s true cost drivers – and those should be the starting point for any effective wellness program.