Workplace wellness programs have two main goals: improve employees' health and lower their employers' healthcare costs. They're not very good at either, new research finds.
For the study, 3,300 employees of the University of Illinois at Urbana-Champaign were given a year of access to iThrive, a workplace wellness program similar to what many companies offer workers. A control group of 1,534 didn't get access to it.
Those offered the program were randomly split into six groups. All were offered biometric screening, a health assessment and various services and classes, such as chronic disease management, tai chi and a fitness challenge. But the six groups were paid different incentives for completing each step of the program — from $50 to $350.
The researchers wanted to answer three questions: Do wellness programs have any effects on health outcomes, medical spending and other measures including productivity? (The jury has been out on that.) Can money spur more people to participate? (Many programs have trouble with enrollment.) And finally, who's most likely to participate? (If only healthy people do, the programs won't achieve much.)
Their study found that wellness programs — even those with incentives — don't change employees' behavior much. The findings were published as a working paper at the National Bureau of Economic Research.
Over the years, hundreds of studies have examined the efficacy of wellness programs with mixed results; a study from Rand Corp. found most programs don't reduce companies' health costs, while a 2010 review found they do.
Much of that research has calculated savings by looking at the difference in healthcare spending between employees who opt in to such programs and those who don't. But the new study, as a randomized control trial, measured differences by randomly creating a control group with no access to the wellness program at all. With that method, the researchers found that medical spending disparities preexisted the wellness program.
"Our results are significantly different," said Damon Jones, an associate professor at the University of Chicago's Harris School of Public Policy who conducted the study along with two researchers from the University of Illinois at Urbana-Champaign. "They rule out the kind of effects you find in nearly 80% of those prior studies.
"We don't see anything trending toward savings."
First, money isn't much of an incentive. Without any cash offered, a little less than half of employees completed the assessment and screening. A $100 reward for completing the screening boosted that rate to 59%. Doubling that reward didn't make much difference, raising the share of employees finishing the screening merely to 63%.
Not that it may have mattered much to their employer. Looking at health insurance claims throughout the year, the researchers found participation in the wellness program didn't result in better health outcomes or lower healthcare costs. The medical spending habits of the employees who didn't have access to the program were almost identical to those of the workers who did, Jones said.
It turns out that those most likely to take advantage of their employer's wellness offerings are healthy people who don't spend a lot on healthcare, and employees with the highest healthcare costs are the least likely to participate. Surveys the researchers offered enrollees also found that wellness had no effect on job satisfaction or productivity.
Despite questions as to whether wellness programs actually work, companies are still pouring money into them. The industry ballooned from $1 billion in 2011 to $6.8 billion five years later, according to an IBIS World analysis, and last year almost a quarter of employers increased their wellness offerings, the Society of Human Resource Management found in its yearly benefits survey.
Some studies have found that wellness programs can take about three years to yield any benefits; the researchers in the University of Illinois analysis tracked savings for only a year, though they plan to keep tracking for four. "It is possible that effects will emerge in the long run," said David Molitor, another researcher on the study.
But the first year of results, he said, doesn't suggest future savings. In fact, the control group had slightly lower health insurance claims than those with access to the program.
Molitor's team also tracked how often employees using the wellness program went to the gym and whether they participated in a local run, to see if the program inspired healthier behaviors. They didn't do either more often than the control group.