The employer wellness movement is gaining steam globally, but some trends are hitting a wall.
More than half of employers internationally are using health promotion strategies and about one third are investing in full-on wellness programs -- including 79 percent of U.S. and Canadian employers -- according to a survey by Xerox's Buck Consultants and sponsored by Cigna.
Just under 80 percent of 1,041 employers from 37 countries who were surveyed professed a commitment to fostering a "workplace of culture of health" and more are starting official wellness programs, yet "challenges and inconsistencies" may be hurting the cause a bit.
"Typical participation and engagement rates indicate that employers are still struggling to find effective approaches to motivate workers," write analysts with Buck Consultants. "There is a significant gap between employers' stated desire to create a 'culture of health' and their assessment of the current status," they argue.
Various elements of wellness programs are growing fast as ways to avoid premium increases and high claims, or to boost morale and productivity.
Globally, the survey found, telemedicine is the fastest growing wellness program -- especially in Canada, Latin America and the U.S. -- followed by support for biking to work, on-site child care (particularly in Asia), on-site health coaching and personal health records. More companies are also trying to foster wellness and productivity through expanded use of time-off policies, flexible scheduling, telecommuting, ergonomic work stations and tobacco-free sites.
And healthcare-specific programs linking financial rewards or penalties to participation in risk assessments and wellness improvement are continuing their growth.
Globally, about 70 percent of employers have health risk assessment and biometric screening programs and 55 percent have associated incentive components, with rewards or penalties linked to participation, often in the form of premium discounts or increases.
The United States, though, is a leader on all fronts. Almost 90 percent of American employers already have a health risk assessment program and biometric screening components, and 90 percent currently use incentives -- up from just 62 percent in 2010.
But, the report noted: "After explosive growth in the use of incentives from 2010 to 2012, the growth rate plateaued and most regions experienced flat to decreasing rates of incentive use from 2012 to 2014."
This is one of the challenges employers are running into in their wellness strategies -- the tension between carrot and stick and the limitations of behavioral motivation.
"Incentive amount has a direct correlation to program participation levels, but initiatives that require long-term lifestyle changes (such as tracking exercise and working with a health coach( are not as greatly influenced by incentives as are more immediate programs (such as health assessments and biometric screenings)," the Buck analysts write.
But, employers can also have a good turnout -- and make headway on the cost reduction that many are ultimately seeking -- without large incentives, they argue. This is particularly true in the U.S., where 59 percent of the employers surveyed listed reducing their healthcare spending as a top priority.
"Employee wellness communication -- with personalization of employee messages -- is closely linked to healthcare cost trend reduction." All of the U.S. companies surveyed who reported reduced cost trends of six percent or more sent their employees targeted wellness emails, they found.
While wellness programs and their associated incentives are growing in popularity with employers, they may not necessarily be well-received by employees -- indeed, the movement has its critics and has seen some backlashes, for instance among Penn State University employees.
To help improve wellness programs and boost their ROI long-term, Buck analysts also argue that employers need to do a better job tracking employee satisfaction.
Employees who want to use a wellness program will be "better engaged" and "make more informed decisions about their career, health, and wealth," and they may ultimately be more likely to be in "alignment with the company's business and financial goals," Buck analysts write.