Download Improving workforce health and productivity

Improving workforce
health and productivity
Connecting the elements of workplace culture
U.S. research findings
Employers increasingly connect
organizational culture to the workplace
experience and to employees’
physical, emotional and financial
well-being.
Improving workforce
health and productivity
Table of contents
Connecting the elements of workplace
culture: U.S. findings of Willis Towers
Watson’s 2015/2016 Staying@Work Survey
Top priorities.............................................................................................................................................................7
Executive summary..........................................................................................................................................2
Health and productivity — A core component
of organizational health...............................................................................................................................6
Building a valuable competitive advantage.........................................................................8
The employee health risk challenge............................................................................................9
Engagement and other challenges............................................................................................14
Strengthening the foundation..........................................................................................................18
Beyond incentives – building a workplace culture of health.....................23
Financial well-being......................................................................................................................................26
What highly effective employers are doing.....................................................................28
Summary: good intentions, formidable obstacles,
notable successes.........................................................................................................................................34
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Employee Health and Business Success
Executive summary
Workforce health and productivity is a top priority for U.S.
employers. Our 2015/2016 Staying@Work Survey found that
84% of U.S. respondents see health and productivity as a
core component of their organization’s health strategy, and
nearly four in five plan to strengthen their commitment to
health and well-being programs.
But even more significant than their commitment is the way
organizations are redefining workforce health. Employers
increasingly connect organizational culture to the workplace
experience and to employees’ physical, emotional and
financial well-being. So employers are coordinating their
individual efforts beneath a broader umbrella — a health and
productivity strategy that aligns with the employee value
proposition (EVP) and organizational goals, and differentiates
them from the competition.
The emphasis on the workplace culture over program design
represents a major shift for many U.S. organizations — and,
we believe, a big step forward in employers achieving their
health and productivity goals. By 2018, 94% of surveyed
employers plan to develop a workplace culture that supports
and enables employees in their pursuit of well-being while
holding employees accountable for their health. Ninetyone percent also intend to articulate a formal health and
productivity strategy and explain it to current and prospective
employees, and more than half plan to customize their
programs for various workforce segments.
What’s motivating employers to shift direction on their
health and productivity journey? To a large extent, it’s about
recognizing the ways in which some employees’ sedentary
lifestyles, obesity and stress are raising health care costs
and hurting productivity. But that’s not the only thing. It’s also
about employers’ continuing struggle to engage employees to
participate in health-related initiatives. The evidence suggests
that financial incentives alone are insufficiently engaging,
prompting employers to reevaluate their assumptions. They’re
also investing more in measurement and analytics to assess
the return on their health and productivity investments, and
rebuilding their programs based on what they know is working.
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The emphasis on the workplace culture over
program design represents a major shift for
many U.S. organizations — and, we believe, a
big step forward in employers achieving their
health and productivity goals.
Looking at health holistically
Seventy-five percent of U.S. employers identify stress as
their workforce’s top health risk. They’re also concerned
about the effects of rising rates of employee obesity (70%),
sedentary lifestyles (61%) and poor nutrition (50%) on
health and productivity. But whereas past initiatives tended
to address health issues separately, employers today view
these issues as being connected, both with each other and
with the workplace itself. For example, mitigating stressors
like insufficient sleep and financial worries can improve
employees’ physical and emotional well-being, helping them
bring their best self to work each day. Because of these
links, it’s important for employers to address employee health
holistically. Focusing on individual health factors separately
can fail to help employees whose problems are complex.
What employers want to achieve
U.S. organizations share a number of health and productivity
goals. Leading the list are improvements to medical and
pharmacy benefit plans, which isn’t surprising given that
employers’ annual health care costs now exceed $12,000 per
employee.
But employers also see the value of a comprehensive wellbeing strategy for improving employees’ emotional and
financial health. They understand that unaddressed health
risks directly affect employee performance and, ultimately,
the organization’s financial results. Employees with multiple
health risks miss more days of work and are less engaged
with their jobs than their healthier counterparts, and the drag
on performance can reverberate throughout the organization,
as others must work harder to compensate.
There’s growing recognition among employers that, to make
a measureable difference in employees’ overall health and
productivity, they must drive health and well-being initiatives
deeper into the organization, embedding them in the
workplace and employees’ day-to-day work experience. In
short, employers want their health and productivity programs
to both reflect and achieve broader organizational goals.
So while employers are naturally concerned with controlling
health benefit costs, they also want to help employees be
healthier and happier at work. Employers recognize that it’s
both good for business and the right thing to do.
What’s standing in the way of success?
A lack of employee engagement is the most formidable
challenge to the success of health and productivity programs.
U.S. employers have struggled to get more workers to
participate in these programs for more than a decade.
Other significant obstacles include the lack of long-term
measurable returns, inadequate program budgets and
fragmented delivery.
A lack of employee engagement is the most
formidable challenge to the success of health
and productivity programs.
Overcoming these barriers calls for a multidimensional
approach. But the approach must be built on a solid
foundation: a health and productivity strategy that reflects
a broad vision, uses data gathered over the long term for
decision making and program development, sets out a
budget, and reflects employees’ needs and preferences.
Lacking such a guiding strategy, it can be difficult to obtain
leadership support, secure the necessary resources and
motivate employees.
Glossary
Health and productivity
The phrase health and productivity encompasses the
strategy, tactics and programs aimed at improving
employee/family health and well-being, and strengthening
the organization’s workforce effectiveness.
Health and well-being
While definitions and measures of health and wellbeing vary, we define well-being as a concept that
includes physical, financial and emotional health, as
well as personal connection and belonging. Well-being
encompasses the entire person; it isn’t merely the
absence of disease or infirmity. In simple terms, a person
who’s “well” not only is in good physical health (body) but
also judges life positively and feels good (mind).
Clearly, many employees are ambivalent about their
employer's involvement in their health. While most employees
want to reduce stress and improve their health, nearly half
don’t want their employer to have access to their personal
health information. And almost one-third “don’t trust” their
employer when it comes to their health and well-being.
Employers need to build trust; they can start by asking
employees directly what’s causing their stress and how they
can help.
For example, many employers assume that the answer
to workplace stress is improving work/life balance, but
employees say they’re much more stressed by insufficiently
defined priorities and unmanageable workloads, as well
as the lack of managerial support and inadequate pay.
Employers that build their health initiatives on misguided
assumptions might be wasting their money and alienating
employees in the bargain.
Forging stronger connections with employees
Do financial incentives work?
The good news is that both employers and employees
consider health a top priority, according to the findings of our
2015/2016 Global Benefits Attitudes Survey. Two-thirds of
U.S. employees participating in that survey believe employers
should play a role in helping them live healthier lifestyles.
Yet only one-third credit their employer with helping them
improve their health habits — a decline from 41% in 2011. And
71% of employees say they prefer to manage their health and
well-being themselves.
Eighty-six percent of U.S. organizations offer their employees
some form of financial incentive to participate in health and
well-being programs, and the most common incentives are
financial rewards. Penalties are more controversial, and many
employers are starting to question whether penalties have a
place in their organization’s culture. Nevertheless, a number
are considering them for the future. This is despite the fact
that well-established behavioral science research suggests
that external rewards often fail to engage internal motivation,
with the outcomes favoring the narrow achievement of
rewarded goals rather than the broader goal of overall
healthier lifestyles.
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Improving workforce health and productivity
So far, the impact of financial incentives on participation is
mixed. In 2015, when employees could potentially earn an
average $880 per year, the average payout per employee was
only $365. Only 42% of employees earned the maximum award,
and nearly as many earned no incentives during the year.
through social networks, and encouraging employees to
offer suggestions for making their work environment more
conducive to good health.
Nearly nine in 10 U.S. employers plan to reassess their
incentive program designs over the next three years.
Many organizations are extending well-being programs
and incentive opportunities to family members, refreshing
the designs regularly, and using best practices in choice
architecture and nudges to keep employees interested and
encouraged. Even so, employers clearly are moving beyond
incentives to focus on one of their most important assets —
a healthy workplace.
As part of a more holistic approach to well-being, many
employers are also incorporating efforts to improve
employees’ financial security into their broader health and
productivity strategy. For many employees, financial worries
comprise a significant source of stress, and employers are
recognizing the emotional toll and negative effects of financerelated stress on motivation and engagement.
Financial well-being
Many employers are trying to instill workplace health
throughout the entire employee experience. Our survey data
show that by 2018, nearly two-thirds of U.S. employers expect
that building a health-promoting workplace culture will be
their primary means of boosting employee engagement in
health. This represents a significant shift, as only one-third of
employers identify it as a core strategy today.
Nearly half (47%) of surveyed U.S. employers have developed
a personal financial well-being strategy for their workers, and
another 33% are either planning to adopt such a strategy
by 2018 or considering doing so. Some employers increase
employees’ awareness of the effects of financial well-being
on overall health by including a module or question about
financial stress in the employee health risk assessment.
Roughly one-third of employers either already reward
employees for participating in employer-provided financial
well-being programs or plan to offer such rewards within the
next three years.
The physical work environment can deliver daily reminders
to employees about health and well-being. Seventy percent
of organizations have promoted healthy lifestyles by such
initiatives as offering healthy food choices in cafeterias,
creating walking paths and sponsoring campus bike-sharing
programs. And evidence points to the psychosocial aspects of
the work environment as key to unlocking workforce potential.
Some of the challenges in implementing financial well-being
initiatives are unique. Forty-one percent of employees are
uncomfortable with their employer becoming involved in their
personal finances. Employees are even less comfortable with
targeted, employer-delivered messages about their personal
finances than with those that promote good health-related
habits.
Getting it right can be one of the greatest assets for an
organization’s well-being strategy, serving to inspire and
engage employees daily. A valuable approach — already in
use by 56% of U.S. employers — is asking employees what
they need to improve their health and to succeed at work. In
addition, personalizing messages and tailoring programs to
workers’ individual needs strengthens their connection to the
organization’s initiatives and builds trust.
How high-performing companies succeed
Establishing a healthy workplace
The pursuit of a healthy workplace culture is gaining
traction. Between 2013 and 2015, many more organizations
decided to entrench health and well-being more deeply
into their organization. Their tactics have included giving
managers tools to support employee health and wellbeing, using employee testimonials and/or personal stories,
using key influencers and viral messaging to communicate
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To guide employers on their employee well-being journey,
we looked at effective health and productivity strategies and
practices at organizations across the country. Employers can
adapt these successes for use in their own organization by:
ƒƒ
Creating a workplace environment that accentuates the
links between their employees’ physical, emotional and
financial health, on one side, and individual and workforce
productivity on the other
ƒƒ
Offering a range of programs across the full continuum
of health and well-being activities, as well as user-friendly
tools to help employees make smart health-related choices
ƒƒ
Adopting best practices in the operational management of
their health and well-being programs
About the survey
For nearly two decades, Willis Towers Watson has conducted
our Staying@Work research on health and productivity issues
in North America. Our 2013 Staying@Work Survey was
our first that included employers in Asia, Europe and Latin
America. The 2015 survey, our second global study involved
34 markets, including the Middle East.
The global survey was completed by 1,669 employers
between May and July 2015. Respondents are responsible
for the health and well-being programs in their respective
countries. Respondents by market include:
U.S. industry groups
9%
8%
5%
Energy and utilities
18%
Financial services
General services
Health care
26%
10%
IT and telecom
Manufacturing
11%
Public sector and education
13%
Wholesale and retail
ƒƒ
Asia Pacific: 582 respondents in 13 countries
ƒƒ
Europe, the Middle East and Africa: 247 respondents in 14
Number of full-time employees employed by U.S. respondents
countries
ƒƒ
Latin America: 242 respondents in five countries
ƒƒ
North America: 598 respondents in Canada and the U.S.
13%
1,000 – 2,500
28%
13%
The survey was completed by 487 U.S. employers with 1,000
or more employees. U.S. respondents collectively employ
15.1 million full-time employees, have 12.0 million employees
enrolled in their health care programs and represent all major
industry sectors.
Concurrent with our Staying@Work Survey, we conducted
our second Global Benefits Attitudes Survey, through which
we collected responses from nearly 30,000 employees
in 19 countries, including 5,083 employees in the U.S. The
biannual survey explores employees’ attitudes about factors
related to their benefits, health-related behaviors, current and
prospective financial situations, and workplace experience.
To a great extent, the success of health and well-being
programs depends on employers’ ability to engage
employees in these initiatives. That’s why employees’
attitudes hold important clues for getting the best return on
ƒƒ
Creating a strategy for continually measuring both
employee participation in well-being programs and its
effects on workforce health. With hard data on program
effectiveness, leaders can build a stronger case for
continuing or expanding programs, and secure funding
ƒƒ
Relying on the latest technology to:
ƒƒ
Enlist employees as champions of their own health and
well-being
ƒƒ
Support employees’ efforts to meet well-being-related
goals
ƒƒ
Measure employees’ participation and success
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Improving workforce health and productivity
2,500 to 5,000
5,000 to 10,000
10,000 to 25,000
25,000+
17%
28%
health and productivity investments. Throughout this report,
we complement the emerging trends in employer activities
by presenting the voice of the employee to help employers
understand the critical success factors as they develop and
build upon their health and productivity strategy.
This report highlights U.S. employers’ responses to our
Staying@Work Survey and U.S. employees’ responses to our
Global Benefits Attitudes Survey. A summary of the global
Staying@Work findings — as well as regional reports for Asia
Pacific, Europe and Latin America — are also available.
ƒƒ
Analyze the value of health and well-being programs for
the organization
In short, U.S. employers need to make coordinated efforts
based on a clearly communicated strategy to help employees
understand the benefits of participation — for themselves,
their family and the organization — and use a variety of
approaches to earn employees’ trust and encourage their
engagement.
Figure 1. Employers are committed to health
and productivity
0%
20%
40%
60%
80%
100%
Global
50
37
U.S.
48
36
Health and productivity
— a core component of
organizational health
Canada
46
36
Europe
48
41
Latin America
47
34
Asia Pacific
53
37
It is essential to our organizational health strategy
It plays a moderate role in our organizational health strategy
Employee perspective
Figure 2. Health is a top priority in employees’ lives
All respondents
64%
Generations
Baby Boomers
Generation X
59%
68%
Salary
Less than $50K
$50K to $100K
Over $100K
62%
65%
68%
Source: 2015/2016 Global Benefits Attitudes Survey, U.S.
Note: Percentage responding “strongly agree” or “agree”
on a five-point agreement scale
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The success of any health and well-being program depends
on raising awareness and encouraging employees to do
what it takes to get and stay healthy. The good news is
that employees share their employer’s enthusiasm about
good health. Employees consider their health a top priority,
according to the 2015/2016 Global Benefits Attitudes Survey.
And there’s remarkable consistency among all generations:
67% of Baby Boomers and 68% of Millennials identify health
as a top priority (Figure 2). There’s similar consistency across
earnings groups.
Millennials
67%
6
Our survey findings confirm that a large majority of U.S.
employers — like their counterparts around the world —
are deeply committed to improving their employees’ overall
health and productivity (Figure 1). Eighty-four percent of
U.S. respondents report that health and productivity is a
core component of their organization’s health strategy —
a commitment that has remained strong and steady since
2011. Looking ahead, nearly four in five U.S. employers plan
to strengthen their health and productivity programs through
2018, and organizations in other world regions show similar
levels of unwavering resolve.
Eighty-four percent of U.S. respondents
report that health and productivity is a core
component of their organization’s health
strategy — a commitment that has remained
strong and steady since 2011.
Top priorities
U.S. employers face a complex array of challenges surrounding
their health and productivity programs. When asked about their
top priorities, survey respondents coalesced around a number
of concerns rather than any single theme. Unsurprisingly,
ongoing improvements to their medical and pharmacy plans
top the list. Annual health care costs now exceed $12,000
per employee, and increasing cost pressures from areas like
specialty pharmacy add to employers’ already heavy financial
burden (Figure 3).
Following closely behind on their priority list, U.S. employers also
want to enhance their health and well-being programs in two
important ways. First, they’re looking beyond benefit programs
and employees’ physical health and wellness, broadening their
focus to develop a well-being strategy for improving employees’
emotional, social and financial health as well. Second, they’re
expanding the reach of their health and well-being initiatives
by making them a signature component of the workplace
environment and the day-to-day employee experience. By tying
overall employee well-being to the workplace culture — and
linking workforce well-being goals to the organization’s strategic
business goals — employers can distinguish themselves from
the competition and become employers of choice.
Figure 3. Employers identify health and well-being as
a key part of their health care strategy
0%
20%
40%
60%
80%
100%
Evaluate health and pharmacy plan design strategy
80
15
Increase focus on employee well-being, including physical and
financial health and workplace experience
73
23
Develop/enhance a workplace culture in which employees
are responsible for their health
72
22
Evaluate vendor/network strategy
60
29
Make changes to avoid the excise tax
58
25
Adopt/expand the use of financial incentives to encourage
healthy behaviors
54
30
Evaluate care management programs for chronic and
acutely ill plan members
51
36
Review health care benefits in a total rewards context
49
35
Develop/enhance a health technology strategy including
employee engagement and delivery of care
48
To a great extent (4/5)
7
Improving workforce health and productivity
34
To a moderate extent (3)
Building a valuable competitive advantage
The survey respondents’ top priorities reveal employers’
widely shared desire to radically transform their health and
productivity programs. Half of respondents offer health and
well-being programs but lack a formally articulated strategy
that they’ve aligned with business priorities and explained to
employees (Figure 4). Nevertheless, there has been progress:
10% of respondents have an articulated strategy; 22% have
effectively communicated and delivered on their strategy’s
value proposition; and 12% have differentiated their strategy
for critical workforce segments and have evaluated its
effectiveness.
While employers are at various stages of transformation,
there’s widespread agreement about making health and
well-being an integral part of the EVP that encourages
employees to join and remain with the organization. By 2018,
91% of organizations plan to have an articulated health and
productivity strategy in place, and more than half expect to
customize their program for various workforce segments —
a four fold increase from 2015.
The findings of our 2013 study were similar: Most employers
had no strategy in place then, but planned to adopt a formal
strategy — differentiated for various workforce segments
— in the near future. Does their failure to follow through on
that intention suggest a lack of commitment to health and
productivity improvement? No. Rather, it reflects the significant
challenges organizations face in transforming their value
proposition, and in focusing the workplace culture less on
health programs and more on a holistic approach to improving
employees’ physical, emotional and financial well-being.
Setting objectives that resonate with employees and then
delivering on the strategy’s promises is a journey. It requires
a clear vision of the end goal as well as flexibility along the
way. All signs indicate that employers have an unwavering
commitment to seeing this through, both in the U.S. and
around the world.
In the following pages, we examine the steps U.S. employers
are taking to make their vision a reality. Specifically, we look
at employers’ motivation for investing in employee well-being,
the steps they’re taking to develop and strengthen their
health and well-being initiatives, and how they’re overcoming
the primary barriers and challenges.
Figure 4. Employers take the next step to make health and well-being a key part of their value proposition
No strategy
Offered various
programs but have
not articulated
health and
productivity strategy
2015
2018
Change
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51%
Adopt strategy
Communicate
and deliver
Differentiate health
and productivity
strategy
Reduce emphasis
Articulated health
and productivity
strategy with stated
objectives and goals
for each program
Effectively
communicated
value proposition
behind health and
productivity program
and delivered on its
promises
Customized strategy
for critical workforce
segments and used
organizational analytics
to test program
effectiveness
Reducing focus
on health and
productivity
10%
22%
4%
7%
29%
–47 pps
–3 pps
+7 pps
12%
54%
+42 pps
5%
5%
0 pps
The employee health risk challenge
Understanding the underlying barriers to health and wellbeing is essential to identifying effective solutions. While
approaches might vary depending on the workforce’s
demographic and socioeconomic characteristics, employers
around the world face similar workforce challenges, including
high rates of employee stress, obesity, sedentary lifestyles
and poor nutrition.
Employers worldwide see stress as the number one workforce
performance issue (similar to the findings of our 2013
study), and 75% of U.S. employers identify stress as their
organization’s top related risk factor (Figure 5). So what’s
causing these high levels of stress, and how can employers
help their employees overcome this drag on performance?
Employers and employees have vastly different thoughts about
stress’s causes and prevention methods, which is a concern
(see box: Addressing the wrong stress drivers, page 11).
U.S. employers also worry about rising rates of obesity (70%),
sedentary lifestyles (61%) and poor nutrition (50%) in the
workforce, echoing their concerns of 2013. Many of these
health-related risks are interconnected, prompting employers
to broaden their well-being focus to include factors such as
insufficient sleep and financial worries. Because of these
connections, it’s important for employers to be vigilant in
addressing all risks via a holistic strategy. Addressing risks
individually often fails to improve the overall health and wellbeing of employees struggling with complex problems.
Why are U.S. employers so motivated to strengthen their
employees’ health and well-being? The reasons are complex
and compelling. The bottom line is that employers recognize
it’s both the right thing to do and good for business.
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Improving workforce health and productivity
Figure 5. Lifestyle-related risk factors that can affect
workforce performance
0%
20%
40%
60%
80%
100%
Stress
75
20 5
Overweight/obesity
70
22
9
Lack of physical activity
61
28
11
Poor nutrition
50
30
Insufficient sleep
31
42
Poor financial well-being
28
Tobacco use
25
To a great extent
(5/6/7)
20
27
35
37
30
To moderate extent
(4)
45
Not at all
(1/2/3)
Employers worldwide see stress as the
number one workplace issue (similar to
the findings of our 2013 study), and 75%
of U.S. employers identify stress as their
organization’s top risk factor.
Employee perspective
Figure 6. Lifestyle risks are linked to poor health, lost work days
and lower work engagement
Low
Medium
risk
risk
0 – 1 risks 2 – 3 risks
High
risk
4+ risks
24%
44%
32%
Excellent/very good health
81%
62%
36%
Good health
18%
32%
47%
1%
6%
17%
Absence days
1.7
2.1
3.5
Presenteeism days
6.9
9.5
12.1
% of population
Health status
Fair/poor health
Productivity
Sustainable engagement
High engagement
55%
43%
30%
Low engagement
11%
20%
29%
We looked at the following eight employee risk categories to identify low-,
medium- and high-risk groups: obesity, workplace stress, physical activity,
nutrition, sleep, tobacco use, alcohol use and flu vaccination.
Source: 2015/2016 Global Benefits Attitudes Survey
A common approach to understanding the links between
employees’ health-related risks and their performance is
to identify the risks and then compare the performance of
those with many risks to those with few. Looking at the eight
health risks identified in the findings of our 2015/2016 Global
Benefits Attitudes Survey, we see that the connections are
clear. Having four or more health risks is strongly linked
to poor health and more lost days due to absence and
presenteeism (Figure 6). Employees with multiple health risks
miss almost twice as many days of work as those with few
risks (15.6 versus 8.6).
Poor health also takes an emotional toll on employees,
manifesting as weak sustainable engagement, which is
Willis Towers Watson’s measure of employee engagement.*
Employees at low risk — with no more than one risk factor
— are five times more likely than those with more risk factors
to be highly engaged. Conversely, those at high risk —
individuals with four or more risk factors — are almost equally
as likely to be to be disengaged as highly engaged.
Productivity requires everyone on the team to do their part.
There’s an enormous productivity and morale difference
between a team that includes five highly engaged members
and one member who’s disengaged and a team with a
one-to-one ratio of engaged and disengaged members. So
helping employees address their personal health and financial
challenges pays dividends in both improved well-being
for employees who are struggling and an enhanced work
experience for their coworkers.
*Sustainable engagement involves three types of connections with the organization: (1) being engaged — applying discretionary effort to work goals;
(2) being enabled — having a work environment with the support and resources necessary to work efficiently and effectively without barriers to success;
and (3) feeling energized — having a work experience that promotes social connectedness and feelings of enthusiasm and accomplishment.
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Addressing the wrong stress drivers
There is often a disconnect between what employees
are thinking and what employers believe they are thinking
(Figure 7). For example, while employees rank low pay
as a leading cause of their stress, employers rank it
eleventh on a 12-item list of stressors for employees. The
organization’s culture — including a lack of teamwork
and a tendency to avoid accountability — ranks third on
employees’ stress list, while employers presume it’s in last
place on the list.
Conversely, employers identify insufficient work/life
balance as the top stressor for workers, yet employees
rank it sixth on the list. In one of the few areas of
agreement, both employers and employees feel that
inadequate staffing and its consequences — a lack of
support and an uneven workload —comprise a major
source of stress.
To address workplace stress, employers first need to
understand its root causes. Those who base their efforts
on misguided assumptions risk addressing the wrong
problems and alienating employees.
Employers also need to understand how employees
prefer to manage stress. Employees who responded
to our Global Benefits Attitudes Survey choose one of
two routes. The first is to connect with friends, family
members and colleagues; the other is to pursue selfsoothing activities including exercise, stress-reduction
techniques or sedentary activities, such as indulging in
comfort foods or watching TV. Only one in five employees
seek external help from a professional or use such
services provided by their employer (Figure 8, page 12).
Employee perspective
Figure 7. Employers versus employees: sources of stress
Employer view Employee view*
Lack of work/life balance (excessive workloads and/or long hours)
1
6
Inadequate staffing (lack of support, uneven workload or performance in group)
2
1
Technologies that expand availability during nonworking hours (e.g., mobiles, notebooks)
3
12
Excessive amount of organizational change
4
5
Concerns about personal financial situation
5
7
Unclear or conflicting job expectations
6
4
Concerns about job loss
7
11
Concerns about benefit reduction/loss
8
10
Lack of manager support
9
8
10
9
Low-control/high-demand jobs
Low pay
Company culture
*Source: 2015/2016 Global Benefits Attitudes Survey
Note: Percentage of employers and employees responding 3, 4 or 5 on a 5-point extent scale.
Sample: U.S. — full-time employees with employer-based health care benefits
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Improving workforce health and productivity
11
2
12
3
Employee perspective
Figure 8. The ways employees cope with workplace stress
Self – physical
Personal network
Self – sedentary
External help
Engage in physical activities
Seek support from family,
friends
Indulge myself
Seek professional help
Come up with a plan
Seek support from manager
78%
56%
Use services provided
by my employer
48%
20%
Source: 2015/2016 Global Benefits Attitudes Survey
Employees clearly need help managing stress. But there’s
a significant gap between employers’ attempts to remedy
stress and the stress management steps employees
choose to take. For example, 86% of employers promote
their employee assistance program (EAP) to help their
employees manage stress (Figure 9), yet only 14% of
employees use EAP services in any one year. And few
seek out professional help during stressful times.
Likewise, many employers provide flexible working
arrangements like telecommuting and flex-time options,
even though most employees don’t see inadequate work/
life balance as a top source of stress. And the findings of
our Global Benefits Attitudes Survey indicate that highly
stressed employees are equally as likely to regularly work
from home as are employees who report more manageable
stress levels (14% versus 15%), and they’re just as likely to
work flexible schedules (25% versus 33%).*
Employers committed to reducing workforce stress can
start by asking employees directly what’s causing their
stress. Whether the stress originates in the workplace or
arises from personal factors, such as financial challenges,
employers can develop effective strategies to help.
They can leverage employees’ efforts by encouraging
employees to enjoy well-deserved vacations, initiating
walking groups and other stress-reduction activities, and
offering stress-management programs.
Finally, it’s important for employers to recognize that many
sources of employee stress are within the employer’s
control — including compensation, inadequate staffing,
conflicting expectations and the organizational culture.
Training both senior leaders and line managers to be
supportive, providing clear direction and reviewing
compensation practices can alleviate top stressors for
many workers. With only 36% of employers offering
this type of training to managers today, there are
opportunities for more employers to take action.
Figure 9. Steps taken by employers to manage stress
0%
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40%
60%
80%
100%
Promote the EAP
86
Provide flexible working options
67
Offer employee education and training
55
Offer manager training and coaching to line managers
44
Offer onsite stress management interventions
41
Offer manager training and coaching to senior executives
36
Calibrate jobs to enhance employee control, autonomy
in making decisions
29
Use external specialist/resources to design and
deliver program(s)
28
Use risk assessments/stress audits
25
Offer resilience training/programs
24
Looking ahead, the pace of change in the business
environment is unlikely to slow down; it might only
accelerate. Managers able to keep pace with the
changing landscape — and to equip employees with
updated skills to both meet evolving job needs and
be resilient through these changes — will go a long
way toward mitigating the leading causes of stress for
employees today.
*See Employee Stress: Myths and Reality, 2015/2016 Global Benefits Attitudes Survey.
12
20%
Measurement: a key to effective health and
well-being management
Many employers are committed to continually improving
their health and well-being programs, but don’t adequately
measure their results. Health and productivity has
become a C-suite issue, but the dearth of hard evidence
about the return on these investments often stands in the
way of support from senior leadership.
Effective measurement starts with tracking and
monitoring programs over multiple years. Yet only four
in 10 U.S. employers have a strategy for evaluating their
health and well-being programs over the long term
(Figure 10). While there’s plenty of utilization data —
77% of employers measure program participation rates
— only 46% measure the impact of the programs on
participants’ health, and even fewer (31%) measure the
effects on productivity. As a result, leaders struggle to
build compelling cases for strengthening their offerings
or adding new ones — or, in some cases, even for
maintaining them.
A healthy, financially secure workforce translates directly
to improved financial performance, although the impact
of improved health and well-being can’t be captured in
any single financial measure. An effective measurement
strategy captures the ways in which employees’ wellbeing affects their engagement, health-related behavior,
health care utilization, work loss and satisfaction. And
these factors shouldn’t be viewed in isolation. Rather,
engagement levels, costs and outcomes should be
integrated across multiple data sets to create a broad
range of information against which to measure the
effectiveness of health and well-being programs.
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Improving workforce health and productivity
Figure 10. Can’t manage what you don’t measure
0%
20%
40%
60%
80%
100%
Use clinical-level medical claim/benchmarking data to inform
decisions or changes to health and well-being programs
55
27
Measure active participation or active engagement by
employees/spouses in health and well-being programs
51
26
Share health and well-being program performance metrics
with C-suite or regional management on regular basis
48
29
Use data to identify specific individuals or subgroups for
targeted outreach on relevant health and well-being programs
43
26
Have articulated measurement strategy that supports
multiyear evaluation of health and well-being program
39
32
Use variety of financial and nonfinancial metrics to measure
impact of health and well-being programs
25
28
Use ROI measures to evalute impact of health and
well-being programs
24
22
Measure demonstrated impact of health and well-being
programs on employee productivity
14
17
To a great extent (4/5)
To a moderate extent (3)
Figure 11. Biggest barrier to a successful health and
well-being program: lack of employee engagement
0%
20%
40%
60%
80%
Lack of employee engagement
43
35
Lack of evidence of appreciable financial returns and
which practices work best
34
37
Lack of adequate budget/staff to support effective health
management programs
33
29
Fragmented or disjointed delivery of health and
well-being programs
25
33
Lack of organizational structure to support programs
25
30
Lack of senior leadership or manager support
23
29
Insufficient financial incentives to encourage
program participation
23
29
Lack of actionable data to support targeted outreach
21
35
Lack of overarching strategy for investing in
employee well-being
19
32
Regulatory limitations and uncertainty about
employer-sponsored activities
13
27
Health and well-being programs are too complex
13
25
To a great extent (4/5)
100%
Engagement and
other challenges
To a moderate extent (3)
Successful health and well-being programs generally must
overcome a number of obstacles. In the U.S., weak employee
engagement (low participation rates or low levels of interest
in activities) is the biggest challenge (Figure 11). As found by
earlier surveys, U.S. employers have struggled to get workers
to participate in these programs for more than a decade.
Other significant obstacles include the lack of measurable
returns (71%) and inadequate program budgets (62%).
These are the top two obstacles outside the U.S., where data
availability is often limited. But even in a data-rich market like
the U.S., demonstrating program effectiveness with actionable
data is a challenge. Lacking convincing evidence, employers
struggle to get the funding they need for strong programs.
And without sufficient funds, it’s difficult for employers
to create or buy a diverse range of segmented programs
that meet the varied needs of their workforce, or even to
adequately staff the most basic, companywide offerings.
Thus, establishing a multiyear assessment process is crucial
(see box: Measurement: a key to effective health and wellbeing management, page 13).
Fragmented delivery is another challenge. The U.S. market
offers the strongest, most diverse well-being products,
packed with the latest creative tools and programs for helping
employees live healthier lifestyles. But simply adding more
programs may not close the participation gap. More than half
(58%) of employers struggle to fit together the vast portfolio
of programs to provide an enticing, easy-to-understand,
accessible offering.
How do employers overcome these barriers? It’s a
multidimensional issue on which we focus in the remainder
of this report. As explained earlier, without a holistic health
and productivity strategy that reflects a vision, sets out welldefined goals and includes the measurement of results, it’s
difficult for employers to garner leadership support, create
budgets and secure the resources necessary for success.
Weak engagement among employees and fragmented
program delivery become natural consequences of an
incomplete strategy.
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Motivating employees
The success of any well-being strategy depends on finding
the triggers that prod employees to take action. Because
motivation is internally driven, employers can only provide the
supportive environment, triggers, resources and recognition
that prompt action. While many employers have drawn a clear
path for engaging employees in building and maintaining good
health, others are having trouble motivating their workforce.
Today, only one-third of surveyed U.S. employees recognize
their employer’s efforts and credit their employer with helping
them to lead healthier lifestyles — a decline from 41% in 2011,
Employee perspective
Figure 12. Employers struggle to encourage employees
to improve their health and well-being
the first year we asked employees about this. Instead of
engaging in employer-sponsored activities, most employees
(71%) say they prefer to manage their health and well-being
on their own (Figure 12).
An important question is whether employees want their
employers to be actively involved in their health. The
good news is that two-thirds of U.S. employees agree that
employers have a role to play in encouraging them to live
healthier lifestyles, a sentiment shared by similar numbers of
employees around the globe (Figure 13). But do employers
have a clear pathway to approach employees openly by using
financial incentives, sending targeted messages or having
managers get more directly involved? Our Global Benefits
Attitudes Survey probed employees on each of these issues
(see box: Employee segments, page 17).
We summarized the results by dividing employees into three
groups:
80%
71
60%
ƒƒ
Onboard — These employees support the role of the
employer in encouraging health improvement and are
comfortable with targeted messages.
40%
ƒƒ
Persuadable — These employers are open to some
33
20%
employer involvement but skeptical about its extent.
0%
The well-being initiatives
offered by my employer
have encouraged me
to live a healthier lifestyle.
I prefer to
manage my health
on my own.
ƒƒ
Resistant — These employees don’t support the role of
employers in employee health and well-being and are very
uncomfortable with targeted messages.
Source: 2015/2016 Global Benefits Attitudes Survey
Note: Percentage responding “strongly agree” or “agree” on a
five-point agreement scale
Sample: Full-time employees with employer-provided health
care benefits
Employee perspective
Figure 13. Employers have a role in encouraging employees to live healthy lifestyles
Option A: Employers should take an active role in
encouraging their employees to live healthy lifestyles
Strongly prefer
Global
U.S.
Prefer
Slightly prefer
Option B: It is not the role of an employer to
encourage their employees to live healthy lifestyles
Neutral
Slightly prefer
Prefer
66
65
Source: 2015/2016 Global Benefits Attitudes Survey
Option A includes groups 1, 2 and 3; group 4 is neutral; and option B includes groups 5, 6 and 7 on a seven-point semantic scale.
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Improving workforce health and productivity
Strongly prefer
17
16
Nearly one-third of employees are supportive of their
employers being deeply involved in their personal health
and well-being, and only 13% outright reject their employer
having a role. The greatest opportunity lies with the majority
of employees (56%) who are open to their employer being
involved but remain skeptical about the employer’s role.
How can employers convince the persuadable to jump in? As
many employees say their health is a priority, it could simply
be a matter of helping those employees get started and
using those already on board to convince the persuadable.
On the other hand, identifying pockets of resistance and
understanding the triggers within that group, even though
small, is an important step in building a more convincing case
about the company’s goals and intentions. If some employees
remain resistant to health and well-being programs,
understanding this group can at least help employers assess
potential backlash and manage it before imposing stiffer
requirements or standards for all employees.
In any case, employers generally have a pathway to improving
employee health. Many employers, however, have yet to make a
sufficiently convincing case to boost participation in employersponsored initiatives or have other barriers to overcome.
Managers of health and well-being programs might be asking
themselves why participation remains so low. While there
could be several explanations, one of the most likely is a
reluctance among workers to share personal, health-related
information with their employer. Nearly half of employees
don’t want their employer to have access to such information
(Figure 14). And while the majority accept their employer’s
involvement in their health, nearly one-third don’t trust their
employer when it comes to their personal health and wellbeing. Another explanation for low participation could be that
employees don’t find the programs valuable or compelling.
Nevertheless, employers have been trying to increase
employees’ awareness of health and well-being programs.
One positive finding is that few employees cite their manager
as a barrier to participation. Even so, despite employers’ large
investments in well-being programs, one-third of employees
claim the available programs don’t meet their needs. Why not?
Given the vast number of programs offered by employers,
there may be too much information competing for employees’
attention, drowning out important health-related messages.
Also, the focus of many of these programs on a single issue
may leave some employees unsure whether the programs
can address the full extent of their personal needs, some
of which are complex. Furthermore, many programs that
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Employee perspective
Figure 14. Sensitivities around personal health data impede
health engagement for some employees
0%
10%
20%
30%
40%
50%
I don’t want my employer to have access to my personal
health information
46
The initiatives offered by my employer do not meet my needs
32
I don’t trust my employer to be involved in my health
and well-being
30
I am not sure about the activities provided by my employer
or how to sign up
19
My manager is not/would not be supportive of
my participation
14
Source: 2015/2016 Global Benefits Attitudes Survey
are heavily tied to computer-based modules may not be
compelling enough to engage employees at a time when the
demand for interactive, sensory experiences is at an all-time
high. And many programs that use telephonic approaches
with persistent calls may come across as intrusive and, worse
yet, may frustrate employees and cause them to turn away
from their employer’s initiatives.
Employers clearly need to build employees’ trust in areas
pertaining to health — especially the employer’s access to their
personal data — so that workers begin viewing their employer
as a go-to resource for improving their health and well-being.
It’s important for employers to regularly assess employees’
attitudes, so they can tailor and personalize programs. They
should also publicize the confidentiality of personal health
information within all of their health and well-being programs,
especially those offered through third-party vendors.
Convincing employees who are resistant to their employer’s
involvement may be a difficult road to pursue. Instead, the
more promising path may be to focus on those who need
only a little extra convincing. Even if some employees
prefer to keep their health and well-being status and
information strictly private, employers can create a workplace
environment that supports employees as they tackle health
issues on their own.
Employee segments
Employee attitudes toward employer involvement in health
and well-being
We define three employee types…
Onboard
Persuadable
Resistant
Support the role of the employer in
encouraging employee health improvement and
are comfortable with targeted messages
Employee perspective
Figure 15. Employee attitudes toward employer
involvement in employee health and well-being
0%
20%
40%
60%
80%
Global
Open to some employer involvement but
skeptical about its extent
Don’t support the role of employers in
employee health and well-being and are very
uncomfortable with targeted messages
…based on the following questions:
Encourage
ƒƒ Employers should take an active role in encouraging
employees to live healthy lifestyles.
ƒƒ I am comfortable with my employer rewarding employees for
36
52
12
56
13
U.S.
31
Canada
28
54
18
Europe
23
56
21
Latin America
40
49
45
Target
ƒƒ I am comfortable with my employer sending targeted
messages about how to live a healthier lifestyle to employees
with health issues.
48
Persuadable
Onboard
Resistant
ƒƒ I am comfortable with my manager suggesting ways I can live
a healthier lifestyle.
Employee perspective
Figure 16. Onboard employees are more likely to participate in activities (U.S.)
Onboard
Persuadable
Resistant
Health risk assessment
61%
51%
44%
Biometric screening
67%
59%
47%
Lifestyle risk or condition management program
36%
22%
14%
The initiatives offered by my employer have
encouraged me to live a healthier lifestyle.
46%
30%
14%
My employer offers a variety of initiatives to help me
live a healthy lifestyle.
58%
42%
26%
I don’t want my employer to have access to my health
information.
31%
47%
77%
I don’t trust my employer to be involved in my health.
17%
30%
60%
Program participation (employer-provided programs)
Making connections*
Building trust
Source: 2015/2016 Global Benefits Attitudes Survey
*Percentages include “strongly agree” or “agree.”
Sample: All employees; except U.S. and Canada, full-time employees with employer-provided health care benefits
Improving workforce health and productivity
11
Asia Pacific
living a healthy lifestyle.
17
100%
7
Figure 17. More programs — low participation rates
0%
20%
40%
60%
80%
100%
Worksite wellness and screenings
Health risk assessment/appraisal
48%
85 3 7
Worksite biometric screening
73 5
48%
8
Onsite vaccinations
Strengthening the
foundation
88 12
43%
Onsite or near-site health clinic
35%
32 4
12
Onsite healthy lifestyle coaching in at least one location
38 5
12
18%
Worksite diet/exercise activities
77 6 5
22%
Well-being fairs at some/all locations
74
34%
7 6
Lifestyle change and health management
Web-based/mobile lifestyle behavior coaching programs
58
17%
12%
10
14
Telephonic lifestyle behavior coaching programs
72 6
9
Weight-management programs
81 4
10%
7
Tobacco-cessation programs
89 2 3
8%
Stress or resilience management programs
68 8
11%
9%
Healthy sleep programs
37
9
13
Well-being programs
Well-being programs are the foundation of any health and
productivity strategy. U.S. employers spend about $461
annually per employee on these programs, which have
become commonplace at many organizations. This includes
roughly $200 per employee per year on vendor fees and
onsite services, with the remainder of the program costs tied
to financial incentives. And the word is out with employees:
Over 80% say they’re aware of their organization’s health and
well-being activities (Figure 14, page 16).
U.S. employers continue adding more health and well-being
programs to their repertoire of offerings. The vast majority
offer wellness screenings, onsite well-being services, lifestyle
change programs, and decision-support information and tools
— and the percentages continue to grow. Worksite activities
related to diet and exercise have become increasingly popular
over the last few years, with three-quarters of respondents
offering these programs (Figure 17).
18
Chronic condition (disease) management programs
14%
86 5 5
Maternity support (pre- and post-delivery, child care
resources) programs
81 3 6
14%
Provider access and decision support
EAP
98 1
14%
As technologies become more refined and adapted to the
burgeoning well-being marketplace, there are innovative
approaches to both enhancing the employee experience
and increasing the ease and efficiency of access to health
services. And employers are embracing these new solutions.
A prime example is the emergence of telemedicine, which
was nearly unheard of a few years ago but could become
almost ubiquitous by 2018.
Telemedicine for professional consultations
46
8%
24
20
Expert medical/second opinion program
7%
31 7
25
13%
Price/quality transparency tools
59
11%
Online information on demand
59
Program
participation
Program
offered
in 2015
11
7
Planned
for 2016
18
12
Being
considered for
2017 or 2018
Note: Program participation rates include only organizations offering
the program, and are based on employees who qualify and/or are
recommended to participate in the programs. For example, respondents
were asked to provide the percentage of employees participating in
tobacco-cessation programs who are at risk for tobacco use.
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Program participation
As noted earlier, low program participation rates are clearly
a challenge for employers. Only half of U.S. employees
who are eligible to participate in employer-provided wellbeing programs do so. At the individual program level, some
engagement levels are even lower. Across the board, the
average participation rate for completing an annual health
appraisal and screening is slightly below 50%. For weight
management, chronic condition and stress management,
tobacco-cessation and other important programs,
participation rates among those for whom the programs
were designed are barely above 10%.
Figure 18. Rewards and penalties
0%
Moreover, few employees use the decision-support and
transparency tools provided by employers to help them
navigate the complex health care system and shop around
for cost-effective medical services. However, with education,
communication and targeted rewards it’s likely that the
adoption rates of these relatively new tools will continue to
increase.
20%
40%
60%
80%
100%
Rewards
Offer financial rewards to individuals who participate in
health management programs/activities
36
54
71
77
80
Boosting program participation through financial
incentives
Employers are increasingly likely to use financial incentives
to increase participation. Eighty-six percent offer employees
some form of financial incentive to participate in health
and well-being programs. The most common incentives are
financial rewards, offered by 77% of organizations. In 2009,
only 36% offered such incentives (Figure 18).
Only 27% of employers used penalties in 2015, and many
question whether penalties have a place in their organization’s
culture at all. Nevertheless, a number of employers are
considering them for the future.
A significant minority of employers penalize employees for
tobacco use or use outcome-based incentives that involve
biometric targets such as body mass index, blood pressure
and cholesterol level. Employers have been more willing to
use stronger incentives to encourage employees to stop
using tobacco. On average, tobacco users at organizations
that impose a surcharge — 44% of organizations today —
pay $600 more per year in health care premiums than those
who are tobacco free (Figure 19).
82
Penalties
Penalize individuals who don’t participate or don’t meet
requirements of health management programs/activities
8
19
26
27
30
42
2009
2011
2013
2015
2016*
2017/2018**
*Planned for 2016
**Considering for 2017 and 2018
Note: Based on all respondents
Figure 19. Tobacco surcharges and outcome-based
incentives
0%
20%
40%
60%
80%
100%
Tobacco surcharge
Reward (or penalize) based on smoker, tobacco-use status
(tobacco surcharge)
32
Employers are increasingly likely to use
financial incentives to increase participation.
Similar to the use of penalties, the uptake of tobacco
surcharges and outcome-based incentives has slowed
considerably since our 2013/2014 Staying@Work Survey.
But looking ahead, employer interest appears to be
strong: There’s significant employer interest in adopting or
considering these programs over the next few years.
42
44
46
58
Biometric outcomes
Reward (or penalize) based on biometric outcomes other
than smoker, tobacco-use status
12
16
18
22
52
2011
2016*
2013
2017/2018**
*In place and planning
**In place, planning and considering
19
Improving workforce health and productivity
2015
Employee perspective
Figure 20. Employee comfort with rewards, penalties and nudges are on the decline
I would be comfortable if my employer…
2011
Change
from 2011
to 2015
2013
2015
67%
65%
59%
–8 pps
…sent me reminders to refill my prescriptions or get an annual checkup
51%
56%
54%
+3 pps
…encouraged me to enroll in a wellness program based on health screening
results or a recent illness
54%
51%
43%
–11 pps
45%
43%
39%
–6 pps
—
53%
57%
NA
27%
31%
26%
–1 pps
Rewards
…reduced the premium costs for all healthy workers and those willing to take
steps to manage their illness or lower their health risk
Nudges
Penalties
…increased the premium costs for workers unwilling to take steps to manage
their illness or lower their health risks
Outcome-based incentives
…increased the premium costs for workers unwilling to quit smoking or take
steps to quit smoking or stop using tobacco products
…increased the premium costs for workers unable to achieve targeted
biometric levels or take steps to achieve targeted biometric levels
* Source: 2015/2016 Global Benefits Attitudes Survey
Even so, it’s important to note that the percentage of
employers considering these approaches has dipped
significantly since 2013. That year, 71% were already using
or considering tobacco surcharges, and 68% were using or
considering rewards or penalties for biometric outcomes. Our
recent study found that those percentages have declined to
58% and 52%, respectively. This suggests that such designs
may not align with the value proposition employers are trying
to build, and that they’re increasingly recognizing employees’
growing discomfort with these approaches (Figure 20). In
addition, increased regulations are making biometric outcome
designs more complex to implement and support.
Do financial incentives work?
So far, the impact of financial incentives has been mixed, and
nowhere is this more evident than in employee responses to
the opportunity to earn significant money by participating in
health and well-being programs. In 2015, when employees
and family members could potentially jointly earn an average
$880 per year, the average payout per employee was only
$365. Only 42% of employees earned the maximum award,
and nearly as many didn’t earn any incentives during the year.
Employees are clearly leaving significant money on the table
(Figure 21).
So far, the impact of financial incentives has
been mixed, and nowhere is this more evident
than in employee responses to the opportunity
to earn significant money by participating in
health and well-being programs.
Figure 21. Missed opportunity: employees leave a lot of money
on the table
Didn’t earn
any incentives
Earned some but
not all incentives
40%
$1200
18%
Earned maximum
potential incentives
42%
Upper quartile
1200
$1000
882 Mean
$800
$600
$400
400
Upper quartile
497
365 Mean
Lower quartile
$200
166
Lower quartile
$0
Incentive opportunity
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Actual payout
Mean
Figure 22. Mixed impact of incentives on program participation
Percentage of employees
participating in the programs**
Percentage
of companies
using incentives
to encourage
participation*
Company
Company
offers rewards/
does not offer
imposes
incentives
penalties
Percentage
point
difference
Health risk assessment/appraisal
62%
28%
56%
28
Worksite biometric screening
53%
32%
53%
21
Web-based/mobile lifestyle behavior coaching programs
17%
13%
26%
13
Weight management programs
27%
8%
16%
8
Telephonic lifestyle behavior coaching programs
25%
9%
17%
8
Chronic condition (disease) management programs
21%
13%
18%
5
Worksite diet/exercise activities
21%
21%
26%
5
9%
34%
38%
4
22%
13%
17%
4
Onsite healthy lifestyle coaching in at least one location
10%
16%
20%
4
Tobacco-cessation programs
40%
7%
9%
2
Stress or resilience management programs
14%
11%
13%
2
7%
9%
9%
0
Well-being fairs at some/all locations
Maternity support (pre- and post-delivery, child care resources)
Healthy sleep programs
*Based on companies offering the program
**Program participation rates include only organizations offering the program and are based on employees who qualify and/or are recommended for
program participation.
Do financial incentives increase program participation? In
general, the results suggest that incentives are effective for
simple, discrete, time-limited actions. As shown in Figure 22,
participation rates are twice as high at organizations that
offer financial incentives for completing a health appraisal
or a biometric screening than at organizations with no
incentives. Employers have also enjoyed moderate success
using incentives to boost the use of web-based coaching
programs.
Otherwise, the success of incentives in promoting significant,
sustainable changes in health-related behavior is much more
complex and, in many cases, doubtful. Of course, the size
of the incentive and its form — penalty or reward — could
influence participation rates even further. But there’s little
evidence that financial incentives alone significantly boost
program participation.
The mixed success of incentives in changing employee
behavior is prompting many employers and experts to rethink
their use. While U.S. employers haven’t given up on incentives
entirely, nearly nine in 10 plan to reassess their incentive
designs over the next three years (Figure 23). And employers
are increasingly looking at ways to redesign their incentive
programs by extending well-being programs and incentive
opportunities to family members, refreshing their incentive
21
Improving workforce health and productivity
programs’ designs regularly, and using best practices in both
choice architecture and nudges to keep employees interested
and engaged for longer periods.
Figure 23. Reassessing incentive designs
0%
20%
40%
60%
80%
100%
Reassess incentive strategy: Reassess your organization’s
philosophy and approach to incentives
30
33
24
Family matters: Apply rewards (or penalties) and/or
requirements under health management programs/activities
to employees and spouses alike
42 5
25
Refresh: Refresh the incentive strategy annually to encourage
trial of new health-related activities
29
17
26
Progress-based: Design programs to measure and reward
individuals for making progress toward a healthy lifestyle
26
7
37
Team-based: Reward locations or teams that achieve high
levels of health engagement
14
6
Action taken/tactic
used in 2015
24
Planned
for 2016
Being considered
for 2017 or 2018
Note: Based on respondents offering incentives in 2015
Again, employers can look to their employees for guidance
in developing or restricting their programs. Are financial
incentives necessary for employees to participate in
health and well-being programs? Figure 24 shows that U.S.
employees — who’ve been offered more financial incentives
for longer periods than employees in any other market — are
the most reluctant to participate without an incentive.
But there are limits to the extent that financial incentives
alone can bring about sustainable behavior change.
Emerging ideas about redesigning the workplace, delivering
personalized messages enabled by new technologies, tapping
into regular channels of social interactions in the workplace,
and openly recognizing employees’ health and well-being
accomplishments are taking root. In some organizations, the
implementation of these ideas is helping employers foster
changes in employee behavior that can become lasting habits
focused on overall healthier lifestyles, rather than changes
prompted only by the narrow achievement of rewarded goals.
Increasingly, employers understand the long-term value of
sustainable behavior change and are shifting their focus on
strengthening an element that can speed such change — the
workplace.
Do U.S. employees feel entitled to such incentives? Or has
the long duration of these incentives sapped the intrinsic
motivation of employees to participate in these programs?
The dilemma facing employers is that many employees
have come to expect incentives even as employers are
reconsidering their use. Any attempts to pull back on the
use of incentives could lead to further erosion in already low
levels of program participation.
Where do we go from here? Clearly many employers are
looking to restructure their incentive program designs,
which in many cases pivot significantly from the high-priced
approaches that have become popular in recent years.
There’s growing evidence that well-designed programs,
which use small steps that employees believe are achievable
and provide real-time rewards, can be equally effective at
fostering complex behaviors such as sustainable changes in
physical activity and compliance with medication regimens.
Employee perspective
Figure 24. U.S. employees increasingly view financial incentives as a condition of participation
Option B: I would participate in a company health
initiative only if there were a financial incentive (prize
or other financial reward).
Option A: I would participate in a company health
initiative without a financial incentive.
Strongly prefer
Prefer
Slightly prefer
44
Global
U.S.
Canada
Europe
Neutral
33
23
42
41
44
29
30
30
29
69
48
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Strongly prefer
32
15
25
Source: 2015/2016 Global Benefits Attitudes Survey
Option A includes groups 1, 2 and 3; 4 is neutral; and option B includes groups 5, 6 and 7 on a seven-point semantic scale.
22
Prefer
24
Latin America
Asia Pacific
Slightly prefer
16
27
Beyond incentives – building a workplace
culture of health
U.S. employers are using a variety of strategies to encourage
smart health-related behaviors. Not surprisingly, given the
health plan’s central role in delivering care to employees and
their families, half of surveyed employers see the plan as their
primary vehicle for encouraging healthy employee behaviors.
Medical professionals also play an important role in coaching
and educating employees, and 40% of employers look to
their health care provider community to influence employees’
health-related behaviors (Figure 25).
Direct financial incentives can be effective at raising
employee awareness and achieving simple, well-defined,
short-term behavior change. But employers want to improve
employees’ health and well-being over the long term. That
requires them to tap into employees’ intrinsic motivations,
which are stronger drivers of behavior change than extrinsic
factors such as rewards.
Above all, employers are turning their attention to the entire
employee experience and how it ties to workplace health.
Our survey data show that, by 2018, nearly two-thirds of U.S.
employers expect building a health-promoting workplace
culture will be their primary means of boosting employee
engagement in health. This represents a significant shift,
as only one-third of employers say it’s one of their core
strategies today. Also, fewer employers — from 70% in 2015
down to 47% in 2018 — expect to rely on direct financial
incentives in the future.
Over the next few years, employers will continue to rely
on plan designs and local providers to drive employee
behavior change. But the role of care delivery is evolving as
the numbers of urgent care centers, telehealth centers and
minute clinics grow quite rapidly, providing alternatives for
individuals needing immediate care for acute conditions. As
the relationships between providers and patients become
less sticky, primary care as a hub for managing health-related
behavior may become less apparent. Instead, worksites,
public health initiatives and communities where people
frequently gather could become more instrumental.
Figure 25. Building a healthy workplace culture is becoming the primary employer strategy to boost health engagement
80%
70
60%
51
40%
50
64
47
40
42
20%
34
18
0%
Focus primarily
on plan design
2015
23
Almost 2/3 of employers
expect that building a
culture of health will be
the primary strategy
to promote healthy
behavior by 2018.
2018
Improving workforce health and productivity
Focus primarily on
direct financial
incentives
Rely primarily on
providers, medical
professionals
and emerging delivery
system models
Focus primarily on
strategies to build
the health and
well-being of the
workplace and culture
3
No strategy to
encourage
healthy behaviors
Figure 26. Ingredients for a healthy workplace culture
0%
20%
40%
60%
80%
Organizational goals and leadership
Our senior leaders are visible champions of our
health and well-being strategy
51
Our organization has built health and well-being into
its employee value proposition
49
Employee health and well-being is included in our
organizational goals or value statement
Tools are provided to managers to support their efforts
to promote employee health and well-being
38
Physical environment
Improve the physical environment to encourage
healthy behaviors
70
Certify or audit the work environment and health and
well-being programs to align with the culture
23
Social environment and norms
Have local health champions
and/or committees to promote a healthy workplace
62
Use employee testimonials and personal stories
61
Use key influencers and viral messaging to communicate
through the organization's social networks
32
Personalization and technology
Ensure all online tools are available for at-work and
at-home access
74
Have a dedicated portal to deliver health information
or health challenges
58
Encourage employees to offer suggestions to change
the work environment to improve their well-being
56
Invite family members to participate in various programs
and activities
35
Use consumer marketing techniques to develop a
customized/targeted communication strategy
28
Percentages indicating “Yes” the program or activity is in place
willistowerswatson.com
ƒƒ
Obtain commitment from leadership
ƒƒ
Establish supportive physical and social environment
ƒƒ
Make it personal
ƒƒ
Leverage technology
Obtain commitment from leadership
40
24
100%
What steps are employers taking to build a workplace that
supports employee health and well-being? As shown in
Figure 26, employers are embracing a range of activities
whose approaches fall into four categories:
Health and productivity programs start with senior leaders
who control resources (financial support, employees’
time and access to space) and can eliminate obstacles.
If employers are to transform their health and well-being
strategy into a primary differentiator of their EVP — a goal of
most organizations — only senior leaders can foster the value
system and commitment required to address, support and
align efforts within the organization.
Roughly half of organizations have embedded well-being
into their EVP, and two in five have made it an organizational
goal. Line managers play a critical role in reinforcing
messages from the top and driving the strategy through the
organization. But to make the vision a reality, managers need
regular reinforcement and guidance, and only about one-third
of employers provide managers with the tools they need.
Establish a supportive physical and social
environment
The physical work environment can give employees daily
reminders about health and well-being. Seventy percent of
organizations have incorporated health into the workplace via
initiatives such as healthful cafeteria foods, walking paths and
campus bike-sharing programs that make it easier and more
affordable for employees to adopt good health habits.
But evidence is building an increasingly strong case that
the psychosocial aspects of the work environment are
the keys that can unlock workforce potential. Getting it
wrong can introduce additional stress and anxiety, thereby
eroding employee loyalty and weakening job performance.
Getting it right can provide one of the strongest supports
for an organization’s well-being strategy, serving to inspire
and encourage employees daily. Also, many employers
are tapping into the power of peer influence through local
champions (62%), personal stories (61%) and key influencers
who spread the word (32%).
Employee perspective
Figure 27. Employees are using emerging technologies
to help manage their health and well-being
Make it personal
0%
As everyone has unique personal challenges, workforce
health and well-being ultimately comes down to individuals
making personal commitments. An important approach —
already in use by 56% of employers — is asking employees
what’s missing from their well-being experience and, more
importantly, what they need to succeed at work. Personalizing
messages and tailoring programs to meet workers’
individual needs strengthen employees’ connections to the
organization’s initiatives. However, only 28% of employers
use segmentation techniques to develop customized
communication.
Websites with ratings of doctors/hospitals
40%
60%
35
80%
32
Wearable devices to monitor fitness activity
28
26
Apps to track diet
26
27
Price-comparison sites for health products/services
25
31
Online consultations with medical professionals
23
30
Apps to monitor a health condition
21
Leverage technology
27
Apps to monitor sleep/relaxation
20
Many employers harness the latest technologies to put
health improvement tools into employees’ hands via the
organization’s intranet. Three-quarters (74%) of U.S.
employers make online health-related tools accessible to
workers both at work and at home. And more than half
(58%) have a portal devoted exclusively to health-related
information, including promotions about individual and team
health challenges.
An emerging area of focus is the remote worker or workfrom-home cohort, a large part of the workforce that can be
hard to reach. This is where technology and social networks
can help bridge the gap. Our recent Global Benefits Attitudes
Survey found that employees appreciate these efforts and
tools. More than half of surveyed employees said wearable
devices for monitoring fitness-related activity, apps to track
dietary activity, and websites with ratings of health care
providers and price comparisons of health-related products
and services are important to them (Figure 27).
20%
23
Online forums on health issues
16
Very important
28
Moderately important
Source: 2015/2016 Global Benefits Attitudes Survey, U.S.
Note: “Very important” reflects options 4 or 5; “Moderately important”
reflect 3 out of 5 on a five-point importance scale.
Sample: Full-time employees with an employer-sponsored health plan
The pursuit of a healthy workplace culture is gaining traction.
Between 2013 and 2015, many more organizations decided
to entrench health and well-being more deeply into their
organization, especially by seeking input from employees and
getting managers and change agents within the workplace
more involved (Figure 28).
Figure 28. The pursuit of a healthy workplace culture is gaining traction
25
2013
2015
Change
Encourage employees to offer suggestions to change the work environment to improve
their well-being
36%
56%
20%
Provide tools to managers to support their efforts to promote health and well-being
20%
38%
18%
Have local health champions and/or committees to promote a healthy workplace
45%
62%
17%
Include employee health and well-being in organizational goals or value statement
24%
40%
16%
Use employee testimonials and/or personal stories
47%
61%
14%
Certify or audit the work environment and health and well-being programs to align with
the culture
10%
23%
13%
Use consumer marketing techniques to develop a customized/targeted communication
strategy
17%
28%
11%
Improving workforce health and productivity
Financial well-being
Figure 29. Financial health is becoming a key part of
organizations’ well-being strategy
0%
20%
40%
60%
80%
100%
Include financial well-being as a key part of overall workforce
well-being
47
16
While organizations are embedding health and well-being
more deeply into their core mission and values, they’re also
starting to adopt a more holistic approach to employee
well-being. There’s considerable — and growing — interest
in employees’ financial well-being and in incorporating that
element into the organization’s broader well-being strategy.
Why? Because financial worries constitute a significant
source of stress for many employees, and employers are
recognizing the emotional toll and negative effects of
such stress on engagement in health programs (see box:
Clustering of health and financial issues, page 27).
17
Bring third-party vendors onsite as counselors/educators
to promote financial well-being
54
12
12
Offer or promote use of technology-based resources
47
12
15
Deliver customized or targeted messages to help improve
financial well-being
33
16
18
Offer a comprehensive program of tools, seminars
and education
32
11
19
Nearly half (47%) of surveyed U.S. employers have a personal
financial well-being strategy for their workers, and another
33% either plan to adopt such a strategy by 2018 or are
considering doing so (Figure 29). Many employers are already
doing one or all of the following:
Include financial well-being module or questions in
health risk assessment
24
11
22
Use rewards for individuals who participate in financial
well-being activities
12
8
ƒƒ
Bringing third-party vendors onsite to educate and counsel
17
Action taken/tactic
used in 2015
Planned
for 2016
employees on improving their financial health
Being considered
for 2017 or 2018
ƒƒ
Offering or promoting the use of technology-based
resources
ƒƒ
Delivering targeted messages customized for various
workforce segments about ways to improve financial
well-being
Employee perspective
Figure 30. Employees are uneasy with employer involvement in their personal financial matters
Personal financial issues
Option A: Employers should take an active role
in encouraging their employees to better manage
their finances.
Strongly prefer
Prefer
Option B: It is not the role of an employer to
encourage its employees to better manage their
household finances.
Slightly prefer
Neutral
42
Slightly prefer
Prefer
Strongly prefer
17
41
Targeted messages
Option A: I am comfortable if my employer sends
targeted messages to employees about financial
issues.
30
Source: 2015/2016 Global Benefits Attitudes Survey
Sample: Full-time employees with an employer-sponsored health plan
26
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Option B: It is not the role of an employer to send
targeted information to employees who aren’t saving
enough.
20
50
Clustering of health and financial issues
The reason for employers’ interest in employee wellbeing is clear: Employees are their greatest asset.
Employees who are healthy — both physically and
emotionally — and also financially secure bring their
best self to the job each day. In contrast, employees
who are distracted by health or financial issues are more
stressed, miss more work, face more health-related risks
and are less engaged at work, according to the findings
of our Global Benefits Attitudes Survey.
More than one-quarter of employees face both health
and financial difficulties, thereby amping up the stress
level and the accompanying engagement and productivity
challenges (Figure 31). These employees are twice as
likely to be highly stressed, miss twice as many work
days and are nearly twice as likely to be disengaged with
their job as are employees who are healthier and more
financially secure.
As employers build a holistic approach to employee
well-being, it’s important that the solutions reflect the
multifaceted challenges many employees face each
day. That alignment helps employers forge stronger
connections with their employees, improve job
performance and foster stronger employee loyalty.
Employee perspective
Figure 31. Employee health and financial issues erode job performance
Have financial worries
No financial worries
With health issues
In good health
With health issues
In good health
Percentage of workforce
27%
25%
16%
32%
Highly engaged
30%
41%
43%
51%
Disengaged
27%
23%
19%
14%
4.1
1.9
2.6
1.5
Presenteeism days
12.3
9.6
10.8
7.6
Plan to work to age 70+
50%
41%
16%
14%
High work-related stress
44%
42%
29%
21%
High BMI (obese)
48%
19%
37%
12%
Sleep 7 hours per night
40%
53%
53%
63%
Sick days
Source: 2015/2016 Global Benefits Attitudes Survey, U.S.
Sample: Full-time employees with an employer-sponsored health plan
Some employers increase employee awareness of the effect
of financial well-being on overall health by including a module
or question about finance-related stress in the health risk
assessment. Roughly one-third (37%) are either rewarding
employees for participating in employer-provided financial
well-being activities or plan to offer such rewards within the
next three years.
Some of the challenges in implementing financial well-being
initiatives are unique. Forty-two percent of employees are
uncomfortable with their employer being involved in their
personal financial matters (Figure 30, page 26). Employees
are even less comfortable with targeted messages about
their personal finances — a tactic employers commonly use
to promote good physical health habits.
27
Improving workforce health and productivity
So employers must ask themselves: Do we have permission to
take a more active role in our employees’ financial well-being?
How can we build employees’ trust so they’ll listen to our
messages about financial health and use the tools we provide?
Our recent Global Benefits Attitudes Survey found that
employers have an established track record around health
and well-being, as well as retirement planning. But when it
comes to employees’ personal finances, employers need to
proceed carefully and gradually to gain employees’ trust. For
example, using pull rather than push approaches to market
the programs allows employees to engage when they’re
comfortable. Word-of-mouth and regular promotions, over
time, engender trust and strengthen employers’ connections
with employees around all aspects of their well-being.
What highly effective employers are doing
As in previous years, our 2015/2016 Staying@Work
Survey found strong links among highly effective health
and productivity strategies, high-performing employees
and strong financial results. To evaluate the effectiveness
of health and well-being programs, we asked employers
to rate their performance in 20 areas related to health
and productivity. The assessment covered both health
program effectiveness and elements of the workplace
experience. The employers assessed their own effectiveness
in providing elements essential to developing a healthy,
effective workforce. Taken together, the responses reveal
the effectiveness of an organization’s health and well-being
strategies and programs.
We call the effectiveness metric the organization’s overall
health and productivity effectiveness (OHPE) score (for
more details, see box: Effectiveness methodology). Using
respondents’ OHPE scores, we divided them into three
groups of equal size. We found that employers in the group
with the highest OHPE scores take a distinctive approach to
health and productivity — and their programs are clearly more
successful than those of employers with lower scores.
Their strategy and tactics
High-OHPE organizations take a holistic view of health and
productivity and connect their strategy with the organization’s
EVP. They primarily focus on four vital elements:
ƒƒ
Prevention. They offer a range of programs to keep
employees healthy and encourage them to adopt and
maintain healthy lifestyles.
ƒƒ
Personal support. They address the specific health needs
of employees who have health-related risks and chronic
conditions. And for disabled employees, they use best-inclass return-to-work approaches.
28
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Effectiveness methodology
(OHPE Score)
To evaluate the effectiveness of organizations’ health
and well-being programs, we asked participating
employers to rate their performance in 20 areas
related to health and productivity. Based on these
employer-provided ratings, we created an overall
score for each organization by adding equally
weighted values to their responses. This approach
allowed us to summarize all facets of an effective
health and productivity framework in a single variable
— which we call the organization’s overall health and
productivity effectiveness (OHPE) score.
We then divided the respondent cohort into
three equally sized groups based on the scores.
Organizations with the highest scores are deemed
to have the most effective health and well-being
programs.
For an in-depth look at the characteristics of effective
health and well-being programs, Willis Towers Watson
also developed the Health and Productivity Scorecard,
which inventories the programs and policies of
employers in each of the three effectiveness groups.
In each world region, we’ve identified the programs
and tactics of the organizations with the most
effective health and well-being programs. These best
practices provide a road map for employers to follow
as they consider the next steps of their health and
well-being strategy journey.
ƒƒ
Organizational support. They work at building a healthful
workplace culture and aligning their health and well-being
programs with that culture. They also have senior leaders
that champion the programs.
ƒƒ
Design and delivery. They align their health and well-being
programs with the organization’s EVP, provide employees
with an array of choices, leverage the latest technology,
and use targeted communications to reach employees
where and how they prefer. And, of utmost importance,
they measure the effects of their health and well-being
programs on both individual and workforce productivity.
Their results
First, the employees of high-OHPE organizations are more
engaged in their own health and well-being. This is evidenced
by participation rates in health and well-being programs that
are 21 percentage points higher than the participation rates at
low-OHPE companies (60% versus 39%) (Figure 32).
Second, high-OHPE organizations in the U.S. have better
health outcomes and fewer absence days:
ƒƒ
Medical plan costs are $1,000 lower per employee than
organizations with low OHPE scores (Figure 33)
ƒƒ
29% fewer employees using tobacco
Figure 32. Health and well-being program
participation, U.S.
ƒƒ
24% fewer employees with hypertension
ƒƒ
23% fewer employees with high blood glucose levels
Overall health and productivity effectiveness
0%
10%
20%
30%
40%
50%
(Figure 34, page 30)
60%
ƒƒ
One fewer day of unplanned absence per employee per
Any well-being program
year (Figure 35, page 30)
39
51
21 pps
60
Figure 33. Medical costs and trends, U.S.
Health risk assessment
Overall health and productivity effectiveness
41
46
16 pps
57
$0
$3,000
$6,000
$9,000
$12,000
Medical/Rx costs PEPY (unadjusted)
12,356
Biometric screening
12,124
41
46
0%
Worksite diet/exercise activities
1%
2%
3%
4%
6.0
–0.9 pps
5.3
Web-based lifestyle behavior coaching
Cost trends after plan changes
12
4.4
11 pps
13
4.0
23
–0.9 pps
3.5
Stress or resilience management program
11
9
13
29
6%
6.2
9 pps
27
Low
effectiveness
5%
Cost trends before plan changes
18
20
11,334
14 pps
55
–$1,022
Medium
effectiveness
Improving workforce health and productivity
2 pps
High
effectiveness
Low
effectiveness
Medium
effectiveness
High
effectiveness
Third, like their peers around the world, U.S. employers
with highly effective programs are more likely than loweffectiveness companies to report improving financial and
human capital performance:
Figure 34. Lifestyle risks, U.S.
What percentage of your employees have the following
health risk status?
Overall health and productivity effectiveness
0%
10%
20%
30%
40%
ƒƒ
Nearly 60% more likely to significantly outperform their
peers financially (Figure 36)
Obesity (BMI ≥30 kg/m2)
35
34
–2 pps
33
ƒƒ
50% higher revenue per employee — a proxy for
productivity (global finding)
ƒƒ
Market premiums that are nearly three times higher (global
Tobacco use, current
finding) (Figure 37, page 31)
15
11
11
–4 pps
Figure 36. Self-reported competitive performance, U.S.
Over the past year, how has your organization compared to
other organizations in your industry in the country/region
for which you’re responding to this survey?
Hypertension/High blood pressure
systolic ≥140 or diastolic ≥90)
22
15
–6 pps
16
70%
60%
High glucose level (≥100 with fasting)
62
22
18
–5 pps
50%
17
40%
Diabetes
41
37
8
–2 pps
7
6
30%
20%
Low
effectiveness
Medium
effectiveness
High
effectiveness
31
33
32
26
23
15
10%
0%
Below peers
Low
effectiveness
Figure 35. Absence, U.S.
Overall health and productivity effectiveness
0
1
2
3
4
5
6
Unplanned absence 2015
5.1
4.0
–1 day
4.1
Low
effectiveness
30
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Medium
effectiveness
High
effectiveness
Same as peers
Medium
effectiveness
Above peers
High
effectiveness
Figure 37. Financial outcomes, global
Overall health and productivity effectiveness
$0
$100
$200
$300
$400
$500
Productivity (revenue per employee) in thousands
319
$161
395
480
0%
10%
20%
30%
40%
50%
U.S. employers with highly effective programs
have market premiums that are nearly three
times higher.
60%
Market premium (Tobin's Q)
19
37
33 pps
52
Three-year change in market value — 2011 to 2014
37.5
43.1
7.5 pps
45.0
Low
effectiveness
Medium
effectiveness
High
effectiveness
Source: Standard & Poor’s Compustat, Global Vantage
Market premium (Tobin’s Q) is the ratio of the market value of equity
in 2014 plus the book value of debt divided by the book value of assets
minus one. The data are from 750 organizations whose financial
information was publicly available at the time of the survey (221 APAC,
113 Europe, 94 Latin America, 322 North America). Industry adjustments
were based on a multivariate dummy variable regression model using
industry classifications (n = 31) from the survey to define industries.
31
Improving workforce health and productivity
Improving health and productivity means going beyond programs
To reap the rewards that a strong health and productivity
strategy can deliver — and to make good on their commitment
to improving workforce health — employers can consider
the lessons provided by high-OHPE organizations. Their
strategies are based on four pillars: prevention, personal
support, organizational support, and sound program design and
delivery (see box: Designing an effective employee health and
productivity framework, page 33).
These pillars can form the basis of a formal, enterprise-wide
health and productivity strategy. They can help employers forge
disparate programs into a cohesive whole that has enormous
potential to address vexing, persistent issues such as weak
employee participation and insufficient resources.
Moving ahead: employers have an opportunity
for an employer-employee partnership to
improve health
Employers have the opportunity to engage their workers in
their own health and well-being by involving your workforce in
an assessment of their health-related needs and preferences.
Armed with this knowledge, employers can direct health and
32
willistowerswatson.com
productivity resources to address, first, the most serious
threats to workforce health and, second, the identified
needs of individual locations, regions and various workforce
segments.
By delivering the right messages to employees via the
appropriate channels, they'll become educated about health
risks and proven methods of health improvement. As programs
mature, transitioning to less frequent screenings and health
assessments may lead to more sophisticated, differentiated
approaches to personalizing well-being messages.
Employers can make communication programs more effective
by segmenting the workforce according to employees’
communication preferences and health needs, and then
delivering targeted, personalized messages. Using the full
range of today’s communication technologies will provide
the opportunity to reach workers how, when and where they
prefer. And placing health-related messages within the context
of the overall employment deal will help current and potential
employees understand the value of health and well-being
programs and the employer-employee deal.
What about the most common barriers to health and
productivity effectiveness? Employers can do several
things to overcome them, the most significant of which are
measurement and data analysis.
Measuring the effectiveness of health and well-being programs
will provide quantitative data. Focus on tracking absences
and the effects of absenteeism on productivity. Then use that
information to build a business case for additional investments
in staff, programs, activities and communication needed to
make a high-OHPE organization. Then use the data to enlist
the support of senior leaders in enlarging the budget for
funding your organization’s health and productivity strategy.
This goes beyond return-on-investment, which relies on
medical cost reductions. Leading employers are connecting
their well-being initiatives to a broader set of value drivers,
including employee engagement, turnover, workplace safety,
employee absence rates and other productivity measures
important to the organization.
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Improving workforce health and productivity
Designing an effective employee health and productivity
framework
Prevention: keeping
people healthy
ƒƒ
Health promotion and
safety
ƒƒ
Prevention and
screenings
ƒƒ
Lifestyle
ƒƒ
Emotional health
Personal support:
addressing health needs
ƒƒ
Stay at work/Return to
work
ƒƒ
Care delivery and onsite
services
ƒƒ
Health advocacy
ƒƒ
Financial support and
education
Organizational support:
building a healthy
workplace culture
ƒƒ
Leadership and
alignment
ƒƒ
Measurement and
accountability
ƒƒ
Work environment and
flexibility
ƒƒ
Funding and resources
Design and delivery:
building high-performing
programs
ƒƒ
Engagement approaches
ƒƒ
Technology
ƒƒ
Communication and
change management
ƒƒ
Program management
Summary: good intentions, formidable
obstacles, notable successes
The survey data sends a clear message: For a large majority
(84%) of U.S. employers, health and productivity is a core
component of their organizational health strategy, and a
majority plan to sharpen their focus on building workforce
health and well-being in the coming years. This is because
they recognize the impact of sedentary lifestyles, obesity,
stress and financial challenges on both health care costs and
overall productivity. They understand that a strong health and
productivity program will strengthen the EVP and help the
organization compete.
Employers who are doing these things well are achieving
degrees of success with their health and productivity
strategy. These high achievers serve as role models whose
approaches can be borrowed and adapted.
Though half (51%) of surveyed U.S. employers don’t yet have a
formal health and productivity strategy, many plan to develop
one soon. As this finding mirrors that of our 2013 survey, it’s
clear that many employers haven’t yet been able to follow
through with their plans. Among the primary obstacles are
inadequate employee engagement in health improvement and
insufficient evidence of a positive return on the investment
in health and well-being programs — the latter of which has
made it difficult for employers to build a case for sufficient
budget and staff to implement a wise strategy.
ƒƒ
Build a strong foundation. Create and implement a
For a large majority (84%) of U.S. employers,
health and productivity is a core component
of their organizational health strategy, and
a majority plan to sharpen their focus on
building workforce health and well-being in
the coming years.
Despite the barriers, most U.S. employers are moving away
from a primary focus on program design and taking a broader
view of health and well-being. It’s an approach that factors
in the workplace environment, organizational culture and
employee experience, and attends to employees’ financial
well-being as well as their physical and emotional health.
Employers engaging in this approach are increasing their
measurement of not only program participation but also
program effectiveness, and they’re analyzing data to quantify
the return on their health and well-being investments.
Furthermore, in their financial analyses, they’re reassessing
the use and effectiveness of financial incentives.
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The opportunities
Here’s how employers can learn from these leaders and
customize their successful efforts to meet your organization’s
unique needs:
realistic health and productivity strategy that aligns with
business priorities and EVP, and reflects the organization’s
unique challenges — whether they be a lack of employee
engagement, a limited budget, or organizational health
issues such as stress, lifestyle-related illness or changing
demographics. This will make it easier to identify highimpact programs and increase effectiveness.
The commitment of leaders in senior and middle
management, backed up by resources and budgets, is
also essential. Link health-related programming to other
corporate priorities such as safety, corporate social
responsibility, diversity and inclusion, and sustainability
where there’s clear alignment. This will help organizations
leverage additional resources and create an integrated
employee experience that aligns with clear business
priorities.
The commitment of leaders in senior
and middle management, backed up
by resources and budgets, is also
essential.
Managers can play a key role in
promoting organizational health by
modeling behaviors, encouraging
employees to take advantage of onsite
programs, and helping them eliminate
or reduce workplace stressors.
ƒƒ
Focus on the workplace environment. For nearly twothirds of U.S. employers, building an organizational culture
of health is their primary strategy for promoting healthy
employee behaviors in 2016. This means considering every
aspect of the workplace — from safety to the food offered
in the cafeteria and snack machines — as well as managing
levels of workplace stress and encouraging employees to
be tobacco free.
And the importance of managers and other influencers
continually promoting a culture of health at work can’t be
overemphasized. Managers can play a key role in promoting
organizational health by modeling behaviors, encouraging
employees to take advantage of onsite programs, and
helping them eliminate or reduce workplace stressors.
To get messages across, employers should use multiple
communication channels, such as posters, social networks,
mobile apps and other technologies.
ƒƒ
Offer programs across the full health continuum. Focus
on prevention by offering programs that encourage healthy
lifestyles and teach employees how to access the right
type of care at the right time. If low employee participation
rates are an issue for your organization, consider offering
a range of programs — including opportunities for physical
exercise, classes on stress management, guidance on
healthy living or onsite immunizations, for example.
Offering programs both onsite and off, and at various times
of day, can also encourage employees to take part. And as
financial well-being programs evolve, careful consideration
of employees’ attitudes about the employer’s role will be
important in addressing this significant aspect of well-being.
Offering programs both onsite and off,
and at various times of day, can also
encourage employees to take part.
35
Improving workforce health and productivity
ƒƒ
Leverage new technologies, and make them mobile. The
right technology can increase employees’ interest in their
well-being, and employers’ use of new technologies for
this purpose is gaining traction. Mobile applications help
break down the barriers to access and provide employers
with convenient ways to encourage employees to make
smart health-related decisions and use health care services
effectively. Websites that rate providers, wearable devices
that monitor activity and calorie intake, apps that monitor
health conditions, and price-comparison websites for
health products and services can help employees to make
wise decisions.
Telemedicine can help address simple medical needs
and reduce office visits. To build employees’ trust in the
programs, employers should assure employees that their
health-related data will remain private and secure, and
explain the steps taken to secure it.
To build employees’ trust in the
programs, assure them that their
health-related data will remain private
and secure, and explain the steps
you’ve taken to secure it.
ƒƒ
Personalize the experience. Personalization is another
powerful tactic for boosting engagement. Employers should
make it easy for employees to participate in programs, and
help them understand that the programs were designed
with them in mind. Create individual or team health
challenges such as walks, stair climbs and weight-reduction
activities, and offer prizes. Online tools should be available
both at work and on employees’ personal devices. Create
a dedicated portal to deliver health-related information and
promote health challenges.
Employers can also use consumer marketing techniques
such as segmentation based on health-related behaviors
to design targeted communication campaigns. Offer
specialized programs for employees with specific healthrelated risks, as well as best-in-class return-to-work
programs for those recovering from long-term illness or
disability. Make the connection personal and authentic,
so that the link between health and business success
becomes part of the organizational culture.
It’s important to clarify what’s driven
globally and what’s managed locally.
ƒƒ
Combine global consistency with local execution.
Organizations with operations in multiple countries can
drive synergies and leverage global economies of scale
in health and well-being programs, while addressing
local needs and cultural considerations. It’s important to
clarify what’s driven globally and what’s managed locally.
Organizations that spend time understanding local cultures,
and unique employee needs and behaviors — as well as
tracking the success of various approaches — have the
best chance of increasing program appeal and forging a
connection with employees around health and well-being.
ƒƒ
Continually manage and communicate to promote best
practices. A health and productivity strategy shouldn’t
be static, but should adapt to changing organizational
conditions, evolving best practices and the results of
your ongoing measurement of program effectiveness.
Ask employees to provide periodic feedback to ensure
programs remain relevant and meet ever-changing
workforce needs.
A health and productivity strategy
shouldn’t be static, but should adapt
to changing organizational conditions,
evolving best practices and the results
of your ongoing measurement of
program effectiveness.
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ƒƒ
Employers should know their numbers — and use
them. Establish a baseline, continually measure program
effectiveness using a variety of financial and nonfinancial
metrics, and make changes as needed. Collecting
data on organizational health issues, absence trends,
employee preferences, program usage and costs can
help organizations make data-driven changes, confirm
successes and promote cost-effective interventions.
Collecting data on organizational health
issues, absence trends, employee
preferences, program usage and
costs can help you make data-driven
changes, confirm successes and
promote cost-effective interventions.
There’s good reason for employers to be optimistic about
success going forward as they build an effective health and
productivity strategy.
The effort does require a strategic focus and strong employer
commitment. It also requires being sensitive to the unique
needs of various workforce segments and customizing
health and well-being tactics to meet varied employee
needs. But as the results from high performers demonstrate,
the effort can have a crucial payoff: Such a strategy can
deliver tangible results that will set your organization apart
from its competitors by linking your workforce's health and
productivity performance directly with your organization’s
success.
About Willis Towers Watson
Willis Towers Watson (NASDAQ: WLTW) is a leading global advisory, broking and
solutions company that helps clients around the world turn risk into a path for growth.
With roots dating to 1828, Willis Towers Watson has 39,000 employees in more than
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performance. Together, we unlock potential. Learn more at willistowerswatson.com.
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