For employees, participating in an employer-sponsored wellness program is ostensibly about living well, whether it allows them to focus their efforts to quit smoking, be present at home for their children or budget so they can better plan for retirement.

But research is showing a disconnect. A 2018 study by Willis Towers Watson found most employers (56%) believed their wellness programs allowed employees to live healthier lifestyles. Only 32% of employees in the study agreed.

Furthermore, a recent study presented by Alight Solutions found many employees said they were struggling to live a healthy life even though they were investing more in their health. This was particularly true for financial well-being efforts: fewer than half of employees surveyed by Alight felt they had control of their financial future.

Sources who spoke to HR Dive cited a variety of potential explanations for the gap in perception found by some researchers. Some are design and execution issues employers may have some ability to address — others are a bit more complicated.

Employees rushed, but also overwhelmed

An always-on, digital society has contributed to an economy that makes it difficult for employees to adjust, LuAnn Heinen, vice president of workforce well-being and productivity at the National Business Group on Health, told HR Dive in an interview.

"The pace of change is accelerating so quickly," she said. "We're all doing more with less."

Heinen said employers may need to address some of the problems employees face that are external to work within their wellness programs, health plans and similar levers. These "social determinants of health" include, housing, transportation and food, among other components.

Wellness programs might incorporate solutions such as providing shuttle buses to the office or starting an on-site farmer's market to address such issues. Still, Heinen said she feels that for most employers, "it's early days" on this front, meaning few have yet to truly consider the role of social determinants.

That's not to say wellness programs haven't expanded in their scope at all. In fact, many of these programs have grown to encompass more holistic aspects of well-being, Ray Baumruk, vice president, consumer experience research and insights at Alight, said in an interview. "Employees have responded favorably to that," he said, in part because they understand the connection between work and stress, among other health issues.

A greater amount of choice, though, has "created this unintended consequence of confusion," Baumruk said. Employees may feel pulled in many different directions — between financial, emotional and physical wellness options — and may not even know where to start as a result.

Underutilization remains a problem for employee assistance programs and like-minded initiatives, according to Benefitfocus Director of Benefits and Wellness Misty Guinn, because of a gap in perceived value between workers and employers.

"As an employer, we can no longer launch a wellness program and have it one size fits all," Guinn told HR Dive in an interview.

Personalization and navigation: the keys to communication

Communication can play a large role in improving the employee experience, but employers need to pay attention to how and when they deliver that communication, Baumruk noted. Timing can be just as important as frequency and volume. Getting benefits in front of employees when they need them "is more important than having said it five months ago," Baumruk said.

That may lead employers to adopt a strategy that can reliably deliver specific offerings at exactly the point in time in which employees need them. If an employee begins saving in the 401(k) plan, for example, the employer could notify the worker about additional financial resources.

Navigation support services could help to improve capabilities. Employees in need of caregiving support, for example, could find a home caregiver much faster than if they had tried to do so themselves, Heinen said. Some may prefer in-person options for talking about benefits instead of clicking through links, so employers need to be mindful of this as well, Baumruk said.

"The paradigm of the past is bringing people to benefits," Baumruk said, "but I think more of what needs to occur is bringing benefits to the people."

Guinn added that Benefitfocus follows a strategy of "smart moments" and "smart recommendations" with its wellness programming. Through its portal, the company asks questions to help fill in where its employees are in their search. It also shares statistics that can guide employees to new voluntary offerings, like identity theft protection.

In the end, employers need to encourage workers to be involved in their well-being in order to get programs to deliver on their proposed value, Guinn said. "Interacting with this benefit two times a year doesn't make sense," she told HR Dive. "You have to opt in and ask [employees] to get in the game with you."

Building a 'downhill slide'

Incentives aren't in and of themselves the reason behind a successful wellness program, Heinen said, but they can be effective in achieving certain health goals. She cited the example of General Electric, which in the early 2000s documented some success with using incentives in its tobacco cessation program.

But both Baumruk and Heinen agreed that beyond initial engagement, incentives don't necessarily sustain healthy behaviors. Baumruk suggested that employers attack the problem of sustaining behaviors in other ways, like creating reminders via engagement channels and creating spaces for testimonials and success stories.

"There's a role for incentives," said Heinen, who noted that money isn't the only reward: social incentives like walking groups, or even random raffles, can prove to be effective. Guinn noted past success with gamification and online challenges.

---

"Employee feedback is your secret weapon."

Misty Guinn

Director of benefits and wellness, Benefitfocus

---

When a monetary aspect is involved, Guinn said tying it to something like a free month of grocery delivery could help to demonstrate that the goal of the wellness program is supporting an employee's total well-being.

Employers should also focus on behaviors that employees already see value in and want to partake in, Heinen said, using the analogy of a downhill slide to describe incentives as things that provide easy momentum toward desired behaviors. "You want to get away from … how much money do we need to get people to do something," she said. "Think about what people want to do anyway."

Making use of metrics

Another area for wellness strategy improvement, highlighted in a recent study by Fidelity Investments, is the use of business metrics. Only 22% of employers surveyed by Fidelity said they tied their wellness programs to such metrics. Guinn said those in charge of benefits need to show they're "looking at the whole picture and all the dotted lines."

There are often two sides to metric conversations about wellness programs, Baumruk said. Employers view them in terms of how they help employees achieve things like higher productivity and lower absenteeism, he said, but there's also room for measuring whether the presence of such programs affects how employees feel about the organization and whether or not it's supporting them.

"Employee feedback is your secret weapon," Guinn said. Younger generations tend to be particularly open about where they rate on different aspects of well-being, she added, so capturing those feelings can be critical. Employers can use broad surveys to capture feedback, but Baumruk also suggested using immediate feedback about specific programs.

Measurements can be tailored to be industry-specific, too. Airlines might look at on-time departures between different hubs, and hotels could do the same with revenue per room night, both of which may be impacted by investment in employee health and well-being, according to Heinen. "Look at what are the metrics that matter to your business, and look and see if there's a way to tie what you're doing in wellness programs to your business goals," she said.