Study: Wellness programs show limited clinical results

Although the idea of investing in workplace wellness programs has grown in popularity over the past few years, a new study shows that there is little evidence these programs are in fact improving employee health and productivity.

The study, which was published in JAMA, looked at the profiles of employees at a U.S. warehouse company who were exposed to the company’s wellness program and found that this test group had self-reported greater positive health behaviors than those who were not exposed. However, there were no significant differences in the clinical measures of health after 18 months of wellness incentives.

Authors Zirui Song, M.D., an assistant professor of health policy and medicine at Harvard Medical School, and Katherine Baicker, Ph.D., a public policy researcher at the University of Chicago, looked at employment data, surveys and biometrics from between January 2015 and August 2016.

By 2018, 82% of large companies and 53% of small employers offered wellness programs, according to the study. Many of these programs focus on behavior modifications such as improved nutrition, greater physical activity and smoking cessation.

Despite their growing prevalence, there has been little data collected on the effectiveness of these programs, according to the study. So, the researchers focused on the effect of a multiyear workplace wellness program on health and economic outcomes in a middle- and lower-income employee population at locations across the eastern U.S.

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Self-reported health and behaviors varied most. After going through the program, respondents regularly exercised 8.3% more than those not in a program and 13.6% more carefully managed their weight than those not in an employee wellness program. Song told FierceHealthcare that the greatest impact of the wellness program was felt by workers aged 40 and older, who reported the largest increase in regular exercise.

In clinical measures, statistical differences were small and treatment worksites did not have a detectable effect on health. Those reporting high cholesterol levels in the wellness program were around 30.3%, versus 29.3% in the control group. For hypertension, the respondents were 26.5% in employee wellness programs versus 23.1% in the control group; obesity was 43.5% versus 43%.

So what did these programs ultimately cost employers? Medical spending was around $3,583 per employee for a year in businesses with wellness programs and $3,953 for employees not enrolled in a workplace wellness program. Pharmaceutical spending was a mean of $1,412 per employee in the treatment group versus $1,215 in the control group. And medical costs averaged $780 per year in the treatment group versus $778 in the control group.

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“The lack of differences in clinical measures of health between treatment and control groups at 18 months suggests that more time may be needed for behavior change to produce changes in health outcomes; another possibility is that health outcomes may have changed within the 18 months but reverted back towards baseline at the time of data collection,” Song said.

And employment outcomes were also similar between the two groups of surveyed respondents. Respondents in a wellness program were absent for a mean of 2.5% of scheduled work hours versus 2.6% in the control group. And employees scored better than three out of five in their job performance reviews in just over 60% for both demographics.

“Participation in the program led to no detectable effects on clinical measures of health,” the study concluded. “There were also no detectable effects on health care spending or utilization or employment outcomes.”

As such, the return on investment of wellness programs is still unknown.

“These findings suggest that health behaviors can respond to a wellness program, but they may temper expectations of such programs to generate a large financial return on investment in the short run,” Song added.