Unless your health plan has "grandfathered" status, you are already subject to the Affordable Care Act (ACA) requirement that preventive services (as defined on this government website) be included in your plan, and come without any employee deductible, co-pay or co-insurance provisions.

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ACA Pushes Preventive Care Wellness

2. Unless your health plan has "grandfathered" status, you are
already subject to the Affordable Care Act (ACA) requirement that
preventive services (as defined on this government website) be
included in your plan, and come without any employee deductible, co-
pay or co-insurance provisions. (This assumes, of course, that you are
large enough to be required to play or pay.)
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Also, ACA boosted, from 20 to 30 percent the maximum
incentive/discount you can give employees for participating in a
"health-contingent" wellness program, beginning in 2014. (The
percentage amounts refer to the cost of your employee-only health
coverage.)
A 50 percent incentive limit applies to smoking cessation programs.
Health-contingent wellness plans require employees to satisfy
specified health-related requirements (examples: achieving certain
results on a biometric screening, or meeting targets for an exercise
regimen) to earn the incentive benefit

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Many Programs Fall Short
So what makes a wellness program successful? A stark reminder of the
fact many aren't successful was part of a comprehensive study
published earlier this year by Rand Corporation.
Only 46 percent of employees who are offered wellness programs
"undergo clinical screenings and/or complete a health risk assessment…
and of those identified for an intervention based on screening results…
a fifth or less chose to participate," according to the study.

4. Your goal is have a program which is well above those averages, and
delivers results. A Sibson Consulting "healthy enterprise" study
found companies whose programs and policies place them in the top
quartile of the firm's "wellness index" achieved these results relative
to the rest of the companies surveyed:
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• 37 percent less extended employee absences (4 percent of
employees vs. 6 percent)
• 9 percent lower annual per member per year health costs
($3,431 v. $3,769)
• 33 percent lower employee turnover (8 percent vs. 12 percent)
• 17 percent lower Workers' Comp costs (.74 percent of payroll vs. .89
percent) and
• A 22 percent slower rate of increase in annual per member per year
health cost increases ($235 vs. $302)

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Patience Required
The following tasks and wellness program components, developed by a
group of employers and academics called the Change Agent Workgroup,
are critical to success:
The first step is to give up any expectations you can turn unhealthy
employee lifestyles and the resulting health problems around overnight.
One researcher concluded it generally takes three to five years for a
well-designed wellness program to achieve its full potential.

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• Develop and embrace an organizational vision of health. What would
having a very healthy workforce look like? What would the benefits be?
• Senior management participation and commitment. If you aren't involved
personally, your employees are less apt to take it seriously.
• Workplace policies and the work environment. Lecturing employees to eat
healthy foods, while having candy and high-calorie drink vending machines
scattered around the workplace undercuts your message. Ditto with
enabling employees to smoke at work.
• Diagnostics, informatics and health metrics. Use (or insist wellness program
vendors use) objective scientific measurements to assess individual and
group health, and progress towards improving it.
• Value-based plan design. Focus your attention and investment on high-
impact program elements to get the most bang for your buck.
• Patient-centered medical homes/chronic care management. Strive to
provide for employees with long-term conditions to receive medical care
from a coordinated team of healthcare providers who can focus on helping
the employee holistically.

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Behavior Change Support
In addition, Sibson Consulting encourages employers to incorporate
easy-to-use behavior change support mechanisms in their wellness
programs. These can include programs focusing on fitness, nutrition,
smoking-cessation and health coaching. Programs should focus on
optimal behavior, in a coordinated manner, from a holistic perspective.
Without turning you into the equivalent of a mother hen to your
employees, you should not limit the "optimal behavior" to the purely
physical/medical realm. Instead, also include employees' intellectual,
emotional, social and financial wellbeing "so the employee and the
business can thrive," Sibson maintains.
Finally, the design of effective wellness programs should reflect the
demographics of your company. Recent research on the impact of
gender and age with regard to participation in wellness programs
should be taken into account (see sidebar).

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Consider Your Employee Demographics
A study published in the April, 2013 issue of the Journal of Occupational
and Environmental Medicine titled "How age, sex and program
components relate to employee engagement and health outcomes"
offers useful insights for developing an effective demographically
customized health promotion program. Among the findings:

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• Females and older employees are more likely than others to enroll.
• Tangible (vs. cash) participation incentives such a T-shirt can actually
backfire and reduce enrollment.
• Cash incentives don't guarantee active participation in programs after
employees sign up and take the money.
• Biometric screenings boost the number of older employees who
enroll and participate in programs.
• Using onsite "wellness champion networks" improves behavior
changes for older adults.
• In female-dominated or gender-balanced workplaces, "special
strategies" may be required to get the men engaged in coaching
programs.

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