And as positive results become more and more apparent, they are planning to invest even more in the coming years, according to the latest industry survey research.

“There are many competing studies that indicate that health and wellness programs are providing a strong return on investment in a variety of ways, affecting health care costs and reducing the most expensive medical claims,” says Robert Kennedy, health and wellness practice leader and benefit consultant at Fidelity Investments in Boston, Massachusetts.

“But it also seems that health and wellness programs have grown beyond the employee benefits program and have become part of corporate culture at many companies. Wellness has become part of a long-term strategy for improving the well-being of the workforce, not just reducing claims and premium costs, and is part of an employer’s overall value proposition.”

In addition to health insurance-based programs that target identification of risk factors and biometric screening, employers are increasing spending on health incentive programs, he adds. Employers are continuing to offer cash and gift cards as rewards in incentive programs, but increasing number are building reward systems around health savings accounts (HSAs) and flexible savings accounts (FSAs).

“While the use and measurement of corporate wellness programs continue to evolve, it has become clear that many employers understand the value—and are committed to—wellness-based incentives in their company health plan,” he explains. “Companies are constantly looking for new and creative ways to expand their programs and motivate their workforce such as extending wellness incentives to spouses and offering incentives through a contribution to a health savings account.

“Increasingly, employers are viewing health improvement even more broadly through the lens of well-being and productivity.”

Late last year, Fidelity Investments and its partner, the Washington-based Business Group on Health (NBGH) polled more than 150 corporations about their future plans for the design of and investment in wellness programs as part of their employee benefits.

Nearly all of the respondents (95%) said they plan to offer some kind of health improvement program to their employees and nearly three quarters (74%) plan to offer incentives for participating in the programs—up from 57% in the group’s first survey in 2009.

In the past five years, wellness spending has more than doubled from an average of $260 per employee in 2009. The survey also indicated that mid-market employers with fewer than 5,000 employees reported the biggest increase, up about one-third to an average of $594 in 2014 from about $444 last year.

About 93% of respondents said they plan to continue or increase investment in wellness programs over the next three to five years and about 44% of respondents said they plan to continue or increase spending on wellness programs—even if their companies choose to withdraw from offering group health benefits, as allowed under the Patients Protection and Affordable Care Act.

Although the survey targeted employers with as many as 5,000 employees—very large clients for independent agents and brokers—Kennedy said the results also point to opportunities for anyone that provides employee benefits consulting and services.

Based on the survey results, employers of all sizes are likely to increase their involvement in the wellness movement and will need to rely on advisers that provide the strategic and technical resources to execute evolving programs.

The survey also identified continued support for a wide variety of wellness programs. Most common of these include lifestyle management programs such as physical activity programs, weight management, tobacco cessation and stress management programs.

Other popular services include disease management programs, weight loss and personal health advice services, gym memberships, general health services such as on-site flu shots and environmental facilities such as bike racks and hiking paths.

Among the physical activity programs:
• 69% provide on-site or subsidized weight management programs, compared to 58% in 2009.
• 68% provide on-site fitness centers, up from 55%.
• 63% sponsor fitness and health challenges, up from 56%.
While on-site programs generally increased, one service, off-site gym memberships, declined from 64% in 2009 to 61% this year.

Healthy eating programs also increased in popularity. About 63% of respondents provide nutritional labeling of food in the workplace and healthy food options, up from 44% and 48%, respectively. About 37% provide healthy food discounts, compared to 20% in 2009.

Among health risk management programs:
• 97% provide employee assistance programs, up from 92%.
• 94% provide on-site Flu shots, up from 90%.
• 93% provide smoking cessation up from 66%.
• 90% provide health fairs and lunch programs up from 70%.
• 87% provide a 24-hour nurse line for consultation and advice, up from 79%.
• 43% provide an on-site medical clinic up from 32%.

Incentive amounts vary by program, ranging from an average high of $280 for smoking cessation programs and $200 for participation in disease management programs to about $100 for weight management, stress management and preventive care screenings.

In addition to disease management programs for diabetes, asthma and hypertension, employers are also expanding condition management programs to include maternity, back pain and cancer,

The survey also notes that increasing numbers of employers are expanding wellness programs to include spouses and domestic partners. About 37% said they will include spouses and domestic partners this year, providing an average incentive of about $530, over $100 more than previously. Large employers with 20,000 or more employees expect to spend an average of $611 on spouses and domestic partners this year.

Incentives are increasingly linked to consumer-directed account plan designs. More than one-third (34%) of respondents plan to contribute to an HSA or FSA for engaging in a disease management program, 33% plan to offer an incentive for participation in a stress management program, and 30% said they will contribute to a savings account in order to take part in a weight management program.

Helen Darling, NBGH president and chief executive officer, said the survey paints an encouraging picture of the future of wellness programs. “It is encouraging to see how the use of wellness programs has evolved since 2009, and how employers continue to look for ways to improve their plans and encourage engagement by employees.

“Based on the feedback from this year’s survey respondents, it’s obvious that wellness programs not only play a key role in many corporate health plans today, but they’ll continue to be an integral part of benefit management programs in the future.”

The author
Len Strazewski has been covering employee benefits issues for more than 30 years. He has an M.S. in Industrial Relations from Loyola University in Chicago.