Category: Facts and Research

Employers, health plans, and government agencies all try to ascribe a value to healthy living.  Each one has their own motivation and perspective on why they care, but all of these reasons focus, to some degree, on managing healthcare expenses.  Since individuals (employees, members, etc.) are the focus of healthy living programs, program sponsors should focus on how to engage these users.  A multi-faceted approach works best, and most employers and health plans put rewards and incentives at the center of their engagement strategy.  One of the downfall of this approach is that the economics of participation are largely driven by the sponsor funding prizes to encourage employees to participate.  In addition to funded rewards, sponsors should also focus on the economic value of healthy living to the individual.  NOTE: Healthy living has numerous benefits, but this post focuses strictly on financial benefits.

A study suggests that individuals who exercise with as little as 30 minutes of walking for five days a week could save up to $2,500 a year.  This amount is multiples higher than most sponsor-funded rewards so wellness programs would be wise to educate individuals on this benefit if they believe financial rewards will drive the most engagement.  The study, published in the Journal of the American Heart Association, looked at data from more than 26,000 men and women and included researchers from leading academic institutions and hospitals, including Yale and Johns Hopkins.

To capture the data necessary for the study, researchers utilized the annual Medical Expenditure Panel Survey, which asks a large, representative group what they spent on healthcare (insurance premiums, pharmacy, etc.) in the past year.  It also captures information on diagnosed illnesses as well as lifestyle issues, such as income, educational level, and, most importantly, physical activity levels.  With all this information, the researchers split the respondents into two groups: those that met the national exercise guidelines (30 minutes of moderate exercise five days a week) and those that did not.  The analysis showed that individuals that met the national exercise guidelines spent $2,500 less in annual healthcare expenses as it relates to cardiovascular disease.  The savings included $400 on prescription medicines and far fewer emergency room visits and hospitalizations.  The researchers controlled for insurance coverage.

If financial incentives are a big part of their wellness engagement strategy, sponsors should focus on educating individuals on the lower healthcare costs associated with a physically active lifestyle.  Since the study focused on just cardiovascular disease, the researchers believe that the amount of savings could actually be much higher.

Category: Engagement

“The best job candidates may have their pick of companies to work for, but employers don’t always have their pick of the best candidates.  One reason for this is because some companies aren’t focusing on doing more to distinguish themselves from their competitors.”  An article in Forbes highlights the importance of creating benefit packages that appeal to the workforce an employer wants to build.  The article outlines eight unique benefits that can differentiate an employer from competing companies so they can secure new talent and retain the talent they currently have.  The list of suggested benefits resonated with the Wellable team.  Each one had a direct or indirect connection to employee health and wellness.  Below are the benefits suggested by Forbes and how these benefits relate to employee wellness.

#1 Benefits That Focus On The “Why”
Forbes: “The best ROI on benefits results when leaders focus on the ‘why’ and then develop benefit programs that align with the higher purpose.”

Wellable: Wellness programs often fail because employers misunderstand the reason for having one in the first place.  A healthy workforce has numerous financial and non-financial benefits, but the reason employers should have one is because they care about their employees and their well-being, not because they are trying to lower healthcare expenses.  This is why programs focused on cost reduction looks so different from those focused on the emoployee.

#2 Holistic Wellness With Rewards
Forbes: “This could include giving employees rewards for all things related to health — physical and emotional…These are so easily tracked on APPs and communicate that the company truly cares.”

Wellable: Not much to add here…

#3 Things Employees Actually Want
Forbes: “Poll them. Listen. Respond. One major company I know took away weekly, local fruit. They didn’t realize how much it would hurt morale.”

Wellable: Every company is unique, but a survey showed “employees expressed the greatest preference for wellness and fitness programs at work (30%) followed by a point-based rewards system (25%),” which could also a point-based wellness challenge.

#4 Mini-Sabbaticals
Forbes: “Distinct from vacations and leaves of absence, sabbaticals can be designed in one- or two-week increments every few years to allow employees time off to focus on development or simply to refresh and regroup, away from the normal demands of the job.”

Wellable: There are a number of ways to keep employees well, and an opportunity to refresh (through sabbaticals, flexible work schedules, or 6-hour work days) is certainly one of them.

#5 Development Opportunities
Forbes: When it comes to recruiting millennials, employers “are finding that employees want to work for companies that will invest in their personal and professional development.  The benefits of leadership development far outweigh ping pong tables.”

Wellable: Personal development includes learning to live a healthy and balanced life, manage stress appropriately, and achieve health-related goals.

#6 Parental Flexibility
Forbes: “Offer maternity and paternity leave, including to those who adopt children.  Additionally, allow for telecommuting and flex work schedules so parents can be involved in both their work and family lives.”

Wellable: Successful wellness programs support employees in trying to find the time to be healthy, especially when available time seems to shrink (during parenting).

#7 Personal Branding Help
Forbes: “When employees are encouraged to understand and share their personal brands, both the company and the employee benefit.”

Wellable: Ever talk with someone who successfully achieved a personal health goal?  Success in healthy living, especially when it involves a big change in someone’s life, is part of their personal story.

#8 A Sense Of Community
Forbes: “Companies that can create a powerful sense of community tend to attract and retain talent. Humans are wired for connection and seek belonging.”

Wellable: There are lots of ways to build community within an organization, and it does not always have to center around work.  Employees build community through fitness classes and team-based wellness challenges.

Category: Corporate Wellness

To counter criticism that wearable devices do not produce better health outcomes, Fitbit partnered with Fitabase to create a curated Research Library that contains an up-to-date reference list for studies that have used a Fitbit device.  From validations studies to innovative intervention and one-off case studies, the reference list covers nearly everything that has been published in peer-reviewed journals.  Currently, the resource includes 162 studies, and Fitabase will maintain the Research Library with new references and links to studies as they are published or meet the standards of acceptance.

In regard to corporate wellness research, Fitbit announced the results of two studies that looked at the impact of Fitbit on healthcare costs.  The company sponsored a study to evaluate the return on investment of workplace wearables.  The study reviewed three years of medical claims, pharmacy, biometric, and activity data to analyze a Fitbit corporate wellness programs at a large, self-ensured employer with more than 20,000 employees.  The study included 2,689 participants, 866 of which opted into the program and used the Fitbit tracker for some duration of the program.  The first year was a baseline.  The following two years looked at the impact of the Fitbit program.  The analysis found that the average cost of employees who opted into a workplace Fitbit program was reduced by nearly 25% (about $1,300 per person).  Of those who opted in, 266 employees used their Fitbit tracker for at least half the duration of the program and decreased their healthcare costs even more – about 46%.

Fitbit also referenced a smaller employer study from 2014 by the Dayton Regional Transit Authority (DRTA), which distributed Fitbits to about 600 of their employees.  The DRTA was able to see an improvement in health outcomes including an average decrease in LDL cholesterol levels of 12 points and in glucose levels of 17 points after one year, which the company estimated would save them about $2.3 million over two years.

It is important to note the Fitabase is going to included “nearly” every peer-reviewed study.  Which studies will not be included and why?  Hopefully, the criteria for including or excluding a study will not be based on the outcome.

Category: Facts and Research

Research from HealthFitness and The Connell Group shows that despite wellness program participants having greater satisfaction with wellness programs and perceiving themselves as healthier, nearly 60% of employees do not participate.  There have been numerous surveys trying to identify what causes individuals to not participate, including one covered in another blog post, that have shown similar barriers to engagement.

According to the survey, wellness program non-participants expressed interest in engaging with their program but refrained from actually doing so for a number of reasons.  The good news is that there is interest from non-participants and the barriers they identify are manageable by employers.

The biggest barrier reported by respondents was a lack of information (69%).  In some cases, the proportion of employees aware of programs’ availability is 30% lower than the proportion of employers indicating they offer the program.  Since it is hard to engage employees in a program that they do not know exists, employers should focus on increasing awareness as a means to combat the primary driver of non-participation.  One suggestion would be to communicate wellness benefits through a multi-media strategy that is comprised of traditional (print) and modern (digital) forms of communication.  Also, employers should consider the specific demographics of their population when determining the emphasis of each media strategy.  With digital distribution, employers should use analytics (open rates, click rates, etc.) to assess if the effectiveness of these tools.

Additional barriers include inconvenience, concerns about privacy, and reluctance to participate.  Using modern technologies, crafting and communicating an employee-friendly privacy policy, and surveying employees are great ways to challenge these other barriers.

The survey also showed that 79% of participants say they are extremely satisfied with their employer’s program offering compared to 41% of employee non-participants.  Participants also indicated they are likelier than non-participants to stay with their employer, refer someone to the company, and be more productive.  A clear majority (70%) of participants reported that their program offering means their employer cares about them.  A report from the Global Wellness Institute indicated that employers perceived as “caring” by the their employees have a workforce that is healthier, more productive, and more engaged.

Category: Mobile Wellness

A global survey from GfK suggests that one out of three people online (33%) currently monitor or track their health or fitness via an online or mobile application, fitness wearable, or smartwatch.  As expected, the adoption levels in the 16 countries that were part of the survey varied.  China led the pack with 45% of their online population tracking their health digitally.  They were followed by Brazil and the United States (both at 29%), Germany (28%), and France (26%).  In 11 of the 16 countries, adoption was greater in the male population relative to female.  The age groups 20-29 and 30-39 had the highest levels of adoption with 39% and 41%, respectively.  When asked why the respondents used health and fitness technology, the top responses were to maintain or improve physical condition or fitness (55%) and motivation to exercise.  GfK conducted the online survey to more than 20,000 consumers aged 15 years or older.

With such a large and growing number of individuals embracing these technologies, employers would be wise to incorporate the consumer wellness technology movement into their corporate wellness programs rather than fight it.  Often unknowingly, employers fight the movement by requiring the use of proprietary pedometers from a vendor, not integrating with the latest consumer technologies, and/or requiring the use of proprietary portals/apps that interfere with the consumer technology user experience.  Survey results like this should direct employers to support, rather than compete, with the consumer technology market.  The result will be better engagement at a lower cost.

An ongoing concern with wearable devices and digital health apps have been their ability to sustainably engage users.  The survey results also sheds light on the retention challenges these technologies face.  It revealed that 18% of people used health and fitness technologies in the past but do not currently use them.  Many of these users will likely re-engage with the technology but how many is still unclear.  This is an important consideration for employers looking to embrace the consumer technology movement.  Employers should be concerned about building programs around these solutions, but a quick review into current employer-focused solutions will reveal that sustainable engagement is a far bigger issue with the current offerings that they are likely using.

Category: Corporate Wellness

Work-life balance is something nearly everyone strives for.  There are many ideas behind what work-life balance is as well as many methods to obtain it within the workforce. There has been a lot of buzz about Sweden adopting a shorter work day to increase productivity and create a happier workforce.  Did shorter days deliver on the its promise?  The results vary.

6hourlogoIn a yearlong experimental study funded by the Swedish government, nurses at a retirement home worked six-hour days on an eight-hour salary.  A control group at another facility was used for comparison purposes.  The study wanted to explore the impact of shorter workdays on productivity.  The results showed that 68 nurses who worked six-hour days took half as much sick time as those in the control group, and they were 2.8 times less likely to take any time off in a two-week period.

The six-hour work day is not a new concept as it has been tested before by various organizations, in Sweden and across the world.  A Toyota service center in Gothenburg, Sweden has successfully run a six-hour workweek for 13 years, which has resulted in a 25% profit gain and increases in employee health.  However, one Swedish home care services company also adopted this work concept from 1989 to 2005, but it was abolished due to a lack of data proving it was beneficial.

It is worth looking at the pros and cons of this method of creating a work-life balance to see if it is appropriate for an organization.  A shorter working week may be successful for some organizations but not others.  It often depends on company culture and industry.


  • Employees working long hours may experience burnout and become unproductive due to fatigue. Adopting a shorter workday may decrease the chances of burnout.
  • Shorter workdays may be a successful perk to increase employee retention and decrease staff turnover.
  • An overall healthier workforce will increase productivity and decrease sick days.


  • For many jobs, a six-hour work day is just not feasible. For example, six-hour workdays for doctors, school teachers, or emergency personnel is not feasible due to the requirements of those positions.
  • Distractions happen at the workplace. According to a study, employees spend an estimated 1.5 to three hours per day on personal activities such as email and social media.  If the workday is six hours, then, according to this study, employees will only be working around four hours per day.  Employees with constant access to computers or mobile technologies are more susceptible to distractions like personal email and social media.
  • In industries that are competitive or customer-service based, employers have to maintain compatibility with their competition. Therefore, if a company is available to customers for eight hours a day, it is in the best interest of its competition to do the same.  Sometimes matching availability is not feasible for shorter workdays because the availability window does not break up easily.

Companies differ in many ways and adopting a six-hour workday may work for some companies but not for others.  It is important for companies to consider culture to determine what employees really need with regards to gaining support for their health and wellness.  A shorter workday is not the only way to support a work-life balance.  Employers can offer longer vacation or paid time off as well as telecommuting options.  Employers should focus on work-life balance, employee health, and burnout, but since each organization is unique, the appropriate solutions for promoting work-life balance will differ from group to group.  Asking employees what will benefit them the most is a great way to start.

Category: Facts and Research

A new study published in The Journal of the American Medical Association (JAMA) has the digital health, employee wellness, and wearable community abuzz.  According to the study, wearable activity trackers can count steps and calories burned but cannot help users lose weight.  In fact, the study suggests one could lose more weight without a device.  Before one cues the moment silence for the wearable market, the details of the study need to laid out on the table.  After a quick review, the deficiencies in the study will be apparent.

The Study
Scientists from the University of Pittsburgh Physical Activity and Weight Management Research Center sought out to discover the impact, if any, that wearable activity monitors could have on weight loss.  They recruited 471 overweight men and women ages 18 to 35 to participate in a weight loss program.  The age range for the study was selected so that participants would be competent and familiar with technology, such as activity trackers.  The participants were self-identified as wanting to lose weight.

For the first six months of the study, followed a straightforward, low-calorie diet designed for steady weight loss and were encouraged to be more active (specifically, at least 100 minutes of moderate activity each week).  The end of this program resulted in every participant losing weight.

At this point, the researchers divided the participants into two groups.  The first group was asked to begin logging their daily exercise sessions onto a study website.  The second group received BodyMedia SenseWear activity trackers that provides feedback to the user on step counts, calories burned, and more.  Through occasional check ins from counselors and encouraging text messages, participants managed to log into the study website or wear the device on most days of the 18-month portion of the study.

After 18 months, most of the participants had lost weight (although many had regained the weight lost during the first six months of the study).  The first group, who used the study website, lost an average of 13 pounds while the second group, who used activity trackers, lost an average of eight pounds.

Interpreting The Results
Like many people, the researchers were surprised by the results.  One explanation was that devices could potentially be demotivating.  Imagine a user being so far from their step goal near the end of the day that rather than trying to bridge to gap partially, they instead choose to give up.  Another explanation was the participants may have focused on the technology rather than behaviors.

When interested parties from the wellness community weighed in, they pointed out considerable flaws in the study.  First, they pointed out that the study started in 2010 and the market for these technologies has come a long since then.  For example, BodyMedia SenseWear is no longer being made and its parent company is on the verge of going out of business.  Also, that version of the device did not have a display, users had to log into a website to see their stats, and the device was a clunky piece of hardware that had to be strapped the user’s upper arm. Today, practically every tracker has a monitor that shows numbers in real time and can connect with friends for social support.

Other critics point out that the age group of the study is narrowly defined.  Also, the study evaluated whether a clunky, early fitness tracker was a useful add-on to an already robust weight loss regimen (counseling, text messages, education).

Regardless of one’s opinion on the study, one thing is clear: studies on digital health have a hard time keeping up with technology.  By the time a study passes peer review and gets published, the technologies being evaluated often change dramatically.  Hopefully, this study will prompt more research on the topic.

Category: Corporate Wellness

Personal, individual health coaching is a vital part of a successful wellness program because of its ability to help people cope with preventable health risks and conditions.  Preventable diseases cost businesses thousands of dollars a year.  The Centers for Disease Control and Prevention (CDC) reports that productivity losses linked to absenteeism costs employers $225.8 billion annually in the United States, or $1,685 per employee.  This number is even higher when productivity losses, morale, and temporary labor costs are taken into account.  Another survey projected that the average annual cost per employee for healthcare exceeded $9,800 in 2013. The number has risen steadily since then.

Almost all companies with 200 employees or more offer some sort of wellness program that is available to their employees, among these offerings is onsite individual health coaching.  These coaches act as personal cheerleaders to employees and influence the entire workplace culture with their approach and demeanor.  Anyone can benefit from the services of a health coach through some of the ways listed below.

Healthy Behavior Changes
A health coach can assist employees in making healthy lifestyle changes and breaking bad habits, such as smoking, unhealthy eating, lack of exercise, and chronic stress.  When working with a health coach, employees will be given the tools to identify unhealthy behaviors and strategies to turn the negative behaviors into positive ones.  Also, a health coach can help employees through the barriers that may be holding them back and guide them through their behavior changes each step of the way.  The personalized approach increases an employee’s chances of making sustainable changes towards the betterment of their health, and as a result, a healthier workforce allows a company to succeed.  In a recent study, participants lost a significant amount of weight when working with a health coach when compared to those working in a rigorous weight loss program without a health coach.  The study suggests that health coaches may be promising as a cost effective obesity treatment strategy.

Goal Setting
Setting goals is imperative to personal and professional success.  The challenges are that employees may not know how to set goals appropriately or how to successfully attain their goals.  A health coach can help your employees set goals using the SMART system, which is an acronym for specific, measurable, achievable, results-focused, and time- bound.  Working together, the health coach can assist an employee in making SMART goals for themselves and help them achieve these goals one step at a time through communication and feedback.

Stress Reduction
Stress effects all employees at some point in their lives.  Sometimes an individual may not know how to handle that stress turns to unhealthy behaviors to mask it.  Masking can include drinking, eating (unhealthy or too much/too little), overworking, or smoking.  Often, individuals don’t even realize they are turning to these bad behaviors in response to stress, which makes it even harder to self-correct.  A health coach can help employees identify stressors and work through them in a healthy and manageable way.

So how does this help employers?  When your employees are healthy, achieving their goals and managing stress appropriately, they are more productive, have less sick days, and consume less healthcare.  By having a health coach by their side, employees are more likely to incorporate healthy behaviors into their day and be more successful in their professional responsibilities, which in turn makes a company’s culture stronger and a lot healthier!

Category: Facts and Research

According to an online survey of 2,000 Americans from Ketchum, a global research and analytics firm, 47% of American smartphone users have an app that tracks fitness, working out, health, or medicine.  Furthermore, 83% of people who use fitness or workout apps use them at least once a week.  The results of the survey are not surprising as mobile health continues to become regular interaction for individuals across the country.

The results do, however, highlight a challenge employers must address when designing their employee wellness program.  More and more individuals are adopting consumer health and wellness apps, and despite having market leaders, no single app or device has more than 50% market share in any category (steps, nutrition, etc.).  As a result, employers must decide whether to embrace the consumer movement or disrupt it with their own proprietary program.  Wellable supports the former.  Rather than interfering with what nearly half of Americans are currently using, employers support employees as they seek out and user consumer wellness technologies.  This will result in more sustainable engagement by allowing employees to identify and use the solutions that are best suited for them.

The survey also found that there’s an opportunity to educate with just over half (51%) of respondents feeling they have a lot to learn about how mHealth can benefit their health.  This is where employers can add the most value.  Employers can help educate employees on the consumer wellness technology options available to them.  By helping to facilitate the adoption process and outlining the benefits of these solutions, employers will be driving their program to success.

Category: Corporate Wellness

A recent article published on Slate, an online magazine of news, politics, technology, and culture, called workplace wellness programs a “sham”.  The article went on to describe how these programs, defined largely by biometric screenings and health risk assessments (HRAs), are really just cost shifting mechanisms from employers to employees.  As we read the article, we found ourselves agreeing with most of the individual points made in the entire piece yet disagreeing with the overall thesis.  For all wellness programs to be shams, these programs, as defined within the article, must be solely defined by biometric screenings, HRAs, and a number of other selectively bad services.  That being said, it is imprudent to throw the good out with the bad and characterize all wellness programs as a sham.  At the very end of the piece, the author offers hope:

“To make their employees healthier, it’s clear, employers need to totally redefine what a wellness program is.  A wellness program that’s actually about wellness would be entirely voluntary, not financially coercive.  It wouldn’t collect any personal health information from employees.  It wouldn’t weigh people or take their blood samples.  It would be truly a benefit, not a cost-saving measure.  It might reimburse employees for their gym or yoga studio memberships.  It might subsidize a community-supported agriculture membership.”

The problem with the author’s call to action is that it assumes that programs like these do not exist and that all wellness vendors promote “sham” services.  For years, Wellable has been fighting against screenings, HRAs, and excess testing.  It would have been easy for us to add these services to our solution; instead, we wrote countless blog posts and a free eBook about the myths of biometric screenings.  Furthermore, all of our programs are voluntary and do not collect personal health information.  We don’t mention this with shameless self-promotion or as if Wellable is the only company with this approach.  We find that more and more employers, brokers, and health plans are moving away from wellness as a sham to wellness as a benefit, and although the change is slower than many would like, there is a noticeable shift in how groups think about employee wellness.

5 Ugly Truths About Biometric Screenings

If the author (or the many people she quoted in the article) genuinely want to see a change in the employee wellness, they may best be served by identifying the specific programs that are dragging the industry to a point beyond redemption and promoting those programs that satisfy the criteria that they feel is gold standard.