From the Blog:

11 simple steps to avoid an anti-wellness uprising

Many of you have read recently of the Penn State wellness scandal – where a well-intentioned wellness program spawned some employee protest and a media firestorm – leaving the people and vendors behind it sweating in the heat of the national spotlight.  This post is to help you maintain all of the momentum, health improvement and financial opportunities you have created – without the nasty side-effects.

No one can control a properly functioning media.  You can, however, control both your strategy and message to your people.  This post is designed to help you do just that.

As you increase your organization’s efforts to assess, engage and help your workforce improve their health, productivity and well-being, tread carefully and strategically.

Know Why You are Offering Wellness

There are many reasons why universities and other employers embrace wellness.  They want to:

  • Improve employee performance and productivity
  • Increase employee well-being
  • Reduce costs through benefits/incentive design
  • Reduce costs through healthier people
  • Attract and retain top talent (be an employer of choice)
  • Gain insight into business/workforce issues
  • Be perceived as industry leader
  • “That’s just how we roll”
  • Insert yours here: ________________

If you had to put a rank order on your top 5, could you?  Would your executive team choose the same 5?  (Side note:  This is one of the hardest things to get a large, complex institution to do.)

We recently polled our clients about which of these matter most, and gained an interesting insight:  it depends.  There is wide variability in the responses, based on geography, culture, industry and the tenor set by organizational leaders. And it’s OK to pick more than one or two.

In 2013, reasons three and four (health cost related) are not always ranked at the top, but they are stalwarts of the list.

Bravely Face Reality WITH Your Employees

Like it or not, our country faces a stark financial reality:  Health costs have risen at about three times as fast as consumer prices.  Wages are under pressure and jobs are shifting overseas.  And even though lifestyle diseases are epidemic, and there are more than twice as many working age diabetics as there were 20 years ago in the US (CDC data), there are plenty of opportunities to save millions.  Some are on the demand-side (think human behavior, consumerism, social engagement and environmental policies) and some are on the supply-side (think narrow networks, efficiency via technology, medical “centers of excellence” and price transparency tools).

And you have to look at all of these.  As Susan Basso, VP of HR at Penn State said, “What we are telling faculty is that the status quo is not an option.”

If you include all key employee constituencies in the launch, and there is still pushback about a controversial aspect of the program – for example asking people if they are pregnant in a health risk assessment, view it as an opportunity:

  • To remind them why you are doing wellness
  • That their personal information is protected by HIPAA (with teeth), GINA and other regulations – their employer can’t see personally identifiable health information
  • That you care about their health and the health of their baby, for both altruistic and financial reasons  (As a parent of a very expensive – but ultimately very healthy – baby, I know this firsthand)
  • That you can and will help them with pre- and post-natal care and resources
  • They can join healthy eating and walking challenges, or other campaigns to stay connected to their friends or other soon-to-be parents

Addressing cost growth requires a strategy that spans benefit decisions, medical delivery strategies, consumer awareness, human behavior, caring and the big ‘C’ – culture

Don’t Let Compliance Trump Culture

Using financial incentives is a great way to ensure initial participation and compliance rates.  High participation in assessments and other preventive programs is a great way to understand your workforce in aggregate, and also to route them into the broad (think weight, obesity and diabetes) and narrow (think pregnancy) programs you already invest in.  Financial incentives are here to stay.

No matter how compelling and powerful these financial incentives are – they are dwarfed by the power of cultural and social incentives and norms.  All of which you, as an employer, get to influence.  You can’t pay people enough to change their behaviors or motivations in the long-term.  In fact, if people perceive the program as “forced” – even though all wellness programs are voluntary by law – they will not only skip the program – they will vocally and publicly oppose it.

They may even kill it.

What To Do?

Be very intentional about your mission, values and culture, and bring them to life in your program.  Follow these 11 simple steps to avoid an uprising and a PR disaster – and the loss of all of your investments to date.  (These are is taken from the list of 23 Limeade Best Practices we share with our clients):

Engage Leaders

1. Clearly communicate rationale & commitment – include a video and email from the President, CEO, CFO, Chief People Officer, Chief Well-Being Officer or other CXO.  A big part of your commitment to the program is your commitment to privacy and non-discrimination
2. Communicate fairness & alignment.  Consider a statement that addresses the goals head-on:  “We save money and so do you” or – if you feel it necessary – “If we don’t commit to wellness we will have to take other, more serious measures”
3. Visible CXO participation.  Are your leaders in the charity 10k?  Are they managing their stress and energy levels in ways others should emulate?


4. Make “What’s in it for me?” crystal clear at launch.  Craft a simple message and offer
5. Communicate at least monthly.  Be consistent, clear and include perspectives as diverse as your workforce
6. Include success stories.  Emotion is a powerful motivator, and stories spread virally

Have SMART Goals, Metrics and Data

7. Align around common business goals & metrics – your priorities from the list above.  It’s OK to update them annually, too
8. Share success stories, outcomes and “insights” at the organizational level, too.  Close the circle with your people

Make Sure Your Program is really YOUR Program

9. The program should feel like it’s coming from within (e.g. your brand, colors, language, tone).  Match the vibe of your organization in your social challenges and improvement plans.  Ask only the types of assessment questions and do only the types of screenings and preventive care that tie to your goals

Include Meaningful Incentives

10. HIPAA allows 30% of the cost of care to be used in financial incentives for wellness.  How close to the max will you go to get the desired (and socially and medically prudent) activities and outcomes?
11. Keep it simple.  Have a simple incentive design with fewer, more relevant choices.  It may just be “Do these three things for Health Plan A, or get Health Plan B”

Public Debate is an Opportunity

If you as leaders have articulated your rationale on video – your PR response is on the shelf, ready to be dusted off at any time.  If you speak publicly about your commitment, share data and show up as a real person, you will have earned the attention and trust – if not the unanimous agreement – of your people.

Frankly, employee wellness should never be one of your more controversial initiatives.  And employee engagement should be one of your favorite topics.

One of the great things about our institutions of higher learning, and our country, is that we embrace public debate toward the greater good.  The best wellness programs shift over time to reflect and reinforce the cultures from which they emerge.  Wellness is where financial imperatives and cultural norms meet, thrash a little, and make progress.  The best programs are ones that both people and Presidents get, like and use.