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Characteristics and Prevalence

• Approximately half of U.S. employers offer wellness promotion initiatives, and larger employers are more likely to have more complex programs.
• Programs often include wellness screening activities to identify health risks and interventions to reduce risks and promote healthy lifestyles.

Impact

• Employee uptake of worksite wellness programs remains limited. Fewer than half of employees (46 percent) in the firms surveyed undergo clinical screening or complete a health risk assessment (HRA), which is used to identify employees for interventions.
• We found statistically significant and clinically meaningful improvements among program participants in exercise frequency, smoking behavior, and weight control, but not cholesterol control.
• Participation in a wellness program over five years is associated with lower health care costs and decreasing health care use. The average annual difference is an estimated $157, but the change is not statistically significant.

The Role of Financial Incentives

• Incentives for completing an HRA are effective, particularly above a threshold of $50. On average, an increase in the HRA incentive by $10 is associated with a 1.6 percentage point increase in the HRA completion rate for incentives in the range of $0-$100.
• Smoking cessation is also the only health behavior for which achieving the goal earned a greater reward than participating in a program.
• "High-powered" incentives that tie as much as 20% of the cost of coverage to achieving a health goal remain rare.

Key Facilitators

• Broad outreach and clear messaging from organizational leaders.
• Making wellness activities convenient and accessible for all employees.
• Making wellness an organizational priority among senior leaders.
• Leveraging existing resources and building relationships with health plans to expand offerings at little to no cost.
• Approaching wellness with a continuous quality improvement attitude, and solicit feedback from employees to improve programs.