Why Employees Participate—or Don't—in Wellness Programs

By Stephen Miller, CEBS Jan 16, 2014
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When people were asked why they weren’t participating in their employer’s wellness program, most said they felt confident they could make changes on their own, according to new research from the nonprofit Employee Benefit Research Institute (EBRI).

Findings from the 2013 EBRI/Greenwald & Associates Consumer Engagement in Health Care Survey, published in a December 2013 EBRI Issue Brief, highlight factors influencing participation in workplace wellness programs, including health-risk assessments, health-promotion initiatives and biometric screenings.

Among those who took part in their employer’s wellness program, the reasons they gave for doing so were to:

  • Improve their health (77 percent).
  • Maintain their health (75 percent).
  • Learn more about their own health risks (71 percent).
  • Take advantage of the program's convenience to work (70 percent).
  • Win incentive prizes (58 percent).
  • Reduce premiums (50 percent).

When employees who chose not to participate in a wellness program were asked why, the top reasons they gave were that they:

  • Can make changes on their own (70 percent).
  • Lack time (56 percent).
  • Believe they are already healthy (53 percent).
  • Felt the program was not conveniently located (43 percent).
  • Just didn't know enough about the program (43 percent).
  • Worried their employer would know their personal health information (33 percent).

To improve participation rates, wellness program communications and education efforts should speak to these concerns, which may be based on faulty assumptions.

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To improve participation, address concerns

based on faulty assumptions.

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For the most part, there were no differences in the above answers by plan type—whether respondents were enrolled in traditional health coverage, consumer-driven health plans (CDHPs) with a health savings account or health reimbursement arrangement, or high-deductible health plans without an account.

Paying for Participation

However, responses did vary by plan type when workers were asked if financial incentives might persuade them to participate in a workplace wellness program, with enrollees in CDHPs and high-deductible plans more responsive to incentives that minimized their out-of-pocket spending.

For instance, those with coverage through CDHPs and high-deductible plans were more likely than traditional-plan enrollees to say they would probably participate if they were offered a $250 cash incentive, a discounted premium, reduced drug-cost-sharing or reduced office-visit cost-sharing.

CDHP enrollees also were more likely than others to report that their employer offered a cash incentive or reward for participating in a wellness program.

Monetary Incentives and Consistent Messages

Johnson & Johnson pares $500 off the annual premium for employees who submit health information, which is then used to create an individual health risk profile and recommend activities for the employee, such as a diabetes management program. The company also wants to make sure employees act on their health information, so it offers an additional $100 to $250 for participation in a recommended activity, reports the U.S. Chamber of Commerce.

Mixed messages can have an impact on wellness program participation. For example, "a company can spend a lot of time talking about healthy behavior, but the effect will be blunted if leadership shows no interest in the initiatives or if vending machines are still full of junk food," the chamber notes.


Stephen Miller, CEBS, is an online editor/manager for SHRM.​

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