Employee wellness programs are receiving attention recently, and for good reason. There are benefits for employers and employees, including economic, health, and intangible benefits. Wellness programs can be tailored to the needs and capabilities of each company and its employees.
A RAND report found that about half of employers in the United States with at least 50 employees offer an employee wellness program.  More than 9 out of 10 large companies with at least 50,000 employees offer one. 
Still, not all companies offer employee wellness programs, and among those who do, many do not offer comprehensive ones. They may find it too expensive, too complicated, or too burdensome to set up or expand employee wellness programs, but this need not be the case. A well-chosen smartphone app, such as Lark Health Coach, can promote employee wellness in many ways, and be simple to implement.
Employee wellness programs are designed to improve the wellbeing of employees, but there is no single employee wellness program definition. Generally, such programs offer benefits, separate from standard health insurance plans, that are aimed at improving employee physical, psychological, and/or mental health. Often, an employee wellness program involves screening, weight loss or other coaching, and/or education.
A program can be as simple as publishing an employee newsletter or offering influenza vaccines to employees; more than 3 of 4 employers who offer health insurance are estimated to offer an employee wellness program that fits this definition.  However, only 6% of employers are estimated to offer a “comprehensive employee wellness program,” as laid out by Healthy People 2010, comprising health education, a work environment supporting healthy behaviors and health-promoting policies, integration, links to additional wellness programs, and worksite screening and education.
Worksite wellness programs are designed to improve the well-being of employees, but how this is manifested depends on the “employee wellness” definition. One way to look at employee wellness is through primary, secondary, and tertiary prevention. 
· Primary prevention: keeping healthy people healthy. This might include fitness programs, healthy eating counseling, and education on safe sex, stress management, and vaccinations, directed at healthy employees, including those who may not already be focused on healthy behaviors.
· Secondary prevention: catching high-risk people. This might include screening for high-risk individuals, such as hypertension or diabetes screening for obese or sedentary employees. It could also include smoking cessation or weight loss counseling.
· Tertiary prevention: minimizing the effects of diseases. This might include self-management programs and provision of glucometers for employees with diabetes.
Employee wellness programs can be as diverse as the companies that offer them. Employees are likely to be able to choose whether or not to participate, unlike with healthcare insurance programs that may be mandatory. Employees might carry out healthy behaviors at home or at work, attend health fairs, or sign up for smoking cessation programs.
You need to tailor your own worksite wellness program to your needs, but taking a look at some common steps can help guide the planning process. 
· Conduct a Health Risk Appraisal (HRA) to find common employee health risks, such as obesity, low use of seatbelts, high levels of stress, or low physical activity levels. This helps develop targets and objectives for the program, which helps guide the components it will have. It also provides a baseline for later evaluation of the program to see whether it is working. The HRA can also be used to recruit employees to participate by showing them that they are at risk based on their HRA results.
· Form a planning committee to establish goals, and develop goals and programs to meet them. A wellness committee can include employers, to encourage ownership of the program, and might include about 1 member per 50 employees.
· Designate wellness professionals to take the lead. These might be external professionals who are trained in screening techniques, such as measuring blood pressure and administering surveys. They might also coach participants through the program. Since wellness professionals can be expensive to hire for long-term follow-up, a smartphone app that acts as a health coach can be a more feasible option that still gets results.
· Expand the program by marketing it to employees to raise awareness, and incentivizing participation.
Companies can piece together a program that works for them. These are some examples of decisions they can make.
· Getting an outside company and/or consultants to design and/or run the program or parts of it.
· Providing financial or reward incentives for signing up, maintaining participation and/or achieving milestones such as losing 10 lb. or lowering blood pressure by 10 mmHg.
· Paying for memberships to local gyms, or setting aside space in the workplace for exercise equipment that is available for employees to use.
· Encouraging “walk-and-talk” meetings, stretch breaks, and lunchtime or afternoon walks or group fitness classes.
· Providing employees with health coaching apps, such as Lark, that are low-cost to the employer and encourage employees to adopt healthy eating patterns and increase physical activity.
· Offering smoking cessation, weight loss programs, and employee challenges to meet goals.
· Hosting an annually health fair, alone or together with other companies, that offers hypertension, diabetes, and other screenings, educational materials on healthy behaviors and awareness of common health conditions such as diabetes, and/or promotions from vendors such as health food companies, fitness centers, and massage or spa companies.
· Improving food choices in the workplace by replacing soda with water in vending machines, providing fresh fruit and other healthy snacks to employees, and increasing nutritious options in workplace cafeterias.
The purpose of employee wellness programs is to improve employees’ health and well-being, often through preventive care. Goals can include preventing and managing chronic diseases to lower their health and economic burden, improving employee morale and motivation, and improving employees’ quality of life.
An employee wellness program is not quite the same as an employee wellness center. As mentioned above, an employee wellness program can be anything from providing free water bottles to employees, to offering health screenings, healthy food, gym memberships, and comprehensive programs to prevent and/or manage health conditions.
An employee wellness center is a physical place that is dedicated to employee wellness. It might offer one or more of the following services.
· Routine medical services, such as annual physicals, pharmacy services, doctor’s appointments for sick visits, flu vaccines, and chronic disease management and monitoring.
· Dietitian and exercise physiologist consultations.
· Lactation rooms.
· Exercise equipment and sports facilities.
· Health screenings and expos.
Employee wellness centers that offer enough services may seem to be “one-stop shopping” for employees. The centers can make employees feel at home because they (and sometimes their families) are the only clients.
Employee wellness programs have many benefits for employees and often for their families. They can improve their physical, mental, and psychological well-being.
See more of the abstract, The Health and Cost Benefits of Work Site Health-Promotion Programs.
Employee wellness programs often target leading risk factors for mortality. The World Health Organization lists high blood pressure, tobacco use, high blood sugar, physical inactivity, overweight and obesity, high cholesterol, unsafe sex, and alcohol use as the top 8 contributors to deaths worldwide; low fruit and vegetable intake is number 12.  All of these factors are modifiable through behavior change.
A comprehensive program with group or individual education or counseling programs and appropriate fitness, dining, and other facilities can help employees reduce these risk factors. For ongoing support, employers could offer a health coaching app as an effective, lower-cost option that is fully supportive of users’ health goals, from lowering sugar intake to increasing vegetable consumption to managing blood pressure.
It stands to reason that employees who are motivated and have high morale would be better employees. They might be expected to be more productive and contribute to a better workplace atmosphere than employees who have no interest in coming to work each day. Wellness programs could raise motivation and morale through:
· Providing healthy snacks to stave off hunger without inducing guilt.
· Encouraging fitness breaks to prevent boredom and fatigue on the job.
· Sponsoring team-building activities so employees want to support each other and feel proud of their contributions.
Increased morale and motivation can be reflected in lower employee turnover rates. “Harvard Business Review” presents examples such as a 4% turnover rate with implementation of a program at SAS Institute, and a 50% reduction in attrition at Biltmore. 
How healthy is your work environment? Another question is whether your work culture is one of health. As you answer, consider:
· Are doughnuts or fruit more likely to be served in a morning meeting?
· Do employees feel more comfortable going outside for lunch or eating while working at their desks?
· When an employee takes off early to watch his daughter’s softball game, do the other employees roll their eyes or tell him to show them pictures of the game tomorrow?
Workplace wellness programs can improve the healthiness of the work environment in many ways. They can improve employees’ physical health – think: apples instead of cookies at the afternoon meeting, and taking a 3:00 p.m. group walk most days. The environment can also support mental and psychological health by encouraging family time, for example.
Lowering stress is another way to improve the work environment. This can be done through:
· Allowing voices to be heard in decision-making processes.
· Asking employees for their opinions.
· Supporting family time.
· Recognizing accomplishments.
· Leaving communication open.
Employee wellness programs can improve employee health in many ways. They include:
· Weight loss.
· Increased fitness.
· Lower blood pressure.
· Lower blood sugar.
· Fewer hospitalizations.
Stress impacts the development of chronic conditions such as obesity, diabetes, hypertension, and mental health disorders, just to name a few. Employee wellness programs can address stress in two major ways.
· First, by lowering job-related stress by improving the health environment.
· Second, by assisting with stress management techniques so employees are better equipped to handle their stressors.
Further health gains from stress reduction. Employee assistance programs can pay off when they offer counseling and related services to employees. These services might assist not only with work-related stress, but also stress from other sources, such as family or relationships. In one year-long comprehensive program, high levels of emotional stress decreased from 21 to 15%. 
Any savvy reader knows that employees are in business: companies are looking at their bottom line. In other words, CEOs are not providing chef-prepared lunches and massages to employees, and bikes to employees’ children, simply because they are good people. They are doing it to help their bottom line. Does it work?
The answer is that employee wellness programs are almost certainly worthwhile. There is no single dollar amount that applies to each company, since each company and its wellness program are different. However, many studies have shown positive returns on investment (ROI), lower healthcare costs, and improved productivity.
Current findings suggest that the greatest cost savings come not from promoting healthy behaviors among low-risk, already-healthy employees, but rather from reducing costs associated with chronic diseases. This can include preventing chronic disease development among high-risk employees, for example, preventing diabetes among employees with prediabetes through diet and exercise.
Even greater healthcare cost savings can come from managing chronic conditions to prevent progression or complications, for example, enrolling employees with hypertension in programs to monitor their blood pressure, improve medication compliance rates, and incorporate more fruits and vegetables into their diets.
Take the classic example of Johnson & Johnson’s wellness program, which includes health risk assessment, vaccinations, education, and chronic condition management resources for employees. The program saved a total of over $38 million in its first four years, averaging $224 per patient per year.  Savings in inpatient hospital use accounted for over half that amount, and reductions in mental health expenses made up another third. Overall, ROI was $2.71, according to “Harvard Business Review”. 
There are other promising figures on the economic benefits of workplace wellness programs that result from reduced healthcare costs. 
· $1,421 lower costs over one year for employees who were initially “high risk,” with a $6 ROI.
· $1.5 million in cost savings with a program that included workers’ comp and injury care.
· $1,500 less per year in health care claims from high-risk participants than non-participants.
Since healthcare cost savings and ROI are higher with high-risk employees, it makes sense to include chronic disease management and high-risk patient disease prevention elements in a workplace wellness program. A simple and low-cost way to do this is with a smartphone app, such as Lark, that combines health coaching with tracking and monitoring to encourage long-term healthy behavior change and improve health outcomes.
The values of healthcare costs and cost saving values may be staggering, but they are small compared to values related to productivity. A study in “Journal of Occupational and Environmental Medicine” estimates that the costs of absenteeism, or missed days of work, and “presenteeism”, or being at work without being as productive as expected, are 2.3 times the cost of healthcare for employees.  Workplace wellness programs can improve productivity and lead to fewer sick days.
· 80% reduction in lost work days within 6 years of implementing a program at MD Anderson Cancer Center. 
· $3,  $5.82,  or $2.73  ROI from reduced absenteeism.
· Programs addressing obesity, stress, and multiple risk factors simultaneously are likely to have a positive effect on absenteeism, according to research published in “American Journal of Health Promotion”. 
Employee wellness statistics tend to show that companies with employee wellness programs are more productive.
Dollars saved are not the only metric. Other examples of important quantitative metrics are blood sugar levels, body mass index (BMI), physical activity levels, and number of sick days. Even for businesses, though, qualitative metrics can matter. Enter value on investment (VOI), which Kaiser Permanente describes as a qualitative metric, analogous to ROI as a quantitative one. When calculating their own versions of VOI, employers can consider morale, retention, and even worker compensation claims. 
Employee wellness centers and programs can offer a wide variety of services to employees. What they have in common is that employee wellness initiatives have clear benefits for the employees. Sample services include:
· Health risk appraisals (HRA)/assessments
· Nutritious food options in vending machines and cafeterias.
· Primary care
· Fitness centers
· Chronic disease management counseling and devices such as glucometers.
· Discounts on wellness products, such as running shoes and gym memberships.
Employee wellness programs and centers can educate and motivate employees to improve health behaviors and make their health a priority. Areas of education and motivation can include:
· Best nutrition for health promotion and disease prevention and management.
· Weight loss and maintenance.
· Easier ways to make fitness and healthy eating part of daily life at work and home.
· How and why to track fitness, diet, and medication use.
· Stress management techniques.
· Reasons to put health and wellness first.
Addressing these areas can require the ongoing expertise of wellness specialists, but costs can be dramatically reduced by using smartphone apps. Lark Health Coach is proven to have high engagement and user satisfaction. It offers programs ranging from primary prevention – wellness for low-risk employees – to tertiary prevention – managing high-stakes conditions such as diabetes.
Employee wellness programs can highlight special events and incorporate shorter-term campaigns to generate interest and maintain participation. These are some ideas for making these pushes.
· Organize employee challenges, such as weight loss or fitness challenges.
· Host special events on National Employee Health and Wellness Day, such as a company picnic with healthy food and water, health education handouts, and relay races.
· Sponsor a company-wide softball league or team.
Interactive wellness activities can also maintain interest. These can include healthy company potlucks, workout challenges in which employees are divided into teams and their workouts count towards their team’s total, and health fairs with sponsors that provide samples, coupons, and/or handouts.
Whatever diversity is present between various employee wellness programs, they must all comply with the Preserving Employee Wellness Act, HR 1313.  The act makes it easier to implement certain components of worksite wellness programs. It:
· Permits collection of employee genetic information.
· Permits wellness programs including genetic testing and family history inquiries.
· Permits employers to ask about health histories.
Successful wellness programs need careful planning.  Before wellness programs can be implemented, goals need to be defined. They can be based on:
· Health outcomes, such as amount of weight loss, percent reduction in high-risk individuals, or number of participants who quit smoking.
· Process outcomes, such as percent employees who signed up and/or stayed in the program, or satisfaction reported.
The budget needs to be defined. Smaller companies are likely to have smaller budgets and less elaborate programs, while larger companies could have more comprehensive programs. Small companies could potentially pool resources to be able to afford more far-reaching programs.
Determining the budget requires calculating the cost of the program per employee. This amount can vary widely. For example, a health risk assessment can cost less than $1 per employee, or up to $50 depending on whether biometrics and mail are used.  Other costs can be related to hiring wellness coaches, purchasing fitness equipment, health monitoring devices, and vaccinations, and partnering with gyms to offer employee discounts.
The program needs a workable incentive program, since incentives have been shown to increase participation. These can be in the form of reductions in healthcare premiums with program participation, financial incentives or rewards for achieving health goals, or recognition systems for employee success. Also, feedback and evaluation are necessary.
An article in “Annual Review of Public Health” identifies characteristics of successful worksite programs.  They include:
· Initial and follow-up HRAs.
· Customized behavior change messages, which are 18% more successful than generic ones.
· High participation rates.
· Self-care/self-management including goal setting.
· Multiple risk addressing.
· Easy access to programs.
· Social support.
A smartphone app such as Lark can facilitate many of these criteria. It is a health coach that learns users’ patterns to provide customized behavior change support. It addresses multiple risks such as excess weight, poor diet patterns, low physical activity, and high stress. Access to Lark is easy, since it on your smartphone. Receiving Lark, and possibly synced devices such as bluetooth scales, can even be among the program’s incentives.
Many companies have already implemented wellness programs and demonstrated successful outcomes.
· Scripps Employee Wellness Program  includes biometric screenings, health risk assessments, flu shots, and employee care clinics, along with on-site wellness activities and online support.  Cost savings have included $2.6 million in avoided medical and pharmacy costs as of 2008.
· Kaiser Permanente Employee Wellness Programs  have earned awards. They include on-site and online programs for comprehensive behavior change and wellness.
· Hamilton County Employee Wellness Program  in Ohio aims to facilitate health for its employees and includes a wellness clinic  with primary care and medications, health coaching, and customized wellness programs, with no copay.
· Martin Country Employee Wellness Center  also has no copay and offers primary care services, as well as urgent care and some emergency services.
Though it takes an investment of time, effort, and money, implementing a high-quality wellness program is probably worthwhile. It can improve employee health and make your business more profitable. Large or small, your company can surely benefit from help, such as ready-to-go smartphone apps that your employees can use within weeks.