Beyond Wellness ROI

For those that follow the wellness industry closely, there have been a few news-worthy items that have come across this year. With all of the new legislation affecting benefits professionals, these items have gone mostly unnoticed outside of the inner circle of wellness devotees. The debacle that was the Penn State wellness effort has probably been the most publicized story; bringing out a flurry of wellness experts that have been waiting to tell everyone “I told you so”.

Buried deeper in the industry storylines was an interesting evolution of message that came from Dee Edington ; considered by many to be on the Mt. Rushmore of wellness. Edington has long built on his research showing that excess medical risks correlate with excess medical cost; put simpler, if you're unhealthy or don’t take care of yourself, you are going to cost more. For years, many followed this as their North Star, trying to find the holy grail in wellness; Return on Investment (ROI). For those that are unfamiliar, the reason that ROI is such an enigma is that you are trying to prove that you saved money by getting something to not happen. Let me repeat, you need to prove that your intervention caused something that would have otherwise taken place, to not happen. This is not like saying “if I didn’t grab the back of your shirt you would have walked into oncoming traffic”. This is more like “if you buy this shirt, you will be wearing it one day 5 years from now, and someone will grab the back of it, preventing you from walking into oncoming traffic”. Or as in some proclamations you’ll see in the wellness industry “walk 10,000 steps a day and you won’t have a heart attack in 15 years that will cost your company $300,000.” That takes some awfully good foresight.

So Edington, after building a foundation of focusing on the risk factors that drive excess costs, has expanded his message to say that we really need to consider all factors when judging the efficacy of a wellness effort. As Carol Harnett covers here, this includes measures like employee satisfaction (Happiness), productivity and presenteeism.

As I said earlier, this change has gone relatively unnoticed outside of the close followers of the wellness industry. I feel that this needs to be looked at more closely and is actually big news. While the Penn State controversy was getting all of the headlines, a thought-leader in the industry made a prognostication for the future of the wellness industry that we should be paying attention to.

I believe that we are reaching a pivotal point in the evolution of the wellness industry and Edington is exactly correct. As wellness detractors such as Al Lewis (as he is often considered) agree, maybe we can’t rely on ROI to be the only and ultimate goal of wellness. If a wellness program is something that you are going to put in place for your employees, do it for reasons beyond financial motivations to save a buck.

The good news is that most people make decisions every day for far different reasons than ROI. Many employers (not all) provide benefits to their employees because they care about them and want them to be happy to work for them. Google the best places to work and you will find stories of companies that offer nap areas, onsite dry cleaning, child care, and the list goes on. Do you think offering child care onsite provides ROI to these companies? Of course not. There is an emotional motivation for the employer to take care of those that make them successful and an emotion from the employee of feeling appreciated. After all, their employer is addressing what may be a key pain point by caring for the #1 priority for most employees; their family.

While their messages are different (along with how they deliver them), I agree with both Edington and Al Lewis. Let’s throw away the notion that we have to cost justify every decision we make as a black and white issue. If that were the case, my wife would probably have “fired me” for buying a new iPhone as my means to make phone calls when cheaper options could have done the job!