Americans are unhealthy physically, mentally, and financially.  So, it is no surprise that employees are asking for help.  What is surprising is how few people actually engage in the very programs they say they want.

Part I of this article explored the four categories of failure of wellness programs: relevance, trust, time, and awareness.  But to really understand what is not working, it can be helpful to look at what is working.

“Take-up rate” is the percentage of employees who have access to a benefit that actually purchase it.  This differs from the participation rate, which is the total rate of employees engaging with a benefit.  Benefits with high take-up rates reflect what people really want—if they have access to it, they get it.  The chart below from the Bureau of Labor Statistics illustrates that more people—about four-in-five—actually purchase their dental and vision care benefits than even their medical care programs.

Why is this?  What makes these benefits so distinct and popular?  Let’s look at how they rate in the four categories of failure of wellness programs:

  1. Relevance. Most people are already going to the dentist.  Most people with vision issues are getting eye exams and corrective lenses.  These benefits are so ubiquitous that nearly every provider of dental or vision care accepts them.  These programs are relevant because people can get the services they are already getting from the providers they already trust, but with these programs they get those services at a discount.  These are highly relevant benefits, and the 20% of employees that are not paying for them likely either have a better deal or do use dental and vision care.
  2. Trust. Dental and vision programs have been around for decades and keeping extra cash in peoples’ pockets for just as long.  They do not require participants to divulge sensitive information that would not want their employers to know.  In short, they are easy to trust.
  3. Time. Again, most people are already using these services.  The only added time is remembering to tell your provider about your benefit and either showing you card or sharing your program ID.  This is an extremely small time cost—there is no added activity or trip required.
  4. Awareness. Despite these programs typically getting minimal facetime at open enrollment meetings, people remember them because of how relevant, valuable, and easy-to-use they are.

How can we design wellness programs to overcome the barriers in these four categories?

Most importantly, people need to be able to quickly and easily connect the dots between a wellness program and the positive outcomes it will create in their life.  Humans are built to make snap cost/benefit decisions, and if a program cannot communicate its relevance and value to individual needs, it is likely to fail.

This starts with providing a high-quality resource with proven outcomes across varying demographics.  But the truth is the wellness includes a host of variables that make it far more complex than dental and vision care, in part because—as the statistics demonstrate—we are not currently engaging in the wellness activities that will keep us from being stressed, sick, overweight, and trapped in debt.

In order to establish relevance, then, it is essential to provide personal guidance that will help each employee understand the value of the program specific to their individual circumstances.  Changing behavior requires a strong, personal incentive as opposed to the general goals of “health and well-being.”  Providing human guidance to help people understand how to extract value from programs is essential.

Trust is another huge obstacle.  Unlike dental and vision programs, mental wellness programs would require employees to admit to depression, anxiety, and even rage issues.  Will their employer use that information against them?  What about an employee facing a personal crisis like divorce or bankruptcy that could have a direct effect on their ability to perform at work?  Not only do employers need to take active steps to establish trust with their people, they need to provide programs that are confidential in sensitive areas like mental health and financial wellness.

Time is frequently cited as a barrier to participation.  Employees often see wellness programs as another off-hours to-do item.  If they do not trust the intent of their employers, they may even believe they are being asked to participate in an activity that is really designed to benefit their employer but needs to be done off-the-clock.  Beyond establishing some basic trust and a program geared towards participant outcomes instead of employer savings, the most important step here is to give employees time to use the benefit during working hours.

Many employers are scared to give-up what feels like essential productivity time (which has been exacerbated by the labor shortage) to focus on wellness.  But here are some inescapable truths: employees that are deficient in wellness are much less productive; humans are not built to stay focused on tasks for extended periods; and people are already taking the breaks they need, they are just hiding them.  In short—the time is already being lost, why not make it productive?

The awareness problem will solve itself if the other three problems can be solved.  If people understand the value of a program as it relates to their personal circumstances, trust its quality and confidence, and are given the time to engage, they will not forget it.  Just imagine a calendar item on your schedule that pops-up “Your free mental health session” that is another 30 minutes you are guaranteed not to have to be in another meeting (as long as you engage).  Building these activities into the workday not only incentivizes use, it makes them nearly impossible to forget.

Some employers are already taking this approach.  Building wellness into the workplace instead of viewing it as a separate activity, they are providing the resources, guidance, and time to fully engage in the activities that we know drive positive outcomes for people and their companies.  This requires the courage to rethink the workday and invest meaningfully in programs that take the time and care to personalize pathways based on each participant’s definition of success.

The Great Resignation, War for Talent, and labor shortage have made the choices clear: get serious about investing in people and their wellness, or watch your organization miss out on talent, community, and profit.