Prevention and wellness is not only the next trillion-dollar industry but will eventually become larger than today’s multi-trillion-dollar healthcare treatment industry. That was a prediction offered by a number of different speakers at TEDMEDin Washington D.C. last month.
However, skeptics noted that wellness may always be the industry of the future, because there’s a lack of consensus on what kind of wellness measures really work and how they can be measured.
Serving as capstone to TEDMED was an afternoon of 20 breakout workshops, each addressing a “Great Challenge” in health and medicine. Innosight was invited to facilitate three of those workshops, including a session on “Inventing Wellness Programs that Work.” The workshop brought together a diverse group who all had passionate views on health and wellness. We heard from payors, benefit designers, fitness start-ups, healthcare providers, storytellers and students.
On one level, the logic seems clear. Healthy employees cost less and are more productive. Employers have a strong economic incentive to lower their healthcare costs by motivating their employees to quit smoking, eat right and exercise regularly. A study by the Harvard School of Public Health found that companies save more than $3 for every $1 spent on wellness programs. Yet another study found that those savings are difficult to achieve without being discriminatory toward workers with high health risks.
To kick things off, IBM physician Basit Chaundry told a story about how he was inspired to enter the field as an NYU medical student after walking by a men’s shelter every day on his way to the hospital. IBM has developed a model wellness program, using incentives such as a $150 weekly payment if they engage in 30 minutes of exercise three times per week for 12 weeks. Workers can also earn another $150/week for improving nutrition if they keep a food diary. The company has reported to have saved $100 million to $130 million for each of the past four years.
But panelists noted that other companies have struggled to achieve similar results and that many incentives and punitive measures have failed to stop the rising tide of obesity and diabetes. To tackle these wider issues, the delegates were asked to take either the perspective of an employee or an employer and ideate barriers that prevented successful wellness plans and potential solutions. The breakouts had very spirited discussions, and four challenge themes emerged:
- Lack of focus on emotional and social needs: Offering rewards and penalties is a narrow, functional way of looking at employee wellness. It’s important but not adequate. In order to achieve their stated goals, wellness programs need to be designed with a laser focus on social and emotional needs which point to basic “jobs to be done,” such as becoming better parents or getting positive recognition from co-workers.For instance, it is proven that peer groups are more effective than financial incentives in many cases, yet the standard protocol for incentives in health and wellness is financial.
- Lack of common metrics: Wellness is defined in many ways by many people and this ambiguous definition makes productive conversations challenging. There was general agreement that the current definition of wellness was too focused on prevention or recovering from illness versus enhancement of health and wellbeing. As a part of that debate, the group aimed toward finding a proper set of standards to track and measure progress. Should we measure happiness, productivity, stress, or biometric data such asbody mass index and blood pressure?
- Lack of ROI: Since wellness is such a long-term proposition, it is ultimately hard to quantify a return on an investment in wellness programs. According to a study by the Department of Labor, 93 percent of all employers and 70 percent of those with 500 or more employees did not measure the ROI of their health management programs.
- Lack of accountability: In the U.S., it is unclear who should have ultimate accountability for health and wellness. Employers so far have been investing in wellness, but many panelists noted that ultimately governments too should be playing a more active role, citing examples such as smoking cessation. Additionally, the individuals are rarely held accountable for their personal decisions. As a result, they do not necessarily make the best decisions, even with carrot and/or stick incentives. What kinds of tools are needed to carry out this change?
The session culminated by designing a single “AND, BUT, THEREFORE” statement, an action-prompting exercise that was common among all the Great Challenge groups at TEDMED. This is our statement:
People want to be happy and healthy AND companies and communities need healthy and productive employees/citizens. BUT wellness programs are poorly defined with result horizons that are long term and hard to measure. THEREFORE we need a new model that clearly defines wellness that is focused on individual needs and has proven, measurable outcomes.