Confronting Health & Wellness Opportunity Costs

Health & wellness programs must abide human nature to maximize opportunity.

I was shocked, but not surprised, when I saw a health and wellness company's website tout a 40% participation rate. Celebrating 40% of the population lowering their claims expense by 10% seems reasonable, but it ignores the opportunity costs - the loss of potential gain from other alternatives.

The fact is, this vendor's results are the norm, not the exception. Unfortunately, too many health and wellness programs fail to reach most employees, and the reason is simple: ignoring human nature.  

Out of Touch

Consider, for example, a large government wellness program that sends out annual notices to members, with much fanfare, about getting started in the wellness program with their "RealAge" test.

Let's consider this "RealAge" test postcard arriving in the mail at the home of Mr. Tom Anxious. Tom's struggling with anxiety because his job is stressful, his marriage isn't always perfect, and he doesn't have the time he wants for his children. Unfortunately, Tom's anxiety also impacts his job performance because of the negative consequences on his sleep and energy. Finally, Tom's worry robs him of the energy and motivation to stay current on medical exams, and he self-medicates with too much evening libation.  

Tom's a great candidate for a health and wellness program. With the right program, Tom would engage and learn coping techniques to help him lower his anxiety. Moreover, the cascading positive impact of reducing his anxiety would permeate all aspects of his life - including his health and job performance.

However, instead of being greeted with a simple notice of how much his employer cares about Tom and is there to help with everyday life challenges, Tom is greeted with a marketing message that stokes his already anxious brain. Instead of asking Tom to share how his employer program can help him, the program assumes the answers. It prescribes Tom's path, ignores his ego, and disregards his natural need for self-control.

It's hard not to be cynical, knowing what I know about psychology and how the human brain works, but the lack of insight in this approach is infuriating. Instead of presenting an oasis of hope for someone needing help, this out-of-touch effort injects more friction where resistance is high. Plenty of science tells us it's already challenging to get someone to ask for or accept help. It's human nature to avoid change and see new and different as stressful. The evidence is clear that it's costly to ignore natural human tendencies.


We could stick with Tom, but let's consider a new potential member, Ms. Sally Beimhigh. Sally knows she's tacked on a few pounds over the years; however, she's also young enough that she doesn't yet suffer the consequences of low energy, high cholesterol, and high blood pressure. Not to mention, Sally's also consuming daily social nuggets to reinforce her acceptance of extra pounds as simply a "personal decision." Finally, Sally has other issues she sees as more pressing. She's worried about her finances and struggling with low self-esteem from bad relationships.

Everyone in healthcare knows that Sally's weight will be a cost factor as she ages, but Sally is not yet seeing the consequences. Unfortunately for Sally, however, her company's health and wellness program success is tied to a few key measures, and if she doesn't lower her BMI, it will reflect poorly on the vendor and the program.

Because the incentives are enticing, Sally does recognize she could use some help, so she signs up. She completes a biometric screening, and her BMI means mandatory health coaching. At this point, while engagement and awareness are both wins for the program, the wins are about to turn into lost opportunities.

Because her company's program measures success by its ability to lower Sally's BMI risk factor, that's the focus of her coaching call. Sally's coach, Joe Excitide, goes through her biometric results and the ways they can lower Sally's BMI and get her "feeling better." Unfortunately, however, Sally's coach does more talking than listening. He doesn't ask Sally about the non-measured risk factors because those are outside the program's scope. His goal is to improve her nutrition and exercise, not to address how Sally's financial and other life stressors, regardless of how they increase her cortisol levels, which drives up her weight, blood pressure, and other risk factors. (It's not by accident that I mentioned the coach's goals, not Sally's.)

Wrap Up

These are just two examples of how health and wellness programs that ignore human nature miss the opportunities to maximize an organization's positive impact potential.

From an ROI perspective, focusing on 40% with high spending may seem like a big win, but what's the opportunity cost of the other 60%? How many of the remaining employee population are like Tom and Sally, headed towards the high-cost bucket, but could be engaged and redirected if their program acknowledged human nature?

Here's a little experiment that can help anyone experience the difference and see the potential. First, spend a day telling your friends they need to change something in their lives. Now, if you have any friends left after that experiment, spend the next day asking them how they're doing and how you can be there for them, and then listen to what they say.

That's the difference in WellVisor's approach. Listening and letting the individual  choose their own path to better gets them started on the journey where they're ready - which is far better than missing out on the opportunity to help an employee in need.

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