Editor’s Note: We recently sat down with Seth Serxner, Ph.D., MPH, who is the chief health officer at Optum, a leading health services innovation company. Dr. Serxner is an industry thought leader in population health, strategy, behavior change, and well-being. He provides guidance to employers, payers, and providers regarding program engagement, designing for impact and key success metrics. We spoke to him about current wellness trends and a new Optum research study linking employee loyalty to well-being programs.
Jonathan: Given today's job market, how important is it for employers to offer benefits such as wellness programs?
Seth: Traditionally, the value proposition regarding health and wellness programs has been primarily focused on ROI. In the last few years, however, we've been able to shift that conversation to VOI or value on investment. That means helping employers view these programs not just as a cost-containment strategy, but as part of their business, growth and talent strategies.
We recently conducted a study to assess the impact of well-being programs on employee loyalty. Our analysis was based on a metric known as the Employee Net Promoter Score, which helps businesses measure employees’ experience. We found that employees who actively participate in these programs are much more likely to be proud to work for their employer and promote their company to friends and family as a great place to work.
Companies often just assume that their programs help recruit and retain people. But having a shiny onsite fitness center that’s empty most of the day is not sufficient. We felt like we needed to examine this more deeply. Some of the results were quite surprising to us.
Jonathan: I saw that 48 percent of those who frequently participate in their wellness programs are likely to recommend the employer, compared with only 18 percent of employers not offering such programs. That's a huge difference. Based upon those statistics, do you think employers should be making well-being and wellness a priority?
Seth: I think it's certainly part of an overall strategy. Offering a wellness program solely for reasons of recruitment, retention, and employee loyalty is probably not the right approach. I think it’s a very happy benefit. A major goal is to have a highly engaged, active workforce. It’s logical that employees who feel that their company cares about them - and has helped them make progress in achieving their wellness goals - are going to reciprocate and feel good about their company. I think it really helps build the overall value on investment case.
Jonathan: What surprised you about the survey findings?
Seth: There were two findings that really stood out for me. First, regardless of whether you participated in wellness programs or not, the mere presence of such programs drives employee loyalty, especially when seven or eight programs are offered. Second, offering that critical mass of programs sends a positive message to employees and helps create a perceived culture of health.
So, as an employee, I have all these programs available, which I may or may not use but I sense that they're around if I need them. I see my colleagues taking advantage of them. I'm feeling the good energy of my organization.
It is important to remember that a random set of wellness programs – even seven or eight such programs - won’t necessarily engender a positive employee experience and loyalty. To optimize engagement, you need the right mix of relevant, easily accessible programs. Once you have a coherently designed and integrated group of programs, employees will start to feel it.
Jonathan: You bring up my next question. Why is that the magic number? Do you feel like giving eight versus, let’s say, two programs because there's not enough diverse offerings, or based upon each individual’s needs, a program that touches them? Why is there such a big difference?
Seth: I think part of it is, while we're using the word ‘wellness’, we're also talking about population health. We're talking more about physical and mental health which include EAP, medical and drug programs, and chronic condition programs. When you think about the continuum of care needed for employees at-risk - those with complex and acute conditions - it takes more than a fitness step-up challenge or a smoking cessation program; it requires a full range of programs and services that are provided in a coherent way. It is critical to offer programs on an engaging digital platform, supported by clear, consistent communications and a strong culture.
Jonathan: Do you feel there is a direct connection between employee engagement and business outcomes?
Seth: We do. We see some data to that effect. One study, for example, compared airline locations where employees had higher than average employee engagement in health and wellness programs with locations with lower engagement. The locations with more engaged workers had better on-time airport departures, fewer mishandled bags, fewer safety issues, and better customer service.
We are increasingly having conversations with employers about the link between employee engagement and business metrics, and the broader value proposition. Companies are also thinking about wellness programs at the enterprise-wide level – as opposed to a standalone initiative - to create a much more sustainable approach.
Jonathan: Do you think that employers are aware of the findings that you came out with besides you sharing it out there? Do you think they realize what some of these statistics are and the differences between the engaged employees’ productivity outcomes? Do you think they have any clue it is that significant?
Seth: I do not. I think they may have a sense of it, but I think it's very challenging for them. I was at a meeting recently with more than 100 employers. We were asked how many were really trying to address wellness programs from a more strategic, holistic viewpoint. I don't think they understand quite yet where these programs fit in the overall value proposition. The good news is that they are starting to expand their horizons - focusing on cost-containment as well as ROI and building that broader business case. That is why we're excited to be able to share our research findings.
Jonathan: What are the practical takeaways for employers from the survey?
Seth: There is a couple. First, is the metric itself - employee Net Promoter Score. The ends question is very straightforward: “On a scale of 0-10, how likely are you to recommend this company as a place to work?” Employees scoring nine and ten are very proactive. Those scoring in the mid-range are neutral, while those on the lower end of the scale are considered detractors. Building that metric into annual surveys is important and a way to benchmark against others.
Second, the findings underscore that building a critical mass of programs in a systematic way – rather than a single point solution - across the population helps create a culture of health and correlates with positive business metrics.
Jonathan: Is there any area that you feel in corporate wellness today that is underserved, where there is not much of a focus on that's changing, or that needs to change?
Seth: Addressing behavioral health is increasingly important to companies these days. Surprisingly, however, our research found that across mental, physical, social, and financial health, we're still not seeing the kind of investment in the behavioral health side that we would have expected, given the intense interest in it.
A hot topic is how to open the dialogue around mental health. There is some interest in initiatives like resiliency and mindfulness, and a lot of opportunity on the medical behavioral side. We know that managing employees with a chronic condition and a concomitant mental health issue is far more expensive than managing people without mental health comorbidity. I think this is the next big focus for employers. We know it's a big cost driver that employers, providers, and payers need to address.
Jonathan: Speaking of mental health, what are companies doing to address the stigma surrounding depression and other mental health conditions?
Seth: We have full campaigns with clients around “It's OK to not be OK.” You may be doing OK, but are you really OK? And there are some very interesting and important ways that employers are trying to make it OK. We have some clients that are tackling the perceived stigma around contacting EAP by simply eliminating that terminology and rebranding their EAP offering as part of a broader well-being approach. Employees don't even realize that they are calling EAP; they just know they can call a designated number because they're unsure, for example, how to tell the kids that their dog must be put down.
Employees wouldn’t normally think about calling EAP about such issues but would consider calling the well-being line. The American Psychiatric Association Foundation and other organizations have some excellent campaigns to destigmatize these kinds of life issues.
Jonathan: To wrap it up with one last question, where do you see the future of this industry heading and are there any changes you'd like to see?
Seth: I see the concept of well-being shifting from where wellness was - addressing behaviors and lifestyles that put people at premature risk of disease and death - to well-being, meaning those factors that increase a person's likelihood of living a long, happy life.
It’s a shift from what's going to kill you sooner to what's going to help you live longer and happier. The factors around that are so relevant, such as sleep, financial well-being, and being present. An example might be, rather than taking a hard line on, say, counting calories and carbs, emphasizing moderate portions and colorful Mediterranean diets instead.
So, I see a shift to well-being and that balances social connection and feeds into our conversation about mental health. Along with that, I see a holistic perspective around program metrics that extend beyond cost containment.
It’s about the quality of life and quality of work, and how do we measure that? There are some good measures out there. Additionally, modalities for delivering wellness programs will continue to evolve, encompassing everything from digital platforms to on-site human presence.
Jonathan: That covers it from our side. Thank you. I think you’ve provided some really great insight.
