Complete onsite fitness centers staffed by fitness professionals are at the high end of the expense scale. Fitness centers often feature a host of cardiovascular training devices and health-monitoring equipment. At the low end of the spectrum are less expensive measures, such as posters and paycheck envelope stuffers that heighten worker awareness of wellness ideals.

Return On Investment
In most cases, management's primary concern when it sponsors a Wellness Program is whether the program meets its goals. Does it reduce health care costs, increase productivity, and lower absenteeism? To check bottom-line benefits, management must look at a variety of outcomes, including medical-care costs, sick days, injury rates, and worker turnover. Accurate data on these variables is difficult to acquire and even harder to measure. In addition, an estimation of the bottom-line return on a Wellness Program requires at least four years of data. Improved productivity and lower absenteeism can be measured, but how do you put a price tag on a better quality of life enjoyed by workers and their families?
What wellness professionals often turn to is the traditional return-on-investment ratio for wellness programs of three to one:  For every $1 spent on wellness, employers can expect to save $5 on reduced absenteeism and lowered health-benefit payments. 
 
Wellness Programs are a long-term investment. But how long should you wait for results?  Finance and the Chief Executive Officers (CEO) want hard numbers to show ROI.  Wellness Return On Investment (ROI) is tougher to calculate than, say, a 401(k).  Current studies have established some benchmark data on wellness ROI you can use as a guideline. It's useful whether you already have a health promotion program or are thinking about starting one. It usually takes at least 18 months from the launch of a health promotion program to see any results in your health care plan bottom line. For a lot of firms, 18 months is the point at which workers' improving health starts to cancel the cost of sponsoring and administering the health promotion program. By and large, the long-term cost savings from a wellness program are going to be driven by how much you're willing to spend. Normally, corporations get what they pay for - both in time and money invested.

As a rule of thumb, the typical cost to the employer is about $3 to $5 per participating employee per month. Within three years of launch, you ought to be seeing meaningful savings.  The average Return On Investment tends to be about $4 to $5 saved for every dollar spent. So how can you manage the costs in the short-term in order to achieve the long-term savings?  How can you maximize the long-term payoff?

 

Consider making wellness programs budget-neutral
For many companies, the most effective way to manage the cost of a Wellness Program in the start-up phase is to make it a budget-neutral expense.
In other words, the Wellness Program neither adds to your medical costs at the outset, nor lowers them.

 

Example:  You plan to roll out a Wellness Program effective January 1.  The wellness program will cost the organization $5 per staff member. You can roll the $5 per month cost directly into the employee's monthly share of their health care premium. In this age of continuous cost-shifting, most workers are used to seeing small increases in their monthly contributions each plan year. Just make certain you're not hitting folks with a big hike on top of that $5.

 

Comparably designed health promotion programs pay off about the same - meaning staff purchase in and participate at the same rate, whether they're budget neutral or the employer absorbs the cost. But when employees get clobbered by large-scale contribution hikes at the outset, they often resist the health promotion program.  The long-term Return On Investment for these health promotion programs is often disappointing.  If you're faced with a situation where achieving a budget-neutral health promotion program would trigger push-back, your firm is better off absorbing most or all of the wellness costs.  The largest hurdle is to get over the hump for those first 18 months or so.
 
Some Considerations For A Wellness Program 
Wellness professionals agree that effective programs require support from all levels of the organization. Mid-level managers are the ones who decide how workers spend their time on a day-to-day basis. It's important for them to let workers know that it is OK to take time for wellness.

Worker Resistance 
Some workers do not take advantage of their company's Wellness Program. They are in what is called "the pre-contemplation stage." They have simply never thought about changing their lifestyle to maintain wellness. Workers who are most at risk are often most resistant to changing their behavior. An awareness and education program can help reach these workers and encourage them to make some changes in their health habits. A company-sponsored health fair will not change their behavior, but it may move them into a position where they are ready to change.

Programs that involve physical activity intimidate some workers. Some workers may be overweight and out-of-shape, and they want to get in shape before they join the fitness center. They may feel that workers who use the fitness center are all healthy, and they may be reluctant to participate because they do not want to feel out of place. Women, in particular, may be reluctant to wear exercise clothing. They may feel they are being asked to do things that are insulting. This can engender guilt and shame, which do not feel good to them, so why should they participate? Wellness Programs are supposed to make them feel good. However, not all non-participants are necessarily non-exercisers. Some workers may take advantage of other wellness opportunities that are not work-centered, such as a fitness center close to their homes. Some see nutritionists privately or participate in local walking clubs.

The most common reason offered for nonparticipation is time. Many hard-core resistors feel overburdened with family commitments and professional demands. Many wellness professionals, however, consider this a cover-up for lack of commitment.

Privacy
Some workers, simply do not want to participate in health screenings at work. They may prefer, instead, to have their test done by a private physician. This could reflect a concern for how their employer might use the health information gleaned from a wellness program. Workers should be made aware that their health information will not be used against them and that they will not be discriminated against if they do not measure up to traditional norms for health.

Starting a Wellness Program 
Where does a company start? Too many companies start by building fitness facilities because they feel these should be included in their programs. An alternative is to first assess goals. Is the goal cost containment, improved morale, or reduced turnover? It is easy to answer yes to these questions, but like most aspects of business planning, prioritizing goals, and carefully designing strategies to meet these goals are the keys to success. A company having an aging, male work force with low turnover will need a very different set of programs than a quickly-growing company made up of young workers with a 20 percent annual turnover. As a long-term plan with these goals is built, a determination should also be made as to whether to lease or buy the products and services. This will allow for appropriate budgeting.

Second, health promotion is a long-term investment. A workshop on wellness can be a very valuable service to workers. However, for a health-promotion program to be truly successful, a company must be willing to invest long-term - three to five years - from the initial planning.

Third, the company must be comprehensive and creative in its thinking. It may not be enough just to have aerobics classes, weight-loss programs, and smoking cessation. Most people do not like to attend group programming, so consideration should be given to innovative self-care services. Means to tie healthy behaviors to benefits programs by creating incentives should be considered. Humor can play a huge role as a means of reducing stress and improving productivity and innovation. Workers should be taught how to be wise health-care consumers. Flu vaccinations, mammography, and other screenings at the worksite may be appropriate. Planning should take occupational health, mental health, the worker-assistance program, and health behaviors into account. Sorting through these options and developing a comprehensive plan may require outside help.

If cost containment is the goal, research consistently recommends that the program involve an initial health assessment, including fitness testing, biometrics data collection (e.g., cholesterol, body composition, and blood pressure), and health-risk appraisal, followed by feedback sessions and ongoing educational follow-up. If biometrics screening is being done, effective repeat programming should be planned to ensure that individuals have an opportunity to chart progress. Furthermore, if the individuals are at high risk, the means to refer people into medical care should be considered. While this may spike the outpatient utilization chart for a short time, it will have significant long-term financial and health savings.

Fourth, workers should be involved in promoting the program as much as possible - they are the most valuable resource in promoting the Wellness Program. Worker participation should be made a part of their jobs. Time for committee work and subsequent work assignments should not become penalties on top of an already full workload.

Fifth, marketing is essential. For some reason, most health-promotion program leaders think one flyer on the lunchroom bulletin board should "pack the house" at the next smoking-cessation or health-assessment program. Health promotion should be thought of as a new product line and the same steps that would be taken to roll out the product should be taken with the health program. While the program may be confronted with changing some very ingrained unhealthy behaviors, it can be done.

Alcohol And Other Drugs In The Workplace 
Alcohol and other drugs are a considerable problem in the workplace. Consider the following information from a National Council on Alcohol and Drug Dependence (NCADD) fact sheet:

An Overview