Make a Quantum Leap in Wellness Engagement

“Organizations that can prove they are adding value to people’s lives will continue to grow and thrive.” Tim Rath

In an unregulated industry with no clear definition of “engagement,” the door is wide open for results “cherry picking” or claiming high rates of success for what is largely meaningless contact. Trying to determine the average engagement in corporate health programs is actually very difficult. Industry reports do exist, but many reported rates of “engagement” may be inflated as they count a one-time incentive driven screening as “engaged.”

To properly define engagement, it’s best to work backwards from the goals or type of outcomes you want to achieve and then determine what level of participation is most likely to achieve those goals. If you simply want to raise awareness, have a bit of fun, or check the box in order to promote that you “offer a wellness benefit”, then isolated, incentive driven one-time participation may be completely fine.

However, if you want to actually make a measurable impact on your employee experience, employee health, and organizational performance, then sporadic short-run engagement is insufficient.

In this area, an overwhelming majority of corporate “wellness” programs are vastly under-performing. They are one-dimensional or focus too heavily on specific generic actions, occur in the periphery, and many create a burden for employees (penalties, require proactive opt-in, logging points etc). Comprehensive program reviews have found that less than 7% of programs are comprehensive enough to have a significant sustained positive impact on individual health or organizational performance (Goetzel & Ozminkowski, 2008).

In order for people to make sustainable and meaningful change, they need to be consistently and actively engaged in the process: actively participating, learning, and progressively implementing actions. Therefore if measurable change and genuine employee value is the goal, the only real way to define engagement is by sustained, repeat and ongoing participation – ideally without incentives.

Comprehensive & personalized programs are more effective than incentives To take your health program engagement and effectiveness to a new level, you would be much better served by investing in a more comprehensive, personal-level program rather than trying to add or modify incentive strategies. Incentive strategies in reality are “let’s try to make marginal short term gains for a program our employees are clearly not responding to” strategies. Recent evidence (NBGH) suggests the major reason employees do not participate in corporate health programs is because they lack “personal relevance.” Is that really surprising when you consider the one-dimensional, dictated prescriptive nature of most programs?In addition, a 2014 RAND study found that engagement in comprehensive programs more than doubled the rates of engagement in more limited traditional programs and outperformed the impact of adding incentives to those programs by around 30%.

Programs will only have a positive impact on an employee’s job satisfaction if they provide value, and they will only provide value if they help people improve. This only occurs if employees clearly see the personal relevance and remain voluntarily and continually engaged long term.

Are you comparing apples to apples? It’s common for vendors to report engagement or satisfaction only from participants, or based on the largest attended (and often incentivized) event. For example, we recently consulted for a company of 20,000 employees who reported a “health program participation rate” of around 60%. When we dug deeper, we determined they had 60% of their employees “opt-in” and participate in an annual screening – primarily based on incentives and plan design. However, they only had 2.5% of their population complete follow up coaching or any meaningful change intervention. So is their engagement really 60%, or more like 3%? Another client’s vendor reported employee satisfaction from a recent challenge as “96% would recommend the program to a friend and would choose to participate again next year.” That sounds impressive, but when you read the fine print, that percentage is only from a sub group of respondents who “completed the entire challenge and both the pre-and post challenge survey”. That clearly creates a response bias to the few people who were really into the challenge, and it represented less than 5% of this employer’s total workforce.

At HBD, our mission is to help people change and enhance their lives by changing their health habits and behaviors. This is only achievable when people are effectively and consistently engaged. That’s why we monitor and report our non-incentivized participation back to our clients as a proportion of total workforce, monthly. By watching sustained high average monthly engagement (in excess of 80% of the total workforce monthly), we know the majority of people are routinely and consistently engaged on an ongoing basis. This is what creates the platform that allows us to help individuals on an effective and sustainable personal pathway to change. We aim to lift the curtain on vendor reporting and provide an easy, transparent view of a program’s success.


So with that context, let’s take a look at our engagement numbers in comparison to the industry:


– Average one-time engagement in wellness programs: 20% – Average one-time engagement in health programs with incentives: 40% – Average engagement in “comprehensive” health programs: 52%

Average sustained month-to-month engagement in HBD’s programs without incentives: 82%

*Level of engagement considered optimal for achieving the best program outcomes and returns for an organization >60% (Goetzel & Ozminkowski, 2008).

The type AND frequency of engagement matters if you hope to provide employees value and achieve sustainable health and wellbeing improvements. Our methodologies which include integrating consistent engagement into an employee’s workflow, and providing personal level contact and coaching helps us create some of the highest performing programs globally.

If you are seeking to make a quantum leap in the effectiveness of your workplace health programming, please contact us to discuss your unique workforce and challenges.