How To Make Small Business Wellness Work
One fact is becoming more and more apparent: small businesses cannot afford to do nothing about wellness. There is overwhelming evidence that doing wellness at a small company makes a difference in employees’ lives and for the business. A small company, Rural Wisconsin Health Cooperative, saw positive results with a wellness program for their 60 employees.
They had 90% participation and saw significant improvements in health behavior and productivity. With any program you’ll often see a big change once you start, but it’s rarer to see steady change after 12 months. An increase of half a vegetable serving per day doesn’t seem like much, but it’s 4-5 times the impact you’ll find in many community interventions.
Lincoln Industries, another small group, saw a 10 point drop in diastolic blood pressure and a 20 point drop in systolic blood pressure after three years among those employees with initially high blood pressure. Obesity rates also decreased or stayed relatively flat over a three year period — an impressive feat in and of itself.
While no wellness program is making obesity go away, you can work to keep it at a low level. These two companies illustrate the impact that a wellness program can have in small business settings. Having just one employee become healthier can make a big impact in a small company.
The majority of the companies in the United States are small businesses that employ fewer than ten people. In fact, half of all U.S. workers work in small businesses. Most of these workers have no access to a wellness program.
Barriers for Small Business Wellness
Small employers need help delivering effective wellness programs. Time and time again we see that if you don’t address the barriers, you will have no success. Here are a few of the most common barriers small businesses face when trying to use wellness programs to improve employee health and reduce employee-related expenses.
First, small companies have a harder time proving a return on investment (ROI) based sheerly on the numbers. Since ROI calculations from lower healthcare costs are easier and more accurate when calculated in large corporations, the majority of ROI studies and case studies have been completed on large companies.
All wellness ROI data from reduced medical spending comes from evaluations of large companies, not small businesses. This does not mean that small business wellness doesn’t reduce healthcare costs, it just means that there are no published scientific studies showing this.
The good news is that there are many other benefits to a small business wellness program besides lower healthcare costs.
Second, small businesses are not self-insured. Small businesses share their health insurance costs with a pool of small employers. If the wellness program does improve employee health and lower healthcare costs, the savings are shared by the other employers in the pool.
Very little comes back to the employer in savings, since there are multiple fixed costs of administration, claims, commissions, profits, and risk and pool charges. It’s unrealistic for a wellness vendor to come in and say they can help with a major reduction in healthcare costs, since the employees’ health isn’t the only factor in determining healthcare costs.
With small businesses, you’ll see a blending of the company medical cost experience with other businesses. Even if a small business has the healthiest employees, any savings that occur will be shared by every business in the pool. A company could hope to reduce by only about 2-5% the cost of insurance premiums if they are a healthy group.
Perhaps the biggest barrier to small business wellness is the question of “who is going to do wellness?” In a small business, employees wear many different hats. Most likely the task of starting and administering a wellness program will be giving to an employee who already has multiple job roles and little if any experience running an effective wellness program.
It is rare for programs like this to actually succeed. A successful wellness program at a small business will require some outside help if it has any chance of showing positive outcomes.
Advantages of Small Business Wellness
The advantages of doing wellness in a small business go way beyond a direct monetary ROI. There is strong social support to capitalize on and participation is always higher in a smaller group. In a small company where employee benefits may be limited, wellness can help build strong morale. Also, small business owners tend to care more about their employees — often creating an environment where everyone is treated like family.
The health benefits of small business wellness are also more important than the same benefits would be in a large corporation. In a small business setting absenteeism and presenteeism (physically at work but not really working) are more detrimental. Because there are so few employees, the absence of just one can make a big difference.
Unlike large companies there is not a group of employees who can pick up the slack or complete the unfinished work. Employee absence in a small business has a big impact. Employees who have health risks are more likely to be absent from work or to have reduced productivity.
Small businesses that do wellness see monetary savings outside the typical ROI healthcare cost measures. They may experience lower absenteeism, lower workers compensation fees, lower short and long-term disability and lower turnover. When employers send the message that they care about their employees’ health, they will see a return on their investment.
What can a Small Business Do?
Once an employer has addressed their barriers and understands the necessity of a worksite wellness program, what do they do next? Well, they have a few options. The first — and arguably least effective — way is to go at it alone. This is where they pick, for example, the person in accounting who does yoga to be in charge.
It is unrealistic, however, to expect someone whose job description doesn’t involve wellness to create and manage a successful program.
A company can also try and use insurance carrier programs. Most of these solutions offer nothing for small businesses. Anything they do offer is self-directed, meaning employees must take themselves to the website, log in and find what they want to do.
There is no evidence of effectiveness and, in fact, data from four of the largest carriers shows these programs reach less than 2-5% of employees. Self-directed programs have very poor participation. And, furthermore, they are only available if you stick with that carrier.
In other words, these programs are 100% self-serving for the carriers. If your company changes insurance carriers, all wellness efforts vanish. These programs range from free to $250 per person.
A third option is to use an insurance broker to help with wellness. The brokerage might have an in-house wellness specialist that comes by and helps with a biometric screening and a health fair or a health risk appraisal. Unfortunately, these aren’t always available to small businesses, and there is no evidence that they work.
A big problem with HRAs at small businesses is that aggregate data may not be available to view because the pool of employees may be too small to protect individual health information. This then eliminates one of the more effective tools in strategic program planning.
The final option is to hire a wellness vendor. A business that wants a successful wellness program needs someone who has direct ownership of the program and has the time to do what needs to be done. A wellness vendor may be able to meet this need and may be able to do so at an affordable price. In a small company, there are limits to what kind of programming can be done. .
A fitness facility onsite may not be an option, for example, and some programs can cost between $100-200 per person. This is where a broker is important. They can help find funding for wellness by adjusting co-pays, deductibles, premiums, or may even pay for the cost of the vendor’s wellness solution.
What Are Successful Small Businesses Doing?
The first thing a successful small business doing wellness has is leadership support. Senior leader support is critical. If the CEO isn’t on board, the program won’t last very long. Small business do the same things that larger companies do: health assessments, culture audit and change processes, activity and incentive tracking tools, behavior change campaigns and program evaluation.
At WellSteps, the WellSteps Guides work with coordinators at each location to handle much of the planning, administrative load, and implementation of wellness program components. Our WellSteps Guides are the secret behind every one of our successful small business wellness programs.
What Small Business Wellness Success Looks Like
Insurance brokers are typical small businesses. Borislow Insurance, a small brokerage company in the Northeast, has been exceptionally good at doing wellness. WellSteps has worked with them for many years and has published a case study on the impact of their wellness program. Not only has Borislow Insurance benefited from having an employee wellness program, but they are now in a position to speak with authority about wellness. As they talk about wellness with their various small business clients they gain trust because they have actually been practicing what they preach. It doesn’t make any sense for a brokerage firm to talk to their clients about wellness if they don’t do it themselves!
Small businesses are the future of wellness. Because of specific barriers and advantages, small businesses need help conducting effective wellness programs. If done correctly, small business can use wellness to improve employee health and the bottom line. Visit WellSteps.com to learn more about worksite wellness programs for your company.