Where Wellness Went Wrong

I recently took an informal survey of friends, family and coworkers. I asked them, "If there is one company, one service provider in your life who you think delivers bad service and a bad customer experience, who would it be?" The answers were not surprising and confirmed what I had suspected all along. Nearly everyone I asked replied "my cable provider" or "my insurance company."

It turns out that research backs up my informal findings. A Net Promoter Score (NPS) is a formal way to measure whether or not a customer would recommend your product or service to a friend. Health insurance is actually one of just two industries that have a negative NPS (the other is cable providers), meaning their customers are likely to actively recommend that friends do not use their provider.

This isn't really surprising, given the state of health care costs and the insurance industry in our country. According to insurance giant Aetna, health care costs in the U.S. have risen from $75 billion in 1970 to $2.6 trillion in 2010, and are expected to reach $4.8 trillion by 2021. These skyrocketing costs have done nothing put place more power in the hands of insurance companies -- the more expensive the care, the more they can charge.

These costs are a huge concern for employers who (for the most part) are in charge of providing health care insurance to the masses. A 2013 survey from Bank of America and Merrill Lynch found that 70 percent of CFOs listed health care costs as their biggest financial concern.

Lowering health care costs is a major priority for companies, and to do that many look to corporate wellness initiatives. These programs, while well intentioned, are unfortunately often not well executed. Earlier this year, the RAND Corporation published a report on the state of workplace wellness, and it did not paint a particularly pretty picture of the industry. Here are re my thoughts on why.

The majority of corporate wellness programs are run by insurance companies -- in fact, estimates I've heard are about 70 percent. Remember that negative Net Promoter Score? As CEOs, how are we supposed to encourage our people to make healthy lifestyle choices, when we're placing someone they hate right in charge of the equation? And since insurance companies make more money off a sick employee than a healthy one -- what motivation do they have to improve the population's health?

Here's the thing about wellness -- it's very personal. Would you ever approach a person at a party and say, "Nice to meet you, how much do you weigh?" The situation is complicated even further when you bring the workplace into the mix. How would you feel if your boss asked you, "Are you planning to become pregnant in the next year?" or "Are you having trouble in your marriage?" Oh, and by the way -- "We're going to penalize you if you choose not to answer." That's exactly how insurance-led wellness programs work. They start with a health-risk assessment that asks a lot of personal questions -- and then report back to your company. Yikes! No wonder it's not working.

As organizations like Penn State have learned, the response to this type of wellness program is not good. By being invasive and punitive in its wellness initiative, the university angered its employees and ended up with egg on their face. The program should have been mutually beneficial for the university and the staff -- but it completely backfired.

Let's take a step back and ask ourselves about the goals of a wellness program. Yes, many do aim to lower costs, but they also aim to make employees healthier. Healthy employees miss fewer days at work, and are actually more engaged and productive. For many organizations, these benefits are even more important than saving money on health care costs.

This leads us to the question of how we can create successful wellness programs. They almost always start at the top with executive buy-in. CEOs should always be in charge of determining and maintaining company culture. Successful programs -- wellness or otherwise - must become a part of the culture.

Asking employees to fill out a form about their health does nothing to actually improve their health. However adding an on-site gym, free yoga classes, removing fried food from the cafeteria and encouraging walking meetings -- these are the types of things that can have a real impact. And these things are really about creating a supportive community of healthy people.

Would you ask Comcast to be in charge of your 401k accounts? Of course not. So why would you let an insurance company dictate something so integral to your company's culture? The bottom line is that we need to let insurance companies do their job -- which is to administer health care -- and let organizations decide the best way to run their individual wellness programs.