In recent months, there has been a lot of discussion in the media about how successful wellness programs actually are.
It's an important conversation, but there's one element that many commentators seem to be missing: how the success of wellness initiatives hinges on their integration with healthcare and other benefits and, importantly, how those benefits are delivered.
The study that started the conversation was conducted over a period of 18 months at BJ's Wholesale Club. After analyzing the experience of 33,000 workers participating in wellness programs, the New York Times reports the key findings:
“While workers who enrolled in the wellness program reported that they learned to exercise more and watch their weight, the research found no significant differences in outcomes like lower blood pressure or sugar levels and other health measures. And it found no significant reduction in workers’ health care costs.”
The surge in popularity of wellness programs is due in large part to rising healthcare costs. Many employers have been forced to look for more creative ways to reduce expenses. And wellness programs appear to offer substantial savings because they promote healthier lifestyles among employees, which lead to reduced claims.
But many of these programs are missing the key ingredient — tools and support for lasting behavior change.
To be truly effective, wellness programs needs to create lasting changes in behavior.
For a fitness program to work, it needs to engage, motivate, and come alongside employees to help them make the decision to change their lifestyle in a way that accommodates and values physical fitness. The same is true of nutritional programs, mindfulness initiatives, and competitions.
True behavior change starts with listening and understanding a person’s current state, motivations, and blockers. Then, you must provide the resources and support they need to make incremental changes, build confidence, and take ownership of their health.
Many wellness programs are administered by wellness coaches, who work with clients to implement changes in their lifestyle that lead to healthier behaviors.
Health coaching as a part of primary care
Ideally, primary care is delivered by a team that works together to manage a patient's healthcare — a duty that extends beyond the current "sick-care" model to include holistic health and long-term wellbeing. The patient's physician is an important part of this primary care team, but they shouldn't be considered the only person on it.
One of the MVPs in this kind of healthcare can be highly trained and fully integrated health coaches. They can work with patients and doctors to address biopsychosocial elements of health and help the patient create the conditions for lasting improvement.
Here's our approach, including 3 elements drawn from the Vera model that we believe are necessary to create real change.
Empathetic Listening — Health coaches, doctors, nurses, and all patient-facing staff should be trained to employ empathetic listening practices that foster meaningful relationships between care providers and patients. With that trust in place, patients feel empowered to share their goals and barriers to better health.
Dedicated Care Teams — Each member of the patient's dedicated care team is an integral part their success. Care teams work collaboratively to develop personalized care and follow-up plans that help patients achieve their goals for better health.
Transtheoretical Model of Change — The goal of this model of behavior change is to include the patient's willingness, behavioral conditioning, and emotional state while planning for their healthcare journey. It focuses on finding strategies and processes that meet the patient where they are, considering things like self-confidence, the stages of change, and how the patient is weighing pros and cons.
These pillars of behavior change all perform best within the context of advanced primary care — delivering a more effective and enriching experience that truly benefits both patients and empowers them to make changes that will keep them healthier for longer.
To be successful, wellness programs can't just be tossed in to the benefits plan as a bonus or an afterthought. Real wellness requires direct integration into the healthcare model, and while it will take a widespread shift in thinking, it's well within our reach.