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Employees in poor health are least likely to use lifestyle and disease management programs

NEW YORK, February 16, 2011 — As employers try to engage employees in health management programs to slow health care cost inflation, fewer employees are placing a high priority on managing and improving their health,

“As employees cope with a period of high financial and personal stress, the focus on improving health has taken a back seat,” said Jeff Levin-Scherz, a physician and senior health care consultant at Towers Watson. “Chronic diseases such as diabetes and heart disease are the number one driver of health care costs, and employers are increasingly committed to offering programs that can empower employees to manage their health and prevent the risks that lead to these diseases. Our findings reveal that this strategy faces an uphill battle in the current economic environment, but we believe employers that creatively use incentives to more fully engage employees in wellness efforts have a head start on their competitors.”

Levin-Scherz also notes that employers with well-thought-out strategies on health care delivery and vendor partnerships are bucking the trend by effectively encouraging employees to proactively manage their own health. In addition, the research shows that employers with high-deductible health plans (HDHPs) have generally done more to support a culture of health and drive engagement, as their employees are more likely to participate in wellness programs.

The Towers Watson survey found that there has been a significant decline in employees’ focus on health over the past two years. For example, only 59% of employee respondents believe that managing their health is a top priority, down from 69% in 2008, and 59% of respondents have taken actions in the last two years to significantly improve their health, down from 65% in 2008. Another revealing finding is that only one in five (20%) employees used employer lifestyle management programs (lose weight, eat healthier, stop smoking and exercise more), down from 26% in 2008.

On the positive side, however, employee awareness of their health risks is rising, with more employees participating in health-screening programs. According to the survey, 43% of employees completed a health risk assessment, up from 26% in 2008. In addition, 31% completed a biometric screening for body mass index and cholesterol and glucose levels, up from 18% in 2008. Furthermore, more than two in three employees (68%) believe they have an ability to change their health status.

Engagement in Health Management Varies by Health Status

Employees in poor health are the least engaged in the management of their health, and those in good health are the most engaged. Compared with healthy employees, those in poor health are less optimistic about their ability to improve their health and less likely than any other group to use employer wellness programs. Only one in five employees in poor health (20%) is using programs to manage chronic conditions. In addition, employees in very good health (23%) are nearly twice as likely to use lifestyle management programs as those in poor health (13%).

“While these are not surprising findings, we are encouraged by the efforts healthy employees are taking to prevent health risks such as high blood sugar and blood pressure that cause chronic diseases,” said Shelly Wolff, senior health care consultant at Towers Watson. “The actions of employees in poor health, however, are of concern because this group is consuming the greatest volume of health care services and driving the greatest share of costs. Employers should consider tailoring communications and consider more personally targeted incentives to encourage participation and drive increased use of programs designed to manage their lifestyles and chronic conditions.”

A comparison of the perspectives of employees in poor and very good health reveals the challenge employers face today in improving the health management engagement. Employees in poor health are less likely to:

Believe their company promotes a healthy work environment (36% of employees with poor health versus 52% with very good health)

Believe that managing health is a top priority (44% versus 68%)

Have taken actions in the last two years to significantly improve their health (45% versus 67%)

Believe they have an ability to change their health status (57% versus 74%)

Believe their company offers programs that encourage them to live a healthier lifestyle (22% versus 38%)

Encouraging Employee Participation in Health Management Programs

With only one in three (34%) of all employees believing that employer programs encourage them to live a healthier lifestyle, employers are looking to take definitive steps to encourage employee engagement in the health management programs they offer.

“Employees are feeling personal economic tension about out-of-pocket health care costs and employment uncertainty that could lead them to temporarily ignore routine or preventive health care,” said Wolff. “The good news is that many employers have implemented plans that feature coverage for preventive services and value-based designs where employees bear less of the cost for higher-value care. In addition, with health care reform calling for an increase in incentives, employers have the tools to put together a powerful program that can help engage employees.”

Employees are increasingly accepting of employers offering incentives/penalties for health status and wellness efforts. Two in three employees (67%) would be comfortable if their health plan or employer reduced premium costs for healthy workers and those willing to take steps to manage their illness or lower their health risks, up from 64% in 2008. Nearly half of employees (47%) would be comfortable if their health plan or employer increased the premium costs for workers unwilling to take steps to manage their illness or lower their health risks, up from 39% in 2008.

The survey also revealed several positive and encouraging findings for employers, among them:

Employees with a primary care physician are more likely to participate in wellness activities.

Medical information websites are becoming an important source of health information, with employees getting health care information from websites (59%) nearly as frequently as their doctors (64%).

Employees in very good health are much more likely to believe that their organization is supporting a culture of health than those in poor health.

Employees who believe their workplace culture is focused on health have a high desire to stay with their employer until they retire.

Additional details and research findings.

About the Survey

The Towers Watson Employee Perspectives on Health Care survey, conducted in May and June of 2010, elicited responses from 9,080 full-time U.S. employees at nongovernment organizations. This brief — Part II of our complete analysis — looks at the data from 3,099 respondents for a subset of questions concerning employer-provided health care programs. Part I reported on an affordability gap that is placing increasing pressure on employees and eroding satisfaction with their health plans.

About Towers Watson

Towers Watson (NYSE, NASDAQ: TW) is a leading global professional services company that helps organizations improve performance through effective people, risk and financial management. The company offers solutions in the areas of employee benefits, talent management, rewards, and risk and capital management. Towers Watson has 14,000 associates around the world and is located on the web at www.towerswatson.com/.

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