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Are employees happier and healthier?

The big buzz in employer health care has been about wellness. All over the nation, companies have been rolling out programs to help their employees get healthier, and some have been more proactive than others.

Organizations who offer these options want to maintain a certain level of participation that helps to drive down the cost of health care by offering preventive solutions to obtain those goals. After all, what business owner or CEO doesn’t want to have a healthier, and happier, work force? Employees who participate in wellness programs have a tendency to be healthier, and they also perform better on the job. Better performance leads to better results, and that typically can be translated to increases in productivity, promotion and income.

Business Insider reports 41 percent of workers said wellness programs made them happier and more productive at work, according to the latest Principal Financial Well Being Index. And better health means time on the job; about 35 percent said they missed fewer days, while 52 percent said their energy had increased.

Nearly half (45 percent) of the study’s respondents said the programs were worth it, but there’s still a bit of disconnect when it comes to what the companies are offering and what workers want. The most common wellness packages included online wellness information and educational tools or resources, but 25 percent of those without discounts to the gym said they would prefer a workout pass instead.

Respondents also said that on-site preventive screenings, access to nutritionists and weight management programs would ramp up their enthusiasm for an employer’s wellness program. Ironically, only 13 percent of the 1,121 workers surveyed said the programs were “very successful” in improving their actual health. Perhaps they have been eating the wrong food at their desk?

When offering incentives to employees, organizations must walk a tightrope at times. Being punitive can backfire. Some companies offer incentives — gas cards, cash, and discount rates — to get employees to live more healthfully and curb costs. But, increasingly, firms are punishing employees financially if they don’t take their own health more seriously, according to Scripps Howard News Service. The National Business Group on Health surveyed large employers and found 80 percent plan to offer financial rewards to employees who participate in certain health initiatives in 2012, up from 54 percent in 2011.

Its survey shows the share of companies “penalizing workers over health measures or lack of participation in wellness plans” is expected to double this year, to 38 percent, the survey shows. Most penalties involve a higher insurance premium. In other cases, employers are refusing to hire nicotine users as a way to create a healthier workplace.

Other surveys confirm this trend: Mercer, a national benefits consulting firm, found 24 percent of the largest companies — those with 20,000 or more employees — will charge higher health insurance premiums for smokers. And 12 percent of firms with more than 500 employees are doing the same, according to the 2011 survey.

How big does a penalty or incentive have to be to influence employee behavior? Would employees be more likely to lose weight if they got a guaranteed payment — say, a $150 gas card — or if they were entered into a lottery to win a much larger sum? Will a simple written reminder get more people to sign up for a flu shot? Finding out what works is paramount, especially as the federal government gives employers more latitude to tinker with premiums for those who quit smoking, lose weight or otherwise try to improve their health.

With “participatory” programs, in which someone might get $50 for completing a body-mass-index exam, there’s no limit on how much cash a company may dole out. But for “outcomes” programs — which reward or punish only if you lose the weight or reduce cholesterol or quit smoking — the amount is capped at 20 percent of the total premium. The new federal health care reform bill raises that limit to 30 percent and, in some cases, to as much as 50 percent, starting in 2014. For a family with a $12,000 health plan, $3,600 of that total could be tied up in outcomes-based discounts.

Critics call punitive measures a slippery slope: Testing for nicotine use today could lead to alcohol testing tomorrow. Employers could refuse to hire people if they don’t like their diet or their family’s history of heart disease. However, such programs could be viewed as biased: Poor people generally have a tougher time quitting smoking and have higher smoking rates to begin with, meaning premiums are being raised on the class of people who can least afford it.

The problem with this is that employees don’t all start from a level playing field in terms of personal health and socioeconomic background. People are helped more by employing effective, evidence-based incentive programs, not refusing to hire them outright. Research also shows that people who are healthier to begin with are more likely to get involved in “participatory” programs.

Employees, as a general rule, are going to be incentivized by monetary exchanges whether punitive or as a financial reward of some type. In many cases, those financial carrots or sticks are enough to motivate the majority of workers to take action. Although it’s possible to see positive change over time, delivering workable wellness programs that make a definite change in employee behavioral aspects take much longer to instill on a corporate basis. Will employees be happier and healthier in 2012? Hopefully so, but at what cost? The most important point is, the health of your company and the health of your team are paramount to the ultimate success of your business.

BY MARK ROBERTS