As more workers battle diabetes, cancer, heart disease, mental illness and other health conditions, employers are finding ways to help them reduce health care costs and focus on overall worker health and well-being, according to a new report. 

The International Foundation of Employee Benefit Plans' Workplace Wellness 2017 Survey Report surveyed 530 U.S. and Canadian organizations, and found that diabetes is the number one condition impacting benefit plan health costs for 41 percent of the respondents. 

The other top conditions impacting costs are cancer (33 percent); arthritis/back/musculoskeletal (32 percent); obesity (29 percent); heart disease (27 percent); hypertension/high blood pressure (26 percent); depression/mental illness (20 percent); high cholesterol (11 percent); smoking (9 percent); and high-risk pregnancy (4 percent). 

To combat these conditions, survey respondents say they offer a wide variety of screening and treatment initiatives. Three in four (76.8 percent) offer free or discounted flu shots, 65.7 percent institute a smoke-free worksite policy, followed by chiropractic services coverage (62.3 percent), health screenings such as blood pressure and cholesterol checks(58.7 percent), health risk assessments/appraisals (56.2 percent) and smoking-cessation programs (55.7 percent), including counseling, medications and treatments such as nicotine patches. Respondents also commonly offer disease management programs (48.1 percent) and case management (39.6 percent), a patient care model focusing on coordinating medical services for individuals. 

Respondents also offer a number of fitness and nutrition initiatives. The most common are wellness competitions such as walking/fitness challenges (51.3 percent), healthy food choices (44 percent) and health coaching (42.6 percent). More than 2 in 5 (42.3 percent) provide standing/walking workstations for workers, followed by on-site or subsidized weight loss/management programs (38.3 percent), activity/exercise breaks that are encouraged during work time (36.8 percent), organized group run/walk events (36.6 percent) and on-site fitness equipment/centers (36 percent). 

In regard to mental and behavioral health initiatives, respondents commonly offer employee assistance programs (85 percent), mental health coverage (63 percent) and substance abuse benefits/coverage (54 percent). 

“In recent years, research has shown that workplace wellness efforts have broadened in scope,” the authors write. “Employers are focusing less on health care cost figures and placing a greater emphasis on overall worker health and well-being.” 

Indeed, 75 percent of the survey respondents say they offer wellness initiatives primarily to improve overall worker health and well-being, while 25 percent say they aim to control or reduce health-related costs.

“Despite significant challenges, organizations are looking to increase the emphasis on a number of wellness-related offerings in the next two years,” the study says. “Most often, organizations are increasing the emphasis on wellness communication (55.8 percent), financial education (46.6 percent), health literacy education (44.2 percent), mental health/stress-related offerings (38.9 percent) and the use of wellness incentives (38.7 percent).” 

Organizations use a variety of different methods and factors to calculate their ROI, including the use of HRA/screening condition/risk trends (29 percent), factoring program expenses into their calculations (29 percent) and using total health plan cost trend lines (21 percent). Almost one-half (46 percent) track health care costs in relation to their efforts, followed by health risk assessment data (42 percent), health screening data (42 percent) and engagement/satisfaction/culture survey data (30 percent). 

“In theory, initiatives with high levels of worker engagement will produce cost savings for employers and improve the health and well-being of workers,” the study says. “Concerns remain as to whether organizations and workers are actually realizing these benefits. Wellness benefits can be difficult to measure because improvements in worker health, morale, productivity, absenteeism and turnover can be influenced by a combination of factors.” 

Among those with wellness initiatives, about 1 in 4 (26.7 percent) analyzes the return on investment of their wellness initiatives. Measurements are most often conducted by wellness vendors, providers or consultants (12.1 percent) or internal staff (10.0 percent). 

“Most organizations with knowledge of their ROI have found between a $1 and $4 return per $1 spent,” the authors write. “Very few have discovered a negative wellness ROI. The average wellness ROI among all organizations with knowledge of their ROI was $2.58 per $1 spent.” 

Respondents who tracked the ROI of their wellness initiatives were asked to rate the success of their efforts. More than 9 in 10 (92.4 percent) stated that their efforts were either very successful or somewhat successful.