How Well-Being Practices are Evolving: HERO Scorecard Analysis
Best practices for creating a thriving workforce are in a constant state of evolution. To keep pace with both research and the real-world experience of diverse organizations as they test well-being strategies in the laboratories of their workforces, every five years or so we overhaul the HERO Health and Well-Being Best Practices Scorecard in Collaboration with Mercer. Version 5 will launch next month. But before we close the books on Version 4, we decided to delve into the robust data collected from the more than 1,300 employers that used it to examine the prevalence of some key strategies and how their use has changed over time.
We compared Scorecard data submitted between 2014 and 2016 with data collected between 2018 and 2020. (For simplicity, we refer to the earlier dataset as 2016 and the current dataset as 2020.) We restricted the analysis to employers with 5,000 or more employees; the 2016 dataset includes 148 employers of this size and the 2020 dataset includes 115.
Whether organizations decide to invest in health and well-being initiatives or not depends, at least to a certain extent, on whether these investments are seen as contributing to business results. Scorecard results suggest there is growing consensus on this point. The Scorecard asks: “To what extent is your program viewed by senior leadership as connected to broader business results?” Employers responding “to a great extent” rose from 22% in 2016 to 30% in 2020 (in both years, the most common response was “to some extent”).
How has this growing recognition of the importance of health and well-being translated to action? To gauge the adoption of the most meaningful practices over time, this longitudinal comparison focuses on the four clusters of practices that emerged from a factor analysis as having a strong, statistically significant effect on Scorecard completers’ perceptions about the effectiveness of their workplace health and well-being initiatives.1
Organizational and leadership support A recent HERO study found that organizational and leadership support is highly predictive of positive health and well-being outcomes such as program participation, health and medical cost impact, and employee perceptions of organizational support. One visible way for an organization to demonstrate support is with the company vision or mission statement. Scorecard respondents reporting that their company vision or mission statement supports a healthy workplace culture jumped from 35% in 2016 to 49% in 2020.
Another practice found to have a strong positive influence is active participation by leaders in health and well-being programs. However, there was no change in this best practice from 2016 to 2020 – in each dataset, 51% of respondents said leaders actively participate. There was some improvement in leaders acting as role models for prioritizing health and work/life balance (for example, by taking activity breaks during the day, not sending email while on vacation, and so on), from 16% in 2016 to 24% in 2020, but even so, this best practice is still far from the norm.
Programs Health assessments and biometric screenings have long been staples of well-being programs. However, a somewhat smaller percentage of employers are assessing employee heath with health assessments and biometric screenings in 2020 (77% and 74%, respectively) than were doing so in 2016 (87% and 78%, respectively). At the same time (and not surprisingly), there has been rapid growth in the use of technology to support health improvement programs, such as wearables (from 61% to 75%), mobile apps (64% to 76%) and social connection programs (from 66% to 79%). HERO Scorecard data has shown that participation rates are higher among employers using technologies that create a more personalized, real-time experience – and participation rates are a leading indicator of program effectiveness.
Program integration Respondents in the 2020 database still have plenty of room for improvement in terms of ensuring that their health and well-being programs are effectively integrated with each other, the health plan, the safety program, and disability programs. In 2020, just 52% of respondents said that “Health and well-being partners provide warm transfer of individuals to programs and services provided by other partners” -- and this is down from 57% in 2016. This trend is concerning because HERO Scorecard data suggest that program integration positively influences program effectiveness.
Incentives and other participation strategies Participation strategies include incentives, communication and education. Of these, financial incentives seem to have the most direct influence on participation rates and affect program outcomes. However, while the majority of 2020 respondents (76%) use some type of financial incentive in connection with their programs, this is down slightly from 79% in 2016. Further, the use of financial incentives to achieve, maintain, or show progress toward specific health status targets (“outcomes-based incentives” as opposed to participatory incentives) has fallen sharply, from 38% in 2016 to 25% in 2020. While Scorecard data do not help us understand the reasons for this trend, it might be due to increasing employer concerns about the permissibility of these types of incentives.
While financial incentives are still widely used, there was an increase in respondents saying that increasing employees’ intrinsic motivation to improve or maintain their health is the primary focus of their engagement strategy, from 29% in 2016 to 38% in 2020.
In the next version of the HERO Scorecard, as in the past updates, we have been guided by analyses of Scorecard data as well as by input from experts in the field. While Version 5 will offer a number of new practices for employers to consider, some of the Version 4 practices will be retired. However, the practices discussed above have demonstrated their continued importance and will, we hope, continue to spread.
This post was adapted from a longer article that appears in the just-published HERO Scorecard Progress Report, which presents expert research commentaries and trend analyses of Scorecard data, along with case studies that illustrate the utility of the HERO Scorecard as a resource for employers.