For starters, employers are using more down-to-earth terminology like "health risk management" or "health improvement" to better reflect the many activities now incorporated into wellness programs, including health screenings and programs to manage diseases, safety and productivity.
But it's about more than just giving wellness a new spin. Employers today are making sizable investments in establishing entire wellness infrastructures. Those may still include fitness centers, but also on-site clinics, health coaches for employees, incentives to employees who adopt healthier lifestyles and data warehouses that will tell employers whether their investments are paying dividends.
Some employers are even redesigning their benefit plans to provide more generous coverage for health screenings and preventive services that medical research has found to be beneficial—or to penalize employees who refuse to shape up.
"Today's wellness movement is getting more traction because it's hooked to broader concepts," says Shelly Wolff, national leader for health and productivity at Watson Wyatt Worldwide in Stamford, Connecticut. "It's not only about exercise; it's diet, it's how you live your day, it's about safety issues, it's a much broader view of ‘what's in it for me as a person.’ Health is cumulative. If I take good care of myself in my 20s and 30s, I'll actually be able to enjoy myself in my 60s."
"It's not called wellness anymore," says Andrew Webber, president and CEO of the National Business Coalition on Health, a coalition of employer-led coalitions based in Washington. "Health and productivity management is a better name for it."
Whereas early wellness programs were mostly anchored in fitness centers that attracted the already healthy, today's wellness programs are designed to appeal to everyone, regardless of their health status.
Comprehensive health promotion programs mostly start with health risk assessments, sometimes coupled with biometric screenings, which measure cholesterol, blood pressure and glucose levels. They also can include virtually anything designed to promote better health and well-being, services that were once associated with employee assistance programs combined with traditional wellness, disease management and sometimes even safety and occupational medicine.
The objective is to keep healthy those who are already healthy, and to move those in the higher risk categories into the lower risk categories, Wolff says.
"Depending on where you are on the continuum, you've got to have programs to make sure those who are low risk don't shift into the medium- and high-risk categories," she says. "The way you do that is you have certain programs focused on the low risk; for the medium-risk people, you've got lifestyle programs and absenteeism programs, work/life balance programs, etc., to help them; and for those who have illness and are seriously ill, that's where you get into disease management."
"Some of it goes back to the old California mind-body connection that we all rolled our eyes at," says Helen Darling, president of the National Business Group on Health. "There is a focus on mental health to make workers happy and engaged and interested. We want them to come to work ready and eager to work. If you want to keep knowledge workers productive, you've got to keep them healthy and not depressed. We know a lot more than we did back then. There's more science, more studies."
Scotts Miracle-Gro Co.'s LiveTotal Health program is a good example. It is rooted in three principles: physical, financial and personal wellness.
"When we said LiveTotal Health, it's not just about physical health and well-being," says Pam Kuryla, vice president for global total rewards at the Marysville, Ohio-based fertilizer maker. "That's the major component of our plan, but it isn't encompassing all of the different components of which we feel someone needs to be aware of in order to be the best they can be."
Because more than half of employer health care costs are attributable to dependents, many of today's corporate wellness programs also include spouses and sometimes even children.
Molson Coors Brewing Co.'s wellness center in Golden, Colorado, for example, is open to employees, spouses, retirees and any of their dependents over the age of 13. The center is a 23,000-square-foot facility located near the main brewery complex that has an indoor track, basketball court, exercise equipment and space for fitness classes. It also offers fitness testing, massage therapy, physical therapy and locker rooms with showers and saunas.
"If the dependents are feeling well, then the employee is going to be more productive and focused at work," says Mark Cauthen, benefit manager for the city of Colorado Springs, Colorado, whose wellness program also is open to both employees and dependents.
Today's wellness programs also provide more long-term assistance, unlike in the past, when completing a smoking cessation program meant the benefit would end. In fact, some employers such as Santa Clara, California-based Intel Corp., cover multiple attempts at quitting, the approach that is recommended by the U.S. Centers for Disease Control and Prevention. A growing number of employers are providing annual nonsmoking discounts on employee premium contributions to encourage employees and families to stay smoke-free.
In a way, value-based plan design, which removes financial barriers to encourage employees who already have a health condition to access beneficial medical treatments, is a component of the new wellness movement, says Marianne Fazen, executive director of the Dallas-Fort Worth Business Group on Health.
"Consumerism is also a part of it, giving more responsibility to the employee to become more proactively engaged in their own health," she says. "These are different words and different phrases, but they're all talking about the same thing: no longer just providing benefits but setting up a structure, an integrated benefits design, that keeps you out of the health care system through wellness and prevention, and then aligns incentives so that if you do have to go in, then to use the high-quality providers and take your medicine [and] be compliant."