In a survey of 3,552 employees at eight companies, the Blue Cross and Blue Shield Association found that participation in wellness initiatives increased by 21 percent if the firms combined wellness education with “activation components,” such as online registration and tracking, participant guides and work-site competition.

The companies took part in the insurers’ Engaging Consumers @ Work program, a 10-week wellness pilot study conducted by Blue Cross and the Department of Health Care Policy at Harvard Medical School. Survey data was collected from June 2006 to April 2007.

The combination of education and motivation increased employees’ awareness of wellness programs by 12 percent and boosted by 15 percent their perception that “my employer is interested in my health.”

Wellness programs are becoming increasingly popular as companies try to reduce their health care costs. But for them to be effective, employers have to do more than hang posters or distribute nutrition guides.

“Employees do not consider or recognize passive education initiatives to be work-site health/wellness programs,” the survey states.

DTE Energy, a Detroit utility company, puts corporate effort into helping employees avoid sickness because that’s where it anticipates the best outcomes are for its bottom line and its workers. The company, which has 10,000 employees, participates in Healthy Blue Living, a program sponsored by the Blue Care Network of Michigan.

“Prevention is far less expensive and far more beneficial to everyone involved than cure,” Richard Lueders, director of compensation and benefits, said at the National Press Club. “It’s the win-win scenario.”

There is some empirical evidence of wellness success. Over the past three years, DTE has saved nearly $12 million on an investment of $7.6 million in disease management. It has reduced its high-risk population from 15 percent to 9 percent the past three years.

Usually, the return on walking programs, health screenings, smoking cessation and nutritional counseling is difficult if not impossible to determine. Food Lion, a supermarket in the southeast and mid-Atlantic region that offers all of those activities, could not pinpoint concrete results.

But Pat Fulcher, vice president of associate services for the 85,000-employee grocery retailer, argues that it is indisputable that a healthy workforce is more reliable and productive.

“There is a tie between wellness and the bottom line,” Fulcher said at the press conference announcing the study. It shows up not only in overall company performance but also in keeping health care costs below expectations, she added.

“We are beating the trend,” Fulcher said.

Still, corporate leaders will eventually want to see a specific payoff to wellness.

“Our CEO does expect a return,” Fulcher said. “But he also understands this is not something you change today. It takes time and effort to get people to change their lifestyles.”

Before joining a wellness program, employees may need be reassured that their medical information will be secure. Lueders says this is achieved by having outside providers run the wellness programs and report only aggregate data about worker ailments to employers.

In addition to getting employees onboard, Blue Cross Blue Shield, DTE Energy and Food Lion also want to raise awareness on Capitol Hill about wellness initiatives. They spent Monday visiting members of Congress, which is likely to begin major health care reform next year.

They’re making the point that companies are encouraging the 162 million people they cover to take better care of themselves—an approach that is rapidly gaining in popularity.

“More employers are designing and executing programs,” said Helen Darling, president of the National Business Group on Health. “It is deeply embedded in the culture of these companies. C-Suite leadership is the key. It really is a sea change.”