Feb. 27, 2024
Haley Potoczek, Healthiest Employers Program Coordinator
Healthiest Employers® started in 2009 as a way to celebrate companies that are putting their people first by investing in the health of their employees. Hundreds of companies apply for local and national recognition in the awards program each year to solidify their ongoing commitment to employee well-being. In addition to the awards component, Healthiest Employers is a benchmarking and research organization providing health and wellness consulting and thought leadership opportunities.
Application Process
With the help of a national, non-biased group of representatives from the academic, medical, clinical, human resources, and business communities, we crafted the categories, scoring, and benchmarking for our online assessment, which is comprised of the following six categories:
- Culture and Leadership Commitment
- Foundational Components
- Strategic Planning
- Communication and Marketing
- Programming and Interventions
- Reporting and Analytics
While recognition continues to be an important aspect of the Healthiest Employers program, many applicants also use the assessment as a tool to transform their wellness programs and further better the health of their employee populations. The questions in the survey are modified each year based on feedback from applicants, vendors, and various other health, wellness, and benefits community members.
Many of our questions are set up to be all-encompassing, as we know that not all wellness programs are the same. The language in our survey ensures that every company has the chance to respond and showcase what their programs offer.
The application is scored Rubric style on a 1-100 scale. The assessment comprises six categories with yes/no, multiple choice, and short answer questions, with each totaling .25-3 points. A Healthiest Employers Index (HEI) is assigned to each application to help rank among companies of similar sizes. This often means that rankings are determined by a fraction of a point, emphasizing the importance of double-checking to ensure all responses related to your program are selected.
How Your Organization Can Improve
Members of our team are constantly asked, “How can we do better?” While we offer a consultation package as part of our annual Benchmark Report offerings, this brief overview of our new questionnaire can be beneficial to anyone considering applying to the program or looking to improve wellness program offerings.
Demographic and Partnership Information
Some companies are often hesitant to provide consultant, third-party administrator, or wellness vendor contact information. We ask for this information because several of these organizations contact us directly each year if their clients make the list. Providing this information allows us to quickly assess which partners are truly making a difference for their clients and helping them succeed on the national level.
Additionally, we know these partners are imperative to the success of your wellness program. In 2023, 88.8% of our applicants responded that they work with a consultant, 81.4% are using wellness vendor services, and 51.2% work with a third-party administrator.
Lean into these relationships when filling out the survey, as we see the majority of our higher-scoring companies collaborating on the application to ensure all of their accomplishments and offerings are highlighted.
Section 1 – Culture and Leadership Commitment
A recent article on Business Wire suggests that managers have the same impact on one’s mental health as a spouse or a partner and an even greater impact than doctors or therapists.
Let that sink in!
Company culture can determine the success of a well-being program, and leadership plays a critical role in affecting an organization's approach to health. Section 1 serves as a way to understand leadership buy-in within the organization and how health is perceived among employees.
#1 Which describes your workforce?
This year, we expanded on this question, as we know that the workforce doesn’t look the same as it did five years ago. There are many differing opinions about what the future of the office looks like. While the COVID-19 pandemic emphasized the desire for flexible work, CNBC reported that 90% of companies will be back in the office in 2024 in some capacity, stressing that the “traditional 5-day, 40-hour work week” is dead.
Because of this, question 1 now has four options to include:
- All employees work in office or onsite.
- We are on a hybrid schedule; each employee is in the office on specific days.
- Only certain teams or roles are given work-from-home opportunities.
- All employees work remotely.
Depending on which option best fits your organization, you will then be prompted to answer a separate set of questions. For example, in-person organizations are asked how the physical space of the office affects employee well-being, while remote organizations are asked how employees are supported while at home.
#3 What kind of career development opportunities do you offer employees?
We added additional choices for this question, as Quantum Workplace claims the top 3 reasons employees quit their jobs are due to a lack of growth opportunities, low pay, or feeling undervalued in their role.
Employees who work in the office spend approximately 25% more time working toward their career goals as opposed to remote workers. While this doesn’t necessarily mean the remote companies are “less healthy,” we encourage organizations to prioritize checking in on those remote employees to ensure they have a clear path to success and are given the same opportunities and resources as their in-person counterparts.
#4 How does your organization support positive work-life balance and employees’ lives and families outside of the workplace?
This month, BenefitsPro released the "top HR trends set to transform the workplace in 2024." Of the top 5 trends listed, 4 have to do with fertility, family planning, or pregnancy benefits:
In the 2023 national dataset, companies are currently providing:
- Family leave options for adoptive parents (82.2%)
- Family planning benefits (52.4%)
- Infertility support and resources (51.7%)
- Childcare assistance (38.8%)
#10 How many days of time off do you provide to your employees?
This year, we asked employers to use the STARTING amount of PTO allowed because a majority of applications stated that PTO increased with merit or years of service. We are hoping that rephrasing this question will allow us to get a better idea of the organizations that are investing in employee mental health right from the beginning.
The United States ranked #2 on the “Top 10 Countries With the Least Paid Vacation Days” and 12th on the “Countries with the Highest Rates of Obesity.” Several studies listed in these articles have indicated that vacations improve overall well-being and have a positive effect on mental health. Consider your time off policies and if they are encouraging of a healthy lifestyle.
Many companies are beginning to consider the idea of unlimited PTO. However, many studies suggest that employees with these policies do not take as much time off and only average 10 days off in total. Instead, can we encourage employees to take the time they need and instead have a “minimum time off policy?” This allows employees to rest and recharge without feeling guilty about taking time for vacations and family events.
#12 How does your organization ensure a diverse and inclusive workforce as well as promote health equity?
This question was expanded this year based on feedback received from former applicants. Responses added include:
- Pay transparency by listing salary ranges on new job postings – ADP reports that embracing pay transparency can help businesses improve trust from employees, talent acquisition from those interested, and productivity in the hopes of moving up the corporate ladder.
- Providing roles and jobs for individuals with special needs or disabilities – According to a 2022 report by the U.S. Bureau of Labor Statistics, 21% of Americans with disabilities were employed, a 2% increase from 2021. It also suggests that the increased opportunities for remote work have helped employ individuals with disabilities.
- Hiring individuals who may have prior criminal convictions – The U.S. Department of Justice released a report on the employment rates of formerly incarcerated individuals to highlight the struggles many face after serving time. Based on information from 50,000 people released in 2010, 33% could not find a job during the four-year study period. Additionally, Katherine Van Shaar’s article on The Center for Growth and Opportunity and Utah State University emphasizes, “It is especially difficult for ex-convicts to stay out of prison if they’re released during difficult economic times. At the same time, labor shortages continue to plague the nation. As of October 31, 2022, the US Bureau of Labor Statistics data showed that the US has over 10 million job openings and only 6 million unemployed workers.”
Section 2 – Foundational Components
The foundation of your wellness program will determine its overall, long-term strength. Shallow programs can be built quickly but have difficulty producing and maintaining results. This section takes a closer look at the core elements of company programs.
More programs don’t always mean better outcomes. Many companies will pile on dozens of lifestyle and incentive programs, but one or two for that specific condition would have sufficed. Don’t spend your valuable budget adding items that aren’t making a difference in your employee population.
#16 Which of the following pillars of well-being does your organization have in place?
Options on the survey include:
- Physical
- Mental/Emotional
- Financial
- Social
- Community
Wellness is not a one-size-fits-all approach. The questions in Section 2 are designed to expand on the different pillars of the program and get a feel for the areas you are most invested in–for both employees and their spouses and dependents.
#18 Which of the following does your organization provide to employees?
#19 Which of the following does your organization provide to spouses/dependents?
These two questions in this section are designed to see what offerings are provided to employees vs. members of their families on the health plan. Historically, people have asked us, “Why do you ask questions about family members and their access to care? What if most spouses are on their own health insurance plans?”
While this is the “Healthiest Employers” award, families are an extension of our employees. If the majority of your employees’ families are choosing to go with another organization’s health plan, what does that say about your own?
It is important to keep in mind, however, that more programs don’t always mean better outcomes. Many companies will pile on dozens of lifestyle and incentive programs for families, but one or two for that specific condition would have sufficed. Don’t spend your budget adding items that aren’t making a difference to the members of your health plan, but ensure you are providing adequate care to meet their unique needs.
#20 When it comes to promoting your well-being program, what social well-being and peer strategies do you utilize?
According to Quantum Workplace, the #3 reason that employees quit for new job opportunities is because of a lack of recognition. More than half of employees look to their immediate manager for real-time recognition and feedback. It is reported that companies with formal recognition programs experience less turnover and frustration among employees. Options for social well-being options in the survey include:
- Health, well-being, and safety committees to help create programs and offerings
- Executive sponsorship from upper leadership to encourage participation and set examples
- Promoting employee success stories as a way to recognize those who are making an impact
- Employee and/or family appreciation days, parties, etc. to include employees' families, which we know play a major role in overall health
#21 How do you support employees’ financial well-being?
Financial health is so important to one’s overall health. Last year, according to Forbes, only 44% of Americans reported being able to cover an unplanned $1,000 emergency. Today’s economic environment is playing a major role in our overall stress, as 77% of Americans currently report being stressed about their financial situations and 58% of Americans believe that money is controlling their lives. Employees with this mindset are not going to be able to bring their best selves to work. Options for financial well-being benefits in the survey include:
- Access to financial advisors/planners to help analyze personal finances
- Student loan assistance can encourage employees to return to school and advance their careers
- Dependent scholarship programs – A recent study suggests that 85% of parents pay for at least a portion of their child's tuition, causing significant financial worry. Scholarship offerings, even small, could provide opportunities for employees' children to apply for some aid for textbooks, living costs, and/or tuition fees.
Section 3 – Strategic Planning
An innovative program begins by developing a mid- and long-term strategy. This section evaluates your organization’s plan for well-being. Work with your consulting firms, wellness vendors, and internal stakeholders to determine what data and programs are already available through your current plans. Many times, employers are not fully aware of the options available to them through their partnerships.
#27 Which of the following data sources are you tracking for the strategic planning of your organization’s well-being program?
The most common responses to this question from the 2023 data:
- 91.4% use employee interest and feedback
- 83.7% analyze medical claims data
- 82.1% factor in EAP utilization
The top-scoring companies are going beyond these commonly selected responses and placing a heavier emphasis on data to prove the value of programs. 98% of the Healthiest 100 Workplaces in America are analyzing gaps in care and chronic condition prevalence among their populations.
#28 Do you have access to a data warehouse to track health analytics data?
Last year, 60.9% of applicants selected that they currently have access to a data warehouse to track their health analytics data.
These services allow employers to utilize their claims data and information to make strategic planning decisions for the future. Additionally, health analytics allow you to detect patterns for potential risk, lower cost claims, and provide suggestions for targeted interventions. 19% of applicants indicated that they are interested in purchasing software for health intelligence, population health analytics, and data warehousing in the next year.
#29-31 How often do you review your population’s chronic conditions and medical and prescription claims?
The majority of applicants are analyzing their chronic conditions annually. While this is a great way to get an idea of the needs of your population, we are seeing more companies analyzing this information more than once per year. The CDC reports that 6 in 10 Americans are currently living with at least one chronic condition.
Chronic conditions also serve as the leading cause of death, disability, and employer healthcare costs. By looking at claims data and chronic condition prevalence multiple times throughout the year, companies can better identify trends and see if there are specific events leading to an increase in this information.
Additionally, analyzing this information more than once a year can help identify trends among this target population.
Section 4 – Marketing and Communications
Marketing and communications are critical in reaching your employees and members. This section evaluates your approach toward effective communication.
#33 Please select the attributes that correctly describe the marketing and communications of your health program.
Many employees report not using certain health or wellness programs because they don’t fully understand their benefits or how they work. Examples of health program promotion may include emails, social media posts, podcasts, blogs or articles, company intranet, town halls or face-to-face meetings, newsletters, and direct mail.
Options commonly selected from our 2023 data:
- 96.3% send email communications about events
- 93.5% include program information and education in the employee onboarding process
- 88.2% have information easily available to employees on the company intranet page
- 83.8% of companies have posters on display throughout the workplace
- 82.2% have a program activities calendar
#38 Which of the following areas are you sending direct communication to employees based on their individual needs or activities?
In 2023, 20.3% of applicants stated that they cannot define who gets specific communication based on individual needs or activities, making this the question with the most missed points opportunity within the survey.
When filling out the application, it is important to remember that communication can come from third parties, helping earn the highest possible score for your organization. This also highlights the importance of working with vendor partners to ensure you receive the most points possible.
#40 Has your organization won any other corporate awards?
This is a new question this year, as we know that many organizations apply for corporate awards year-round. With many reputable awards related to diversity, LGTBQ+ friendly, and company culture, we want to ensure companies are earning recognition for the many things they are doing outside of Healthiest Employers.
Continue applying to various awards to help your company earn recognition for your many strengths!
Winning corporate awards helps recognize employees for the hard work that they are contributing to business.
Section 5 – Programming and Interventions
Does your program use a “carrot” or a “stick”? Effective engagement strategies are often ones that address the self-interest of the employee population. This section evaluates the effectiveness of your programming efforts.
#41 For which of the activities below does your organization incentivize the employee?
How can you best incentivize programs so that employees want to engage? This doesn’t always have to be a cash-based option. The Incentive Research Foundation reported that companies that have rewards programs in place show an average increase in employee productivity by 22%.
Gallup provides an Employee Engagement solution based on the idea that an engaged workforce is what sets companies apart from their competitors. They define employee engagement as “the involvement and enthusiasm of employees in both their work and workplace.”
Based on our survey, the most common selected answers to this question in 2023 were:
- Wellness challenges (87.5%)
- Participation in well-being programs (83.8%)
- Completing annual physical (74.7%)
#42 Which target lifestyle programs or coaching opportunities are available to employees?
Ensure the right programs are in place within your organization. We understand that programs are not a one-size-fits-all for your population. Using data to assess population needs can eliminate guesswork when determining which programs to implement or understanding why a program may not be achieving the expected impact.
For example, in a case study, a Springbuk client was frustrated because their "At Work Diabetes Program" wasn't lowering cost." Through careful analysis of the program data using the Springbuk platform, the team discovered the primary drivers for diabetes were coming from the spouses and dependents, not the employees. Therefore, at-work programs would not be helpful for their diabetes populations.
#46 Does your organization cover weight loss medications such as GLP-1s?
This is a new question added to our survey this year to align with the emerging trends in the industry. Over the past year, we have seen a significant increase in the number of patients using GLP-1s, such as Ozempic and Wegovy, coined “the worst-kept secret in Hollywood” due to its rapid success among celebrities.
While there are mixed results among users, Springbuk’s 2024 Employee Health Trends report states that in a year, GLP-1 agonists are responsible for an increase in Rx spending of almost $5 PMPM (per member per month) over the prior year. This question will likely expand in future Healthiest Employers surveys as we better understand how GLP-1s will impact benefits offerings.
Jennifer Jones, Vice President of Strategic Partnerships and Population Health Practice Leader at Springbuk, stated, “Looking ahead, I think we’re going to see spend on diabetes and obesity treatments like GLP-1s stabilize for many employers, primarily due to many only covering for the indicated use and required prior authorizations that many PBMs instituted mid-year. This smart reshuffling of resources, in my opinion, will make the healthcare world a whole lot more balanced and sustainable.”
Section 6 – Reporting and Analytics
Savvy employers are uncovering new ways to measure success. When it comes to employee health, it is often difficult to understand the value of investment. The questions below describe how your organization reports and analyzes your data.
#47 Which of the following do you use to measure a Value on Investment (VOI) or Return on Investment (ROI)?
We are often asked why proving a value on investment is an important part of the Healthiest Employers program.
In 2022, U.S. healthcare spending increased by approximately 4.1% to reach $4.5 trillion dollars, or around $13,493 per person. Considering these numbers, this could be an extremely costly investment within your own organization. As we continue to see rising inflation costs, management and upper leadership will likely be hesitant to invest or add new programs to healthcare programs.
To help prove the value that the program provides to employees, a VOI/ROI can show quantitative numbers on how these initiatives impact employees.
#51-52 What percentage of your female/male population has completed their age-specific preventive exam?
#53 What percentage of your employee population has participated in biometric screenings?
Healthiest Employers places a heavy emphasis on encouraging preventive care and age-specific exams for the betterment of population health. For men, this could be a prostate screening, while in women, this could be a cervical cancer screening or annual mammogram. Gallup reported that 75% of medical costs come from preventable conditions. Try using this information to encourage employees to get their preventive screenings to prevent high costs, stress, and chronic conditions in the future.
Healthiest 100 Workplaces in America Section
The following questions are used for the Healthiest 100 Workplaces in America™ program, the national award that ranks the highest-scoring companies of all applicants. This section focuses heavily on chronic conditions management and ensuring healthy habits within your population.
#56-59. Has the prevalence of chronic conditions, at-risk members, medical claims, and prescription claims increased?
Many often hesitate to provide this information, fearing that an increase in costs could impact their scores and placement in the awards. However, this question is primarily to see if your organization is prioritizing this information, while also helping identify trends among applicants.
#66 Which of the following social determinants of health does your organization evaluate?
According to Springbuk, "social determinants of health are about improving the underlying social and economic conditions within communities to improve the health for all."
More employers are starting to evaluate Social Determinants of Health (SDoH) when planning their wellness programs, as only about 20% of our overall health can be tied back to health claims, while nearly 50% can be tied back to zip code. The CDC reports utilizing this information more for data and surveillance, evaluation and evidence building, community engagement, and much more. Learn more about the CDC's work on SDoH here.
#67-70 Chronic Conditions Questions
#67 For which of the following chronic conditions does your organization provide educational support and disease management programs?
#68 For which of the following chronic conditions is your organization able to identify the percentage of employees diagnosed with said condition?
#69 For which of the following chronic conditions does your organization currently have systems in place to measure clinical improvements?
#70 For which of the following chronic conditions is your organization able to identify gaps in care?
Applicants are asked to check all from the following:
- Arthritis
- Asthma
- Cancer
- Depression
- Diabetes
- Heart Disease
- Hypertension
- Musculoskeletal Disorders
- Obesity
These specific chronic conditions were selected for the application because of the CDC’s continued research and publications on the topic, as well as Springbuk’s continued identification of trends.
If you are interested in applying for national recognition, find your district deadline and begin your application here!
