Q: My employees would like our firm to institute a wellness program. Would this be worth it?

A: The Affordable Care Act (ACA) allows employers to use up to 30% of the total amount of employees' health insurance premiums to provide outcome-based wellness incentives. Firms are taking this to heart. The 2017 Employee Benefits Report from the Society for Human Resource Management (SHRM) indicated that nearly one-third of organizations increased their wellness benefits by 24% over a 12-month period. Reported results are varied, however, and raise questions about these programs' overall value.

While more than 60% of U.S. businesses offer such programs, research on their effectiveness is mixed. A number of studies show positive gains in cost savings, while others show that these programs have done little to deliver meaningful value.

The hope behind the ACA provision is that it will reduce the prevalence of chronic disease through fostering healthier behaviors. Kevin Volpp and David Asch from the University of Pennsylvania argue that the success of wellness programs hinges not on ACA assumptions but on the way engagement incentives are organized.

They maintain that the path to successful implementation of wellness initiatives is through incentives that provide small but tangible and frequent positive feedback or rewards. For example, a program that promotes exercise with a year-end rebate for gym attendance is far less likely to succeed than one providing incentives at each visit. Volpp and Asch urge continued testing of incentives that deviate from the standard design of these programs. At the same time, SHRM would like to see firms pay more attention to employee engagement than to focusing on financial results. SHRM believes that when employers demonstrate that they truly care for the well-being of their workers, employees respond favorably in all aspects of work.

Wellness programs can be valuable if their incentives are designed effectively and if they are part of a broad employee engagement strategy. They may not be as effective if the program is packaged in a more traditional manner and focused solely on financial results.

Jack Militello is a professor of management at the University of St. Thomas Opus College of Business.