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The Impact of Employee Wellness Programs in the United States

Location: United States
Sample: 200 BJ’s Wholesale Club sites
Research Initiative: Health Care Delivery Initiative
Outcome of Interest: 
Enrollment and attendance
Intervention Type: 
Health care delivery
Preventive health
AEA RCT Registration Number: 
Policy Issue 

In the United States, employee wellness programs appeal to both policymakers and employers for their potential to improve employee health outcomes and slow health care spending growth. In addition to improving health and lowering health care costs, wellness programs may also benefit employers by helping them attract and retain employees and by increasing employee productivity. Half of all U.S. firms with 50 or more workers offer employment-based health promotion initiatives; however, little rigorous evidence exists on the effects of such programs. Can an employee wellness program improve health and well-being, reduce employee absenteeism and turnover, and lower health care utilization and spending?

Context of the Evaluation 

BJ’s Wholesale Club is a large employer that operates about 200 membership-only warehouse stores across the Eastern United States. BJ’s has a diverse workforce with over 25,000 employees, a substantial share of whom are lower income workers. About sixty percent of the firm’s employees are white, 20 percent are black, and 15 percent are Hispanic. The majority of the firm’s employees are hourly employees. The average annual pay for employees, over 40 percent of whom work part time, is about $20,000 per year.

Details of the Intervention 

Researchers are conducting a randomized evaluation to measure the impact of a wellness intervention on employee health and well-being, worker absenteeism and turnover, and health care spending and utilization. Researchers will randomly select 40 BJ’s sites and assign 20 sites to a treatment group and 20 sites to a primary control group, with the remaining sites serving as secondary controls. Each site has about 100 employees. 

Employees of sites assigned to the treatment group will be invited and incentivized to participate in a year-long package of wellness programs, including team-based diet and exercise challenges, physical activity, nutrition counseling, and stress reduction. Wellness Workdays, a company that delivers and manages employee wellness programs across a number of industries, designed and will implement the program in partnership with researchers and BJ’s.

Researchers will measure outcomes using survey, clinical, and administrative data collected from the 20 treatment and 20 primary control sites: (1) pre- and post-intervention surveys of health behaviors, physical and mental health, and overall well-being; (2) on-site clinical health assessments, including cholesterol, diabetic blood sugar control, blood pressure, and body mass index; (3) employment records, including absentee and sick days, job tenure, and work performance; and (4) insurance claims records for those insured through BJ’s, including physician visits, emergency department visits, hospitalizations, and prescription medication use. Researchers will also collect the administrative data (employment and insurance claims records) from the secondary control sites.

Results and Policy Lessons 

Project ongoing; results forthcoming.