3 Trends That Are Transforming Wellbeing

The results are in from the 4th annual Shortlister Well-being Prospectus Report and they aren’t promising for employers and vendors who have yet to substantively evolve their models.

The report is an aggregation of views from the top minds in employee-benefits consulting.  In all, Shortlister — a consulting firm that evaluates vendors in the benefits, wellness and HR tech spaces — surveyed over 100 subject matter experts (SMEs) responsible for consulting with employers on wellbeing programs for their clients. Each of the top 10 employee-benefits consultants in the U.S. were represented, with those 10 firms making up 74% of the total respondents.

In advance of the report’s release, HRE received an early copy. Shortlister President Joe Miller, who will be sharing some of the  findings during the Health & Benefits Leadership Conference, April 24 through 26, recently highlighted three of the more significant takeaways from the research. His insights follow:

Wellness exuberance is waning

Throughout the 2000s and into the mid-2010s, wellness (now wellbeing) programs were hot.  Everyone needed one and, as a result, there was record investment in the space.


In Shortlister’s 2017 prospectus, 81% of respondents indicated that more of their clients were adding niche/point solutions than in the past and 73% were prioritizing wellness as a business objective more than in the past. In 2019, these numbers have trended down to 57% and 68% respectively—and that is coming from the SMEs whose job it is to help find and implement these programs.

Commentary provided by the respondents indicates that employers are beginning to get vendor fatigue. Just too many options, changing too often. What’s more, many cited a lack of data for objectively measuring program impact. Absent this information, HR and benefits teams are reallocating time and budget to other priorities, including HR technologies aimed at recruiting and retaining top talent.

This trend is especially prevalent in the mid-market, where respondents were five times more likely to indicate that they were implementing fewer third-party wellbeing programs than they did in years past, compared to their large-market counterparts.

Outcomes-based programs and carrier programs are on life support

In 2017, consultants indicated that more of their clients were moving toward outcomes-based wellness programs (programs that provide an incentive for achieving a specific health outcome) than were moving away. This trend has seen a 180-degree shift, with the latest numbers revealing that six in 10 (61%) of consultants saying their clients are now moving away from outcomes-based programs. (Only 11% of them said they were moving towards them.)

Similarly, employers seemingly are growing tired of wellbeing programs offered by their carrier. Many reportedly cite the lack of customization as a concern. Overall, 44% of survey respondents said that more of their clients are moving away from these programs, compared to 13% moving towards them.

These were not the only traditional wellness programs seeing a decline in popularity. Other product categories included biometric screenings, health-risk assessments and wearables.

New trends emerge as the market evolves

There was a silver-lining for those with a rooting interest in the wellbeing space. While some air seems to be leaking out of the traditional wellness balloon, you can begin to see the foundation being erected for the next set of challengers.


Large employers, who often lead the innovation trends in benefits, are beginning to let their claims drive their decision-making process much more than the “hope-and-pray” approach to wellness programs of the past. About one-half of the respondents (53%) in the large market indicated that their clients are using claims more often to identify and prioritize the next “point solution”—programs targeting an individual risk such as diabetes or musculoskeletal issues. In this same group, 59% indicated they are implementing more point solutions than in past years.

Two of the point solutions that are currently generating a lot of interest are programs targeting musculoskeletal conditions and emotional/behavioral health. Both of these areas seem to be showing promise, with a handful of new vendors entering the market in the last few years. Unsurprisingly, both point solutions target conditions that are certainly in employers’ top five claims costs, if not top three.

The early feedback on each of these areas has been comparable—about 70% positive to 30% negative—with the thought process being similar for each. Positive sentiment includes the fact that they address a key driver of claims costs and have the potential to improve the quality of life and productivity. Negative sentiment includes the fact that they still need to evolve, the challenges of positioning them within the benefits landscape to attain appropriate utilization and ROI, and the difficulties of moving down market in a cost-effective way.

The consensus of the consultant population is that they’d welcome seeing these point-solution vendors, as well as others that are more mature (diabetes programs) and less mature (sleep disorder programs), continue to evolve their delivery models to achieve the highest impact-to-cost. At the same time, they’ll have to work with their clients to cost-justify the outcomes, avoiding the “purchase paralysis” we’ve seen with soft-dollar benefits like financial wellness.

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