The gloves are coming off: employers are getting ready to dish some tough love about wellness, to convince workers that their very lives as well as the existence of company-sponsored benefits are on the line.

That was one of the undercurrents at the Midwest Business Group on Health annual conference last week. It was a packed house in Chicago, partly because MBGH is celebrating its 30th anniversary of service to member employers, but also because a wealth of new learnings were presented and discussed.

Faced with what portends to be a long, arduous implementation of national health reform, it would have been easy for discussions to slide into anger or despair. But instead, the mood gravitated toward acceptance of the need to adjust to the law, and elevations of hope over what the changes might accomplish.

While the health reform debate raged on, one common grousing was that it would do little to achieve true cost containment. At the meeting, held May 6-7, it became clear that true cost containment is more likely in the hands of the private sector, and individuals.

Overall, there seemed to be three over-arching sentiments among attendees:

1) Few believe health reform will lower employer plan costs, at least in the near term.
2) Because plan costs are more likely to increase, the importance of improving employee well-being has also increased.
3) It’s time to get dead-bolt serious about improving employee engagement in health and wellness programs.

The latter proves important in light of data presented from a 2010 employer survey conducted by the National Business Group on Health and Towers Watson. In it, two-thirds of employers said the biggest challenge to maintaining affordable benefits coverage is employees’ poor health habits.

Underuse of preventive services was also cited by 41%. And in the same survey, 58% of respondents said lack of employee engagement was the biggest obstacle to changing employee health behavior.

Other data unpacked at the conference show employers are becoming more willing to use financial incentives, or carrots, to drive engagement in health improvement programs. But they also appear more willing to adopt disincentives — or “frozen carrots, as some observers have started calling them — to change behaviors.

It appears this increasing desire to get serious about health care, for the sake of employees and for the survival of employer-sponsored benefits, will be necessary to overcome the hurdles ahead.

Among them are better metrics for measuring the impact of wellness plans, and incomplete bodies of evidence about what types of incentives/disincentives work best for wellness. The latter will be assisted by research such as the MBGH employee focus group, results of which were presented last week.

The willingness for employers to measure what they hope to manage will likely improve as kid gloves continue to hit the floor.

Guest blogger David Albertson is the editorial director for Employee Benefit News.