I implemented my first wellness program in 2001. After researching recommendations and case studies about successful wellness programs, my plan included a comprehensive health risks assessment addressing a broad spectrum of lifestyle choices, including biometric testing with a full blood panel.

My company offered the assessment during working hours and allowed participating employees to earn points toward the reimbursement of health- and fitness-related expenses of up to $300 per year just for participating in walking and weight-loss challenges or utilizing an onsite gym.

I thought I'd made my program as attractive as possible to the workforce, and the initiative had the support of the senior management team. We even formed a cross-functional wellness council with representation from all levels of the organization.

During the first 24 months of the program, we achieved an employee participation rate of just over 50%. I thought I was on top of the game. After all, a Deloitte Consulting survey shows 84% of all wellness programs experience less than 50% participation, and 61% of them only achieve 25% at best.

I thought my employee participation was excellent! But I couldn't have been more wrong.

Having 50% of your employees participate in your wellness initiative sounds like a great success — it did to me at the time — but take a closer look at what that actually means in terms of cutting health care cost and overall impact on your business.

You see, the average company's employee supports two dependents. That means if you have 200 employees, you're actually covering 600 lives. Consequently, if 50% of your workforce participates in your wellness program (100 employees in our example), you're truly only impacting 16.6% of your insured population — just a drop in the bucket.

Fifty percent participation simply is not enough to significantly reduce your overall health care costs. You need to have at least 80% of your employees and their spouses actively participating to see rapid changes in your medical claims and a corresponding reduction in your health care costs.

While the number of companies offering wellness initiatives has significantly increased in recent years — a good thing for both employers and employees — there's been no measurable change in participation levels.

It's a harsh reality facing thousands of companies. It's also the reason that my first comprehensive wellness program did not have the desired impact on health care cost even after three years.

That leaves us with the million dollar question: How do you get 80% of your workforce and spouses to actively participate in your wellness initiative? Or, more accurately: How do you turn your employees into raving wellness fans that are actively improving their own health and well-being?

The answer: You need to find a way to interrupt their established behaviors and link a positive outcome to healthy lifestyle choices.

No problem, right?

Most all employees know what is good for them and what is bad, but tend to make decisions based on short-term desires versus long-term considerations. In many cases, it is the overwhelmingly strong desire for some form of immediate gratification that is responsible for many unhealthy lifestyle choices.

How do you break that dependent mentality? Leverage. For instance, how would your employees react if you offered them $1,000 per person per year to participate in a health risk assessment, meet with a health coach and make one or two minor, incremental lifestyle changes? I'd bet 80% or better of your employees would take you up on that offer! Obviously, most companies cannot afford these kinds of powerful incentives — or can they?

As an employer, you spend a lot of money providing your employees with health care benefits. Why not create a larger deductible, increase the employee's premium or change the cost-share to free up money that you can then offer back to the workforce in the form of a sizeable incentive for participating in a health risk assessment or wellness program, or in form of an outcome-based health improvement incentive?

This approach does not cost your company a dime and creates strong motivation for your employees to take real steps to improve their health. The key to this method's success is open and honest communication with your employees and their spouses. Tell them how changing their role in the health care cycle is vital to sustaining the company's ability to offer affordable benefits. Combine that with monetary incentives, and you have created a recipe for long-lasting success.