It’s becoming increasingly critical to get more—and expect more—from our health and wellbeing benefits programs. We need to prove better health outcomes and, ultimately, lower claims. Here, we’ll explore the reasons why benefits often get used the least by the people who need them the most, and how you can leverage modern AI-powered resources to get better results across your entire employee population.
Why your highest-risk members raise the engagement stakes
Employee benefits professionals can’t escape the “engagement” issue. It’s common (and substantiated) knowledge that workers who feel disconnected from their jobs report higher rates of health complications than their more motivated counterparts.
That’s why you invest so much in employee benefits—particularly culture-boosters like wellbeing programs. They work. There’s no shortage of research connecting the dots between employee engagement and their companies’ bottom line. You’ve likely seen a positive impact amongst your employees who participate in your wellbeing initiatives.
But here’s the rub: your wellbeing program superusers tend to be among the “healthy majority.” They’re not the folks who need to quit smoking, lower their blood pressure, manage their sugars, and otherwise cross the nebulous chasm between “unhealthy” or “at-risk” to a state where they can slow down or prevent the costly health issues that are likely to reduce their quality of life.
A 2026 Abbott survey finds that 74% of U.S. adults believe most chronic diseases are preventable, yet only 1 in 4 feel very confident in knowing how to care for their health. Ultimately, your highest-risk members raise the engagement stakes because their lack of confidence and lack of engagement directly drive your plan's highest claims.
What can employers do to promote better behaviors (and outcomes) in the moments that matter, for the “disengaged, unhealthy minority”?
To answer this question, it helps to take a quick detour into human psychology.
The psychology of health consciousness
An article in Harvard Business Review says, “though the brain rewards us for spending mental energy on expanding ourselves, it rewards us even more for conserving our energy—which is why we struggle with activities that don’t immediately spark our curiosity, or why we tend to get bored with things over time.”
Getting up off the couch to break a sweat or selecting a spinach salad over a double cheeseburger can sound like too much to ask—even if we’re allowing for flexibility with the 80/20 rule!
Understanding and accepting what’s holding people back from doing what’s “best” for themselves is a first step to designing employer-sponsored health and wellbeing programs that rise to today’s higher standards.
LET'S TAKE A LOOK AT THREE COMMON HURDLES:
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Resistance and Skepticism: Personal barriers (like pain or stress) and mindsets that wellbeing is "too personal for work" or that employees are "too busy" combine with low program awareness to create massive workforce inertia.
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Lack of Personal Buy-In: Programs often rely on extrinsic motivation (short-term cash carrots), which helps with initial sign-ups but fails to transition employees to the intrinsic motivation needed to build long-haul, lifelong habits.
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The Path of Least Resistance: Complicated health goals, "all-or-nothing" overhauls, and clunky tech mazes introduce severe cognitive friction. This causes stressed or high-risk employees to feel overwhelmed, lose confidence, and freeze before taking the first step.
Overcoming implementation friction: the employers’ real role
While employers play a critical role in cultivating an environment that champions healthy behavior change, they cannot drive this transformation in isolation; ultimately, employees are autonomous adults who manage their own daily lifestyles and independently navigate relationships with their doctors and healthcare providers.
And employers are arguably less likely than healthcare professionals to convince people to do what they need to do to maintain or improve their health. A 2024 U.S. News & World Report survey found that while four in five (81%) people say they usually or always follow their PCP’s health advice, those who don’t say it’s because the advice is difficult to implement in daily life (43% of the time) or cannot afford what their PCP recommends (34% of the time).
This is exactly where employers have skin in the game. You cannot replace the doctor, but you can bridge the gap between clinical advice and daily action. You can help employees—all employees, particularly the hardest-to-engage—overcome their personal barriers and discover their own intrinsic "whys."
But how?
The AI health tech solution
Traditionally, overcoming this awareness gap meant constant, exhausting administration: segmenting email lists, creating multi-format flyers, and shouting over the noise before and after open enrollment. But HR teams cannot manually communicate their way out of a workforce-wide engagement gap.
This is where a modern, AI-powered wellbeing program changes the paradigm:
Provides moment-of-need access to health and benefits information…
Don’t make your employees go searching through portals, emails, drives, and intranets for benefits information. No one wants to search for (and then through) a 52-page PDF to find what they’re looking for.
By ingesting your organization's specific benefits plans, policies, and employee data, an effective AI solution can deeply contextualize every interaction wherever the employee is working (e.g., Slack, Teams, intranet, HRIS). When an employee asks a question—whether they are checking a coverage detail or looking for a program to help with lowering blood sugar—the agent delivers a cited, natural-language answer tailored precisely to their situation.
This hyper-personalization flips the script on the traditional approach of forcing employees to navigate clunky portals and fitting them into generic persona buckets, making benefits highly accessible and actionable in real-time.
…and a clear action path towards feeling better
To break through at the moment of truth, programs must give employees low-acuity (and lower cost), hyper-personalized micro-actions that make starting feel effortless—and even enjoyable. In this sense, AI can help turn overwhelming clinical recommendations like “reduce your lower back pain by strengthening your core,” “lower your A1C by cutting back on dietary sugar,” or “improve your hypertension through 30 minutes of movement every day” into effortless personal habits that help prevent and mitigate costlier issues.
What’s more, AI’s ability to answer employees’ health questions with a progressive care pathway means your people are immediately steered toward the “easiest” self-care solution first and given relevant company benefits when appropriate so they are prepared to take higher-acuity or otherwise next-best action later.
For example, an employee might type in, “My lower back is really sore.” The AI agent responds with an evidence-based video led by a licensed physical therapist that helps them relieve lower back tension in the moment, followed by a message letting them know about coverage through your company’s MSK point solution.
Treats every employee to daily wellbeing
For everyday self-care and whole-person wellbeing, a well-engineered program can raise the fun factor of making consistently healthier choices. In fact, a Yale School of Management piece about the power of intrinsic motivation notes that leveraging our tendencies for enjoyment, social connections, and immediate gratification are key for making meaningful, lasting change.
To maximize impact, a strong workforce program should build these core psychological levers directly into its framework through:
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High-Quality Content: Vetted resources that engage curiosity.
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Community Features: Interactive elements that build social connection.
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Challenges & Gamification: Playful mechanics that drive immediate gratification and consistent participation.
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Strategic Incentives: Meaningful rewards that boost initial momentum.
Arms your HR team with AI-powered program optimization & proactive ROI
Traditional healthcare analytics forces HR teams to look in the rearview mirror, relying on lagging claims data that arrives months after a health issue has already escalated. To truly contain costs, you need a proactive lens. Today's advanced AI-powered health and wellbeing technology captures real-time intent data—giving you the ultimate leading indicator of workforce health.
Instead of guessing what your population needs, an intelligent platform securely captures the real-time questions employees are asking and the topics they are actively engaging with right now. These immediate behavioral signals reveal emerging healthcare trends, allowing you to instantly identify plan design gaps and strategically reallocate wellbeing spend where it will have the greatest impact.
The bottom line: from participation to prevention
You have likely invested significant time and resources into your health and wellbeing programs, employee education, and benefits communication—and for your already-engaged employees, that investment is paying off. But to truly protect your organization's bottom line, you have to engage the employees who typically fall through the cracks.
By removing the traditional friction points of benefits access and providing a more personalized, actionable experience, modern AI-powered health technology does what legacy wellness programs have historically failed to do: it successfully captures the attention of your highest-risk, hardest-to-reach members. Engaging this high-cost claimant population creates a profound shift, enabling benefits leaders to finally address the ultimate elephant in the room—the historical conundrum of proving true actuarial ROI.
When your wellbeing solution possesses the sophisticated intelligence required to intercept risks and guide your unhealthiest members toward proactive care, the resulting downstream medical claims deflection becomes impossible to ignore.