From ROI to VOI: A Smarter Way to Measure Wellness Value

Wellness matters, and a healthier workforce is good for the whole company. That was the thinking behind the first real corporate wellness program, Johnson & Johnson's Live for Life, launched in 1979. Programs took off from there. By 2021, 83% of large employers offered one. But the industry settled on a single metric to prove it was working, return on investment, and it didn't take much digging to see the numbers weren't living up to the claims. That forced teams to reevaluate how they defined success. For brokers and benefits leaders, that shift changes the whole conversation with a client. Wellness still matters. Financial return is still real and still worth proving. But wellness is worth a lot more than a single line on a spreadsheet.

Why did wellness ROI fall short?

Live for Life worked, and well enough that for the next thirty years, wellness ROI became the thing every employer wanted and every vendor promised. By 2010, Harvard Business Review was holding J&J up as proof that wellness programs paid for themselves several times over. Wellness had become the silver bullet for runaway healthcare costs.

Then the math got audited. In 2013, a landmark RAND study (commissioned by the Department of Labor) looked across a wide range of employer wellness programs and found the savings story didn't hold up. Lifestyle programs nudged behavior, sure, but the disease-management piece, the part tied to big claims costs, returned far less than promised. And when the savings were run through statistical testing, the verdict was the word no one wanted: insignificant.

That stung. But call it serendipitous, because it forced the industry to ask a better question. Not "does wellness save money," but "what is wellness actually worth, and how would we even measure that?"

What is VOI (Value on Investment)?

Value on investment is the worth a wellness program delivers to a company and its people, beyond what shows up in claims data. Right now, the gap between what employers offer and what employees feel they're getting is real. In WTW's 2024 Wellbeing Diagnostic Survey, employers said they were prioritizing mental (73%) and physical (50%) wellbeing, while 66% of employees named financial wellbeing as their top concern, the area employers ranked dead last at 23%. A program can be well-funded and well-intentioned and still miss the people it's built for. VOI is how you measure whether a program is landing, not just whether it exists.

A program that feels tone-deaf doesn't just underperform. It gets ignored. Wellhub's 2025 report found 88% of employees say wellbeing support matters as much as salary, but only 59% rate their benefits as good or excellent. VOI is the language a broker can use to reframe a renewal conversation away from pure cost.

ROI vs. VOI: What's the difference?

ROI asks one question: did claims costs drop? VOI asks a bigger one: did the whole picture improve? The clearest way to see the difference is side by side.

So how do you measure VOI? It comes down to the leading indicators that show up long before claims costs ever move:

Engagement? Measured by completion rates, sign-ups, and activity over time.

Health Risk Improvement: Is the population's risk profile getting better? Measured by changes in Know Your Number (KYN) scores and screenings, year over year

Biometric Resolution: Are at-risk employees improving on the markers that matter? Measured by tracking cholesterol, blood pressure, and triglyceride results for flagged individuals across screenings.

Does VOI mean ROI no longer matters?

Not at all. ROI is still a leading decision-making factor, and it should be. It's clear, it's objective, and it makes the obvious case to the people who sign off on the budget. Reducing healthcare costs and keeping a program financially justifiable is critical. Even the most well-meaning company has to make money to keep its doors open.

VOI doesn't replace that. It broadens the lens. When you and your account manager design a program around VOI metrics, you're building the engagement that eventually drives claims costs down. VOI shows up first (engagement, morale), ROI follows over time (the RAND study found savings don't really appear until year three).

What comes next after VOI?

You can't improve what you don't understand. Proving value starts with knowing exactly what to address, for each person, not the work force in the aggregate. A program averaged across thousands of employees can look healthy on paper while missing the people who need it most. Aggregate numbers smooth over the individual, and the individual is where wellness either works or doesn't. That's where personalization comes in.

Personalization is how the next wave of wellness programs turns VOI from a talking point into a track record, meeting employees as individuals instead of a headcount. It means the right resource reaching the right person at the moment it matters, whether that's a biometric result worth acting on or a small habit worth building. Over time, those individual moments add up to something an employer can measure.

Wellworks tracks health and engagement data at that level of detail. Paired with an employer's own retention and culture metrics, it completes the VOI picture, showing not just that a program is running, but that it's moving the numbers that matter to the business.

See how Wellworks For You does just that or walk through it live in our upcoming webinar.

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