» They're boring. It's hard to stay motivated and energized about a program that feels like a chore, which is why it's common to see high participation in the first month or two, with rapid drop-off.

» They don't provide behavioral change processes. Face it. We're trying to get people to adopt healthier behaviors, and to change their lifestyles. Without reminders, education, inspiration, and challenges on a daily basis, they're not likely to make changes in their lifestyle that last down the road.

» They offer the wrong kind of incentives (if any). Many wellness programs don't offer any incentives to participate, and those that do often use cash or gift cards as rewards. But research shows that cash, while asked for most, is the least appreciated form of incentive. Think about it -- if you got a $50 bill two years ago as a reward for doing something healthy, how likely are you to remember today where you spent that money?

» They focus on the Healthy. Yet research shows that it's more effective -- and more cost-effective -- to keep the healthy population healthy. We do believe that meeting the needs of the high-risk population is important -- but we leave that to the disease-management companies.

» They're passive. Employers offer a wellness program -- maybe it's a discounted gym membership, coaching, or access to a weight-loss program -- and employees can take advantage if they want to -- or not. Usually they do for a while, but soon the motivation is gone, and the program is forgotten.

» There's little or no accountability. So you skipped the gym today. Did anyone push, prod, nag, or otherwise try to get you to go? Accountability is vital in helping people to make lifestyle, and behavioral changes.