How we calculate business impact

In this article, we are explaining how we calculate the business case for each company we work with (>30 participants).

For a business case calculation, we are using the Sapiens Stress Diagnostics before and after a 3-9 months program and we are calculating the business case based on actual program outcomes by considering actual salary metrics from our client company.

See this article to understand how we measure the impact of Sapiens programs on chronic stress, resilience, attention regulation and energy leaks.

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How we transfer program impact into a business case

Step 1: Program Results

When we work with your organization, we track the actual program results of the first pilot for the business case that is specific to your company.

For a top-executive cohort of a large EU company with 14-18 participants, the stress diagnostics was done before a Sapiens program in November 2024 and then repeated after Sapiens 1:1 and team interventions in May 2025.
In this period most participants improved most biomarkers that have been measured.

These are selected results: 

• -50% reduction in average pre-bed Cortisol levels (measured in saliva) and +38% more time spent in recovery during sleep (measured with ECG monitoring/HRV analysis
• +26% better stress balance measured with hair steroid analysis (index calculated from Cortisol, Cortisone, DHEA and testosterone) which corresponds to reduced biological chronic stress
• -17% self-reported stress and health symptoms (includes sub-clinical mental health challenges, gut health symptoms, chronic tension/pain, metabolic health related issues, immune system issues, etc.

Note: In the below article, we are calculating the business case with the metrics above as sample metrics from one of our representative clients (direct reports to C-level). These data are not scientifically published yet and full statistical analysis, review of confounding variables etc. hasn't been done yet.
We are working on a scientific study that assesses confounding variables and includes a solid study design for pre-/post measures of Sapiens program results with a large cohort of 200+ participants measuring stress before and 6 months after a program. Until we have finalized this study, the numbers above are considered ‘typical’ or ‘plausible’ results.

Step 2: Value Drivers

For the business case we used the results metrics above and established correlations to business metrics using insights and estimates from scientific studies as described below.

We estimated the transfer from program results to value drivers for a people heavy industry like consulting, law firms or investment firms where there is little impact of assets on productivity.

The major value drivers of Sapiens Programs are Productivity + Talent Retention + Less Unhealthy/Sick Days.

Less Unhealthy/Sick Days in this context refers to an increased amount of time that employees are present at work due to reduced health issues (either because they actually have less sick days or because they are not showing up at work even though they are not feeling and performing at their best).

Other value drivers like better decision making are not considered to keep the business case conservative.

For the program results above, these are the estimated value drivers based on the approximations below: 

• +7,7% Productivity - in simple terms, an employee that required a 40 hour work week to complete his/her tasks now requires roughly 37 hours — so each employee effectively gains nearly 3 hours of productive time every week
• +3,6% Talent Retention - e.g., if your company has 1000 employees this refers to 36 additional employees that are retained per year
• -10,4 % Unhealthy or Sick Days: If employees were missing or significantly underperforming (because of sickness or low energy/fatigue) an average of 9 workdays per year, a 10,4% reduction in unhealthy/sick days means they’re effectively present for 0,94 extra days per year.

Find below the correlates that led to the calculations above that we extracted from a comprehensive literature review.

Productivity: +2% for every +10% in biological stress balance score and +0,5% for every -10% in evening cortisol reduction (sleep quality improvements not considered additionally on productivity)

• Impact of HPA axis dysregulation (chronic stress) on productivity
  • Russel et al., (2019): The human stress response - “The hypothalamic-pituitary-adrenal axis plays a key role in maintaining homeostasis under stress, but chronic exposure to stress can lead to poor cognitive, metabolic, and immune function.”
  • Starr et al. (2019): Chronic stress exposure, diurnal cortisol slope, and implications for mood and fatigue: Moderation by multilocus HPA-Axis genetic variation
• Impact of self-perceived chronic stress on productivity
  • Oboreh et al., (2016): Effects of Stress on Employee Productivity - “Stress, particularly workload pressure, significantly hinders employee productivity in the Nigerian banking industry, necessitating management intervention to minimize its effects”
  • Halkos et al., (2010): The effect of stress and satisfaction on productivity - “Increased stress leads to reduced productivity, while increased satisfaction leads to increased productivity.”
• Impact of HRV on productivity (reducing chronic stress may improve HRV)
  • Melillo et al. (2015): Acute mental stress assessment via short term HRV analysis in healthy adults: A systematic review with meta-analysis
  • Uusitalo et al. (2011): Heart rate variability related to effort at work
  • Eslami et al. (2023): Evaluating High and Low Heart Rate Variability Response and Neurocognitive Performance in Workers: An Exploratory Study: “Higher HRV (RMSSD and HF) was linked to better neurocognitive performance measures. The Cambridge Neuropsychological Test Automated Battery, specifically, the spatial working memory, attention-switching task, rapid visual processing, and spatial span were used.”
• Impact of improved sleep on cognitive performance (reducing chronic stress improves sleep)
  • Litwiler et al. (2017): The Relationship Between Sleep and Work: A Meta-Analysis: “Poor sleep quality and quantity negatively impact employee performance”
  • Lange et al. (2009): A hard day’s night: a longitudinal study on the relationships among job demands and job control, sleep quality and fatigue
• Impact of Chronic Stress Symptoms on Cognitive Performance
  • Tooley et al. (2020): Effects of the Human Gut Microbiota on Cognitive Performance, Brain Structure and Function: A Narrative Review: “Gut microbiota diversity is linked to enhanced cognitive flexibility and executive function, and manipulation of gut microbiota could enhance cognition.”
  • Cooke et al. (2022): Examining the Influence of the Human Gut Microbiota on Cognition and Stress: A Systematic Review of the Literature
• Cognitive performance/attention regulation and workplace productivity
  • Sackett et al., (2023): A contemporary look at the relationship between general cognitive ability and job performance: “General Cognitive Ability has a mean corrected validity of .22 for predicting job performance.”
  • Burgoyne et al., (2020): Attention Control: A Cornerstone of Higher-Order Cognition
  • Dhrsta et al. (2024): The Effect of Concentration and Work Stress on Employee Work Productivity (Note: This one is not a high quality Q1 journal like the others) - Concentration and work stress have a 33,8% influence on employee work productivity

Talent Retention: +1% for every –10% in chronic stress and an additional +0,6% for every -10% in stress symptoms

• Liu et al., 2022: The role of employee psychological stress assessment in reducing human resource turnover in enterprises
• Kachi et al. 2020: Occupational stress and the risk of turnover: a large prospective cohort study of employees in Japan: “High-stress employees had a 2.86 times higher risk of turnover for men and a 1.52 times higher risk for women compared to their lower-stress counterparts”

Presenteeism: +4% healthy workdays for every +10% stress balance score

**(**Note: Aspects of the additional healthy workdays include a -5% burnout rate for each 10% improvement in sleep quality and -5% depression rate for every -10% evening cortisol if evening cortisol was in upper 12,5th percentile at the beginning of the measurement)

• Willert et al. (2010): Effects of a stress management intervention on absenteeism and return to work – results from a randomized wait-list controlled trial: “The stress management interventions (weekly to bi-weekly group sessions on stress mgmt.) were correlated to self-reported absenteeism from work by 29%.”
• Nielsen et al. (2021): The impact of stress and lifestyle factors on short-term sickness absence in a large Danish industrial company: Stress and related factors “were associated with between 29.8% and 37.8% of short-term sickness absence”.
• Burnout/Depression-Risk-to-evening-Cortisol-rate
  • Peussner et al. (1999): Burnout, perceived stress, and cortisol responses to awakening: “higher burnout levels leading to lower cortisol secretion and stronger increases in the first hour after awakening”
  • Burke et al. (2005): Depression and cortisol responses to psychological stress: A meta-analysis

Scientific literature of impact of general health and wellbeing programs on productivity, talent retention and presenteeism

To check the plausibility of the results from the Sapiens business case, below are publications on the general impact of wellbeing and stress management programs for companies: 

Productivity: A study titled ‘Employee Wellbeing, Productivity, and Firm Performance’ by MIT, Oxford and London School of Economics (Krekel et al., 2019) and Oswald et al. demonstrate a correlation between employee well-being interventions and productivity improvements of between 10 and 21 percent.

Talent Retention: Investing in employee health and well-being can boost employee retention. Mercer research shows that companies which foster a “culture of health” experience employee turnover rates 11 percentage points lower than those that do not (Mercer, 2018). Research from Saïd Business School finds that for many employees, factors contributing to their well-being—such as mental and physical health, work-life balance, and job satisfaction—are as crucial as traditional incentives such as salary (De Neve et al., 2019).

A McKinsey Health Institute survey of more than 42,000 respondents found that at least a third consider physical, mental, social, and spiritual health resources when choosing an employer, with Gen Z respondents and those with lower mental health scores giving particular consideration to mental health benefits (McKinsey, 2023)

Presenteeism (incl. less unhealthy days and less stress symptoms): Although not included in the calculation of the economic value at stake globally, healthcare claims often account for the majority of an organization’s total employee health and well-being costs in countries such as the United States where employee health claims are subsidized by employers. Stress related conditions such as hypertension, heart disease, and depression cause substantial on-the-job productivity losses, exceeding $300 per US employee annually (Goetzel et al., 2004). Cardiovascular disease leads to the loss of $156 billion in productivity annually (Virani et al., 2021). US employees with untreated insomnia cost employers approximately $2,280 more per year than those without insomnia because of factors such as absenteeism, presenteeism, diminished performance, and higher rates of accidents and injuries (Kessler et al., 2011). While these healthcare costs are directly influencing company budgets only in the US, European companies still take a significant benefit (yet, less measurable) from increased presenteeism.

Step 3: Calculating the Financial Benefits

Informed conservative assumptions based on previous client metrics enabled us to use the value drivers and transfer them into actual financial benefits.The numbers below are not from our actual clients but are generic yet representative values to follow confidentiality agreements.

Sample metrics used for calculation of this business case

• Average salary per participant = 200.000 EUR
• Annual talent turnover = 10%
• Costs of replacement per employee = 1 year salary
• Annual days off due to sickness, incl. days with significant underperformance due to low energy/fatigue/mental health challenges = 9 days

Value drivers (recap from above):

• +7,7% Productivity
• +3,6% Talent Retention
• +10,4% Presenteeism

Annual Financial Impact from Productivity Gains

• Annual salary per person: 200,000 EUR
• Productivity increase: +7.7%
• Monetary benefit per person: 200.000 EUR x 7,7% = 15.400 EUR per year per employee

Annual Financial Impact from Talent Retention

• Baseline turnover: 10% (i.e., 100 out of 1,000 leave each year)
• Improvement: +3.6% retention = 36 fewer people leaving in total out of 1000
• Cost of replacement: 1 year salary = 200,000 EUR/employee
• Total savings per employee: 36 x 200.000 EUR / 1000 = 7.200 EUR per employee per year

Annual Financial Impact from Less Unhealthy/Sick Days

• Baseline: 9 sick or underperformance days per employee per year
• Improvement: -10,4% fewer sick/underperformance days = 0.94 days regained per person
• Daily cost (assuming 220 workdays/year): 200.000 EUR / 220 = 909 EUR / day
• 0,94 days x 909 EUR = 854 EUR per employee per year

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Total Financial Benefits per year

• +7,7% Productivity ⇒ 15.400 EUR per year per employee
• +3,6% Talent Retention ⇒ 7.200 EUR per person per year
• -10,4% Unhealthy or Sick Days⇒ 854 EUR per employee per year

Total annual savings per employee/per program participant = 23.454 EUR per employee per year

The Sapiens program enabling these results is our 6 months premium offering inclusive 1:1 coaching, expert advice, and 2 rounds of stress diagnostics costing around 5.000 EUR per participant.

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The ROI in year one of the program

• Costs per employee (intensive 6 months program) = 5.000 EUR
• Benefits per employee = 23.454 EUR
• Return on Investment = 369%, i.e., in Year 1, every 1 EUR invested yields about 3,69 EUR in benefits

Additional program benefits not directly included in this calculation are:

• Better decision making
• Longevity of employees
• Employer branding

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Limitiations of this business case calculation

This business case is calculated based on a small cohort of top executives (n=14-18), review of confounding variables and research-grade statistical analysis hasn't been done yet.
Also, the links between the actual outcomes of this group (e.g., reduction in pre-bed cortisol) as well as business metrics (e.g., productivity) have been approximated based on insights from the scientific studies above.
One of the assumptions made in this process is that the measured biological chronic stress reductions (e.g., lower pre-bed cortisol or lower stress hormones in hair) are translating into actual stress reductions.
The link from the approximated value drivers to the financial benefit have been made based on baseline values from a sample client. These values are conservative given our top-executive target audience - e.g., a 200k EUR annual salary has been assumed.

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