It's tough to take issue with the idea of workplace wellness programs, but a new book — through analytics and data — does just that.
The Patient Protection and Affordable Care Act authorized funds for small business wellness programs and required insurers to report on their own initiatives to encourage wellness as part of their quality reporting obligations. The reform law also lets insurers count the expenses of their wellness programs with their claims expenses for calculating their medical loss ratios, according to a blog from Health Affairs.
Workplace wellness is a $6 billion industry in the United States, and there are an estimated 500 vendors now selling workplace wellness programs, according to a May 2013 Reuters report. Although wellness programs are picking up steam, it remains to be seen how and if many will save employers money or curb healthcare spending.
RAND Corp. conducted an analysis last year, collecting information about wellness programs from about 600 businesses with at least 50 employees and analyzed medical claims collected by the Care Continuum Alliance, a trade association for the health and wellness industry. While many employers told RAND they were overwhelmingly confident that the workplace wellness programs would reduce costs, only 44 percent have actually evaluated their efforts, and only 2 percent had precise savings estimates.
A recent study in Health Affairs looked at PepsiCo's Healthy Living program, which involves components such as health risk assessments, on-site wellness events, lifestyle management, disease management, a 24/7 nurse advice line and maternity management.
The lifestyle management and disease management components of the program were estimated to return an average of $0.48 and $3.78, respectively, for every dollar invested when both healthcare and absenteeism impacts were included. Researchers concluded participation in lifestyle management interventions was associated with a small decrease in absenteeism, but had no statistically significant effect on healthcare costs.
Many hospitals are also implementing wellness programs, both in an effort to control costs and to get better footing in the business of population health management. A 2012 survey found 84 percent of 45 hospitals in New York, New Jersey and Connecticut offered wellness programs, and only 35 percent of that pool relied on wellness program options from insurers. The majority of the hospitals had internal wellness coordinators and wellness committees to govern the initiatives.
Oakland, Calif.-based Kaiser Permanente launched an interesting wellness program last fall — one that was actually the brainchild of unions representing its employees. Through the program — which is for all 133,000 employees, union and nonunion alike — Kaiser is offering up to $500 bonuses to regional groups of employees who lose weight, lower their blood pressure, stop smoking and lower their cholesterol levels. If the employee group reaches its health goals, every employee in the group will receive the monetary bonus, even if they do not take steps to get healthy.
It appears as though workplace wellness is an entrepreneurial hot spot, but critics are beginning to question the benefits of these programs. The new book, "Surviving Workplace Wellness: With Your Dignity, Finances and (Major) Organs Intact" takes some stabs at the "clinical comedy of errors as workplace wellness vendors bamboozle employers with the government-propelled fairy tale that the way to save healthcare dollars is to spend more of them."
Paul Levy, former president and CEO of Beth Israel Deaconess Medical Center in Boston and author of the blog Not Running a Hospital, wrote a post about the book. He said the book authors, Al Lewis and Vik Khanna, "pierce the veil of political correctness on this topic, explaining how human resources departments align with vendors and insurers to exploit the understandable hope of all of us that there is a holy grail in the healthcare world."
While ROI for employer-based disease management programs seems to be quite clear, those for general wellness programs are not. Should an employer invest?
A healthy workforce is certainly a desirable aim, but industry trends seem to point to a future where concerns over the health status of a population won't worry employers as much as it will providers.
The move to value-based, population-based care will likely mean providers, not employers, need to be more interested in wellness programs, as their payments will be on the line for the wellness and health improvements employers are trying to hard to achieve today. Providers will also need to navigate the hundreds of vendors offering workplace wellness programs, or internally develop the most effective approaches for their own.
Do you have thoughts on workplace wellness programs? If so, please email mgamble@beckershealthcare.com
More Articles on Workplace Wellness Programs:
Kaiser Offers Cash Bonuses in Employee Wellness Program
How to Improve Workplace Wellness Program Participation
Disease Management Has Greater ROI Than Lifestyle Management in Workplace Health Programs