Wellness programs: Skip the bad press by using a softer touch
Wellness programs seem to be drawing nearly as much flak as praise these days.
A report last week from Kaiser Health News indicated that many employers are raising the bar when it comes to what they ask of employees enrolled in wellness programs, increasingly requiring screening for high blood pressure, cholesterol and blood sugar levels.
Current laws largely encourage the trend. The Affordable Care Act lets employers discount insurance premiums by as much as 30 percent if employees participate in a wellness program, and in response to a lawsuit against Honeywell, a federal judge ruled last November that wellness programs may penalize non-participants.
Nevertheless, critics of the concept have not been shy about their concerns. One of the most outspoken, former Harvard professor Alfred Lewis, pointed out recently that his research shows no company can point to savings achieved from an employee weight-loss program, nor can any company demonstrate sustained weight loss across a large population for two years or more.
Programs that tie premiums directly to health data can also unfairly penalize the working poor, experts have noted, as this population tends to have higher rates of stress-related medical conditions and poorer diets.
Finally, some have raised privacy concerns about including women's pregnancy status in health assessments, noting many may wory that this information will get back to an employer and encourage discrimination.
Even though guidelines from the Equal Employment Opportunity Commission have emphasized that wellness programs can only share aggregated data with employers, I can't help but share these concerns. They were certainly on my mind when I heard my employer-based health coverage offered a wellness rewards program.
Now granted, I'm probably not the key target for wellness programs--though my diet and exercise habits could improve, I'm young and lack any chronic conditions. And I'm not even leaving that much money on the table by choosing not to participate, as the max one can earn is $300.
But I have to give the program credit for being voluntary. No one is compelling me, through the threat of higher premiums, to get my blood tested, wear a fitness tracker or otherwise share health information I'd rather keep to myself.
That concept also seems to be at the heart of UnitedHealth's new wellness program for its workers, run by a California company called Real Appeal. The country's largest insurer will offer 100,000 of its employees enrolled in a company health plan a chance to join the program this month, the Minneapolis Star-Tribune reports.
Focused solely on weight loss, Real Appeal is different for a host of reasons. For one, "We don't have to get [participants'] blood," Seth Tuckerman, the program's chief executive, tells the newspaper, adding that it "doesn't try to attract people by scaring them."
There aren't even financial incentives--let alone penalties--associated with the program, according to the article. What the program does have are some serious bells and whistles, including free blenders for making smoothies, personal health coaching and even a weekly, online TV show with celebrity cameos.
A pilot of the program in Ohio also showed promising results, as 37 percent of participants who were at risk for heart disease or diabetes due to weight reached the target weight loss of 5 percent or greater less than halfway through the program.
Of course, not all insurers or employers have UnitedHealth's ability to test such a fancy program. Yet it's a solid example of a wellness program that trades "have to" for "want to." I don't know about you, but I'm more comfortable with the proposition "here's a way to earn rewards for healthy eating" than "sign up for biometric screenings or else."
Ultimately, the mere existence of wellness programs shows insurers are serious about the imperative to get their members healthier. So it's a shame that a concept so promising has in some cases gotten so off-track, with employers taking on the mentality that the best way to encourage people to participate is to strong-arm them.
There's plenty of opportunity to continue to debate the actual ROI of wellness programs, but in the meantime let's agree on one point: In behavioral modification efforts, as in nutrition, a carrot is almost always better than a stick. - Leslie @HealthPayer
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