At Work

I’m still critical of employer wellness programs when it comes to reducing health care costs

Measuring the results of a wellness program is always questionable. In fact, most employers don’t measure much and what they do measure has little to do with lowering health care costs. Here is an example of some guidance for measuring a wellness program. It comes from an e-mail I received.

Year 1 Goal: Focus on Participation

60% of employees participate in at least one program element

Year 2 Goal: Add Risk Reduction and Satisfaction Metrics

Health risks improve by at least 2% as measured by health appraisal questionnaire
90% employee satisfaction with the program

Measurable improvement in biometric scores(e.g., BMI, cholesterol, blood pressure) compared to year 1

Year 3 Goal: Increase Expectations; Add Financial Performance Metrics

80% employee participation in health screening and other programs over the previous three-year period

50% spouse participation in health screening

Measurable reduction in health care costs and/or absence rates, corresponding to health risk and/or biometric improvements

A few thoughts:

Participation in one or all elements of a wellness program does not mean you are saving money or improving productivity. That is like assuming employees who attend a retirement or financial planning seminar leave the meeting and actually implement the strategies presented and follow them for the next thirty years, they don’t.

Employee satisfaction with the program is no measure. Employees will be satisfied with a free lunch too, even if burgers, fries and a milkshake are on the menu.

As for a “measurable” reduction in health care costs or absence rate…after three years of such a program, not even a slowing of costs, but a reduction…give me a break.

In addition, how are you going to measure that and attribute it to your employees now knowing their BMI or cholesterol levels?  This is like politicians saying they are raising the budget by $50 billion instead of $60 billion while claiming they have reduced the budget deficit by $10 billion.

While there is hope that better lifestyles will improve health and perhaps manage costs over time, in the short-term health costs may rise with these programs. The person learning of high blood pressure may now be under a doctor’s care taking medication. The same is true for the person with high cholesterol or glucose. Is this better than some more serious and expensive result left untreated?  Of course it is, but that hardly represents a measurable reduction in health care costs within three years and likely much longer.  In addition, the individual must remain an employee for many years in order for the current employer to reap any benefit.

All this for a lousy tee shirt and a $25 credit!

There are a number of organizations selling wellness programs and making a lot of money doing it.  Some employers like the publicity claiming success in lowering health care costs because their employees take a health risk assessment. Some in HR are making a career out of health and wellness, it’s the in thing to do after all.  Today wellness is like apple pie and mother, who can mount an argument against it? 

That’s all fine and no doubt over time many people will benefit, but employers embracing the concept should look past the hype and understand the real impact and cost of such programs. If the goal is to save money, employers must establish realistic long-term goals and measures that are statistically valid, track the actual behavior and claims costs of individuals, etc.   Let’s see claims data on each employee for five years before and five years after the start of a wellness program.    If you don’t find that the most active participants already had lower claims experience and health care costs are lower than at the start of the program, I will be a believer.  That’s a lot easier said than done.


Categories: At Work, Healthcare

2 replies »

  1. You may be wasting your time seeking a business case to justify a political social process. As long as the proponents can sell their wares, celebrate their process achievements and cheer about the spirit of involvement they inculcate, they don’t have to show you any stinking cost savings metrics. If management is happy with the activity and willing to budget it for the warm and fuzzies alone, who wants to closely examine the cost/benefit ratios? That’s all an antiquated economic approach based on old-fashioned results-based thinking, anyway. No place for that kind of distracting nonsense in the shiny new 21st Century, I fear.


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