Vik provides a good summary on his blog:
The biggest delusion in Obamacare is the idea that clinically based workplace wellness programs will save either money or lives. They are, in fact, a big government, big company-propelled fantasy that the way to spend less money is to spend more.
Al Lewis and I have penned the antidote to workplace wellness programs for employees who should resent having the privacy invaded, their medical care disrupted, and their money taken for the sake of the government and employers exerting even more control over their lives.
Surviving Workplace Wellness stars the State of Nebraska, Penn State University, Health Fitness Corporation, Truven Health Analytics, WellSteps and a roster of other workplace wellness vendors who missed the casting call for Dumb and Dumber.
Al and Vik use a new technique in characterizing these programs: Analytic rigor, based on actual data, actual costs, and actual results. They 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 health care world.
Yes, Virginia, many wellness programs are part of the medical-industrial arms race. Thanks to Al and Vik for making the truth evident to those who are willing to keep an open mind.
There is a paper published in the most recent (January 2014) issue of Health Affairs on this subject that discusses the experience at PepsiCo. The bottom line is that disease management programs lower healthcare costs after taking into account the money spent on the effort but wellness programs generally don’t.
ReplyDeleteThis summary of the Health Affairs paper isn't accurate. The authors did subtract the "vendor's fee" from the medical savings, but not other intervention costs. At page 127 of the paper the authors state: "[W]e did not have information for the following
ReplyDeletecost items that affect ROI: the cost of PepsiCo’s program staff, the cost of employees’ time required for program participation, and any costs
generated by false positives through extended screening."
The ROI on the disease management program was substantial, so it's possible the unmeasured intervention costs would not have swamped all the medical savings, but we don't know.
Kip Sullivan
Thanks for the close read. My bad -- I meant Mercer's fees.
ReplyDeleteThe DM was separate from the wellness. Absent DM and absent self-reported absenteeism reduction, there was no gross savings to speak of.
If we're counting uncounted things, we might as well also throw in the time required by employees to participate in the wellness program.