Are employer wellness programs effective? Depends who you ask.

Topics: Health Care Reform, Employer-Sponsored Coverage

Workplace wellness programs are becoming commonplace in U.S. companies, but experts are split on their effectiveness.

According to a 2015 Kaiser Family Foundation survey, 81 percent of large companies and 49 percent of companies with 200 or fewer employees offer wellness programs. The Affordable Care Act encouraged greater adoption by allowing companies to offer both greater incentives to participants and penalties to those who do not take part.

Wellness programs typically offer a range of nudges toward good health, ranging from financial incentives to stay healthy to cooking classes or programs to help people quit smoking.

However, as STAT News' Sharon Begley writes, "[T]here is a startling lack of rigorous evidence that they achieve their stated [health] goals."

Concern about wellness program research

Research on the effectiveness of wellness programs is often low quality, Begley writes. For instance, she notes, "Comparing employees who choose to participate in wellness programs to those who don't, as both vendors and many outside researchers do, can also be misleading."

Al Lewis -- president of Disease Management Purchasing Consortium International and a critic of wellness programs -- wrote with colleagues last year in the American Journal of Managed Care that the wellness program industry's "modus operandi is to report only successes and not failures."

A 2013 RAND Corporation study, which Kaiser Family Foundation senior fellow Karen Pollitz considers "the most comprehensive and authoritative" on the subject, found that:

  • Workers who participate in wellness programs lost an average of only one pound across the first three years of participation;
  • Enrollment "was not associated with significant reductions in total cholesterol level"; and
  • Wellness programs did not identify warning signs of disease or improve health enough to prevent emergencies.

The researchers did find some evidence that smoking-cessation programs work -- but only "in the short term."

John Workman of The Advisory Board Company told The Daily Briefing that his research team has been "highly skeptical of any hard-dollar savings from pure wellness programs." He said, "If you're looking strictly to control costs, then plan design, intensive case management of costliest plan members, and improved negotiations with third-party vendors are the proven methods." The Advisory Board Company publishes American Health Line.

 

Ron Goetzel of Truven Health Analytics acknowledged that the performance of workplace wellness programs can be erratic, but he argues that an elite subset of companies run effective programs. He says the best programs follow principles such as:

  • Creating a "culture" of health with bike racks and other resources; and
  • Avoiding programs that "pry, poke, and punish" employees with financial incentives and questionnaires.

Even Lewis admits that some vendors are effective, citing Florida-based wellness vendor US Preventive Medicine as one. He said, "The numbers add up and [disease] events definitely declined."

by Sam Bernstein, staff writer