The scoop on workplace wellness

A Laurel to Sharon Begley of Reuters for not burying the lead on workplace health incentives--a RAND study that seriously questions their impact

For her exclusive coverage of a RAND study revealing the lackluster performance of workplace wellness programs—both on employees’ health and employers’ healthcare costs—Sharon Begley of Reuters deserves a CJR Laurel.

The study, sponsored by the Labor department and Health and Human Services, found that these programs, designed to save employers money by financially incentivizing healthy behaviors among their workers, don’t do either job particularly well. Generally, improvements in health and their subsequent cost savings were modest and, in most cases, not statistically significant. It also found that employers are likely unaware of these findings, because they are not evaluating their own programs for success.

As Begley wrote:

The report found, for instance, that people who participate in such programs lose an average of only one pound a year for three years.

In addition, participation “was not associated with significant reductions in total cholesterol level.” And while there is some evidence that smoking-cessation programs work, they do so only “in the short term.”

This is a major finding, with implications for business, government, and consumers. But it didn’t seem to be newsworthy to anyone except Begley and Dan Munro, who picked up on her story in his own post on May 28th (updated on May 30th). Bloomberg’s Alex Nussbaum did a good job of connecting the dots between the RAND study conclusions and new regulations about workplace health programs that were issued on May 29th. For that, he gets an honorable mention.

Begley posted her story in on May 24th, just before RAND briefly withdrew the report, possibly because it pre-empted new federal regulations, which, among other things, prohibit discrimination of employees who don’t meet workplace wellness program goals. The regulations, issued on May 29th by the same agencies (plus the Internal Revenue Service) that sponsored the RAND study, was covered widely, from multiple angles. Reports from Robert Pear in The New York Times, Jason Notte on, and Begley herself, mentioned the discrimination angle, but focused narrowly on employers’ new government-approved flexibility in how they tie employee incentive pay-outs to their share of health insurance premiums.

Of course, regulation of workplace wellness programs is an important area of coverage, particularly considering that such programs are becoming more popular, and that the vendors selling them to employers, large and small, are proliferating. The immediate need to clarify the details of this business—for both employers and their workers—is real. That explains why business trades are all over this story.

Another angle is the relentless pursuit of corporate tax breaks for employers providing workplace wellness benefits to their employees, by organizations like The National Business Group on Health, for example. The group has been lobbying for workplace-wellness based tax relief for years, and the impact of their success in this effort on Federal tax revenues should not be underestimated.

But none of this means anything without a clear understanding of whether or not these programs work.

The RAND report suggests that there’s a lot of work yet to be done to evaluate their results. Until the programs are proved be successful, reporters might do well to skip the anecdotes of workplace wellness program success. Of course, plenty of people will feel empowered by a program that seeks to empower them. They are the people who will quit smoking or lose weight, or do whatever it is they have a new incentive to do. Inevitably, some people will benefit from innovative—and generous—employer-based accommodations such as desk treadmills that make it easier for them to change health behavior.

But reporters should dig more deeply into the quantitative research examining the impact of these programs—not only on desired clinical outcomes, such as blood pressure reduction, weight loss, or smoking cessation, but on the long-term cost savings achieved through such outcomes. Those outcomes might include reduced hospitalization, reduced absenteeism, or lower insurance premiums. That’s where the news is.

The RAND study is a good place to start. The journal Health Affairs has been publishing something on workplace wellness in virtually every issue in recent years. (If you don’t have a subscription, join the Association for Healthcare Journalists and you’ll get it for free as a benefit of membership.) Other peer-reviewed health and business journals, such as the Journal of Occupational and Environmental Medicine and the American Journal of Health Promotion, are good sources for experts, quantitative research, and current trends in the effort to standardize workplace wellness program evaluation methods. In fact, the current issue features a compelling study about the impact of workplace wellness programs on Medicare beneficiaries’ medical costs.

Sibyl Shalo Wilmont covers healthcare policy issues for The Second Opinion, part of CJR’s politics and policy desk, the United States Project. Follow the project’s work on Twitter @USProjectCJR and follow her @nursesibyl.

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Sibyl Shalo Wilmont is a healthcare journalist and emergency department nurse with insider experience in the pharmaceutical industry, academic medicine, and patient advocacy. She is a graduate student in Hunter College's dual-degree Master's in Community/Public Health Nursing/Master's in Public Health program. Follow her on Twitter @nursesibyl. Tags: , , ,