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Health plan costs - preventive care

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[Guidance Overview] Fact Sheet: Final Rules on Religious and Moral Exemptions and Accommodation for Coverage of Certain Preventive Services Under the ACA
"Exemptions for Religious Beliefs: The first of two final rules provides an exemption from the contraceptive coverage mandate to entities and individuals that object to services covered by the mandate on the basis of sincerely held religious beliefs. Thus, entities that have sincerely held religious beliefs against providing contraceptive services (or services which they consider to be abortifacients) would be exempt from the mandate and no longer be required to provide such coverage. The rules maintain the availability of the accommodation, in which the entity's insurer or third party administrator is responsible for providing contraceptive services to the entity's plan participants and beneficiaries, but they make it voluntary, at the option of the entity. That is, an otherwise exempt entity can elect to take advantage of the accommodation, which would provide contraceptive coverage to its employees and their dependents. Entities that object to covering some, but not all, contraceptive items would be exempt with respect to only those methods to which they object. The exemption is also applicable to institutions of higher education, insurance issuers to the extent they provide a plan to otherwise exempt entities, and individuals whose employers and issuers are willing to provide them a plan compliant with the individuals' beliefs....

Exemptions for Moral Convictions: This rule gives nonprofit organizations, small businesses, and individuals that have non-religious moral convictions opposing services covered by the contraceptive mandate protections that are similar to the religious final rule's protections for religious organizations and businesses. The exemptions apply to nonprofit organizations and to closely held businesses, as well as to institutions of education, health insurance issuers serving exempt entities, and individuals. The voluntary accommodation is also available to entities with moral convictions against providing contraceptive services (or services which they consider to be abortifacient) in their health plans." (U.S. Department of Health and Human Services [HHS])

[Opinion] Aetna Accidentally Invalidates the Wellness Industry's 'Savings' Model
"Aetna studied Aetna employees who, by Aetna's own admission, didn't have anything wrong with them, other than being at risk for developing metabolic syndrome, defined as 'a cluster of conditions that increase your risk for heart attack, stroke and diabetes.' In other words ... the subjects' 'diagnosis' was being at risk for being at risk. Not only did they not have diabetes or heart disease, but they didn't even have a syndrome that put them at risk for developing diabetes or heart disease. You and I should be so healthy.... And yet, Aetna reported savings of $1464/participant in the first year." (Al Lewis and Vik Khanna)
Doubts Surround Effectiveness of Wellness Plans Aimed at Weight Loss
"[A recent study finds] no company has been able to demonstrate sustained weight loss across a large population for two years or more.... Wellness programs that focus on weight loss may in fact have negative effects, [the study] says, arguing that overscreening and crash dieting can impact employees' morale and even harm their health. Despite these concerns, some employers are raising the bar for employees to qualify for program incentives[.]" (FierceHealthPayer)
Preventive Services Tracker
"This tracker presents up-to-date information on the adult preventive services nongrandfathered private plans must cover, by condition, including a summary of the recommendation, the target population, the effective date of coverage, and related federal coverage clarifications." (Henry J. Kaiser Family Foundation)
When Does a Workplace Wellness Program Become Coercive, Rather Than Voluntary?
"But many employers say the [EEOC] proposal doesn't clear up conflicts between the health law and the ADA. In addition, it restricts their ability to offer rewards ... Some employers say the rule could force them to cut the size of wellness programs' financial incentives or penalties, particularly for families and smokers.... Consumer groups are also unhappy, saying the proposal strips workers of important protections against health or disability-related discrimination by loosening earlier government definitions of what constitutes voluntary." (Kaiser Health News)
Wellness Program Didn't Help Employees Lose Weight
"The employees [at a large health system in Philadelphia] were given the goal of losing 5 percent of their body weight and randomized into a control or one of three interventions. One was a standard where they received $550 off the next year's premiums for meeting the goal, another was an 'immediate gratification' intervention where they received $550 as soon as they met the goal, and another was a lottery, where each employee had an 18 percent chance of winning $10 and a 1 percent chance of winning $100 for each day that their weight was in decline to the 5 percent goal over the course of 12 months. Despite these incentives -- including enough money for a short vacation -- no real progress was made among the participants[.]" (Healthcare Payer News)
[Guidance Overview] EEOC Issues Long-Awaited Proposed Rule on Employer Wellness Programs
"The references in the proposed rule regarding the requirement to provide notice and the use of incentives, apply only to wellness programs that are part of or provided by a group health plan or by a health insurance issuer offering group health insurance in connection with a group health plan. In addition, the proposed rule explains that compliance with rules concerning voluntary employee health programs does not ensure compliance with all the antidiscrimination laws the EEOC enforces." (Littler)
A Randomized Trial of Four Financial-Incentive Programs for Smoking Cessation
"Of those assigned to reward-based programs, 90.0% accepted the assignment, as compared with 13.7% of those assigned to deposit-based programs.... Reward-based programs were associated with higher abstinence rates than deposit-based programs ... However, ... the rate of abstinence at 6 months was 13.2 percentage points higher in the deposit-based programs than in the reward-based programs among the estimated 13.7% of the participants who would accept participation in either type of program." (New England Journal of Medicine)
Local Conditions Affect Wellness Program Design
"[An] across-the-board wellness program (beyond its many other limitations) [can] miss many needs by not addressing local conditions that could make life changes more difficult to sustain.... So, how do you find out about what life is like for your people outside of the workplace? One approach might be the Health Policy Institute of Ohio's Health Value Dashboard.... The Dashboard brings the data closer to home by allowing you to zero-in county-by-county to see local factors affecting health that you probably couldn't know otherwise.... The Dashboard can provide the same kind of data on counties across the country, allowing you to see what differences exist at your various locations, allowing you to localize your well being efforts. Got a plant north of Atlanta in Cherokee County? Take a look at the data. The well being job to do there might be completely different than in [Ohio's] Cuyahoga County." (Chelko Consulting Group)
Wellness Committees: Four Reasons Why You Can't Afford Not to Have One
"[1] It makes it easier to get employee buy-in.... [2] It enables the company to tailor the program to a more diverse group.... [3] It gives you a number of different perspectives.... [4] It's a great recognition tool." (HR Benefits Alert)
UHG Piloting Rewards for Health in App Collaboration
"UnitedHealthcare is testing the waters of consumer rewards and digital engagement, in a new partnership with Walgreens that's aiming to spur better health choices. UnitedHealthcare's fully insured members in Arizona and Illinois will be able to earn Walgreens Balance Rewards points for completing health activities like walking. The two companies are collaborating with a pilot integration of the UnitedHealthcare Reward Me program, via its Health4Me app, and Walgreen's Balance Rewards loyalty program." (Healthcare Payer News)
ACA Exchange Plans Miss Compliance with Smoking Cessation
"Only 60 exchange plan issuers out of 348 (17 percent) listed all the FDA-approved and Preventive Services Task Force-recommended tobacco cessation medications and therapies without any cost-sharing, as required by the ACA and federal essential health benefit regulations. In only one state, West Virginia, were all plans in the marketplace (from one insurer, Highmark Blue Cross) noting coverage for all the tobacco cessation medications[.]" (Healthcare Payer News)
EEOC Votes on Proposed Wellness Rule, as House Hearing Focuses on Bills to Rein in Agency
"Although the proposed rule is likely to allow employee wellness programs to have financial incentives up to 30 percent of the cost of coverage (and 50% for tobacco cessation programs), the EEOC may also propose a number of conditions and/or reporting requirements on employers to ensure their wellness programs are voluntary and are not a 'a subterfuge for discriminating based on a health factor.' " (HR Policy Association)
121 Employee Wellness Program Ideas
"The key to having a successful corporate wellness program is by encouraging overall wellbeing while still keeping it fun ... If you can't get people engaged then your wellness program ideas will quickly lose steam. So make your initiatives fun, try new ideas and see what your team values the most. [This article includes a] list of 121 employee wellness program ideas that you can easily implement at your office." (SnackNation)
[Opinion] Testimony on Behalf of American Benefits Council to House Labor and Workforce Committee Hearing on the 'Preserving Employee Wellness Programs Act ' (PDF)
18 pages. Presented by Tamara M. Simon of Buck Consultants. "[This] testimony will describe the current state of employer-sponsored wellness programs. Not only are these programs important for achieving better health outcomes for employees, they also have the potential to increase employee productivity, improve workforce morale and engagement and reduce health care spending.... [O]ngoing legal and regulatory uncertainty is preventing more employers from sponsoring wellness programs[.]" (American Benefits Council)
Financial Incentives and Workplace Wellness-Program Participation (PDF)
20 pages. "Data from a large employer that offered financial incentives to encourage participation in its wellness program are analyzed in this paper. It examines how the characteristics of first-time, wellness-program participants changed with the enhancement of financial incentives for health-risk assessments (HRA) and biometric screenings. Those who completed an HRA or biometric screening in the two years prior to the change in financial incentives (i.e., pre-incentive) are compared to those who completed an HRA or biometric screening in the two years (for HRA) or three years (for biometric screening) after the change in the financial incentives. Findings from this study paint a vivid picture of the type of individual who favorably responds to wellness-program financial incentives." (Employee Benefit Research Institute [EBRI])
[Opinion] When It Comes to the Value of Wellness, Ask About Fairness Not Just About Effectiveness
"[P]rogram participation eliminates only about 10-25 percent of the risk burden, which suggests possible savings of $90 to $225 per year. [One] national survey shows typical participation rates less than 20 percent.... Combined with the small size of the prize, 'bending the curve' with wellness programs as currently designed is an elusive goal.... [T]he lack of a financial return does not rule out value in wellness. The workplace is an excellent setting to improve health habits.... But the problem is that most employers did not invest in wellness to make the organization a happy and healthy place. They invested because vendors and benefits consultants promised lofty returns. Now that those expectations are not materializing, ... employers [may] draw dangerous conclusions." (Health Affairs)
[Opinion] Wellness Industry Leaders Shockingly Admit that Wellness Is Bad for Morale
"Why, having now read this revelation in [their] own words, that wellness is bad for morale, would any company still want to 'do wellness'? Or as we say ... 'If you're a general, would you rather have troops with high morale or troops with low cholesterol?' Isn't this the best argument for getting rid of your wellness program: You can improve morale and save money?" (Al Lewis and Vik Khanna)
Program Measurement and Evaluation Guide: Core Metrics for Employee Health Management (PDF)
89 pages. "The goal of this collaborative project and the Guide is to provide standard measures for the assessment of employee health management. This project does not seek to be prescriptive about the types of programs offered to an employee population. Rather, the recommended metrics can be applied to any program intended to improve the health of a population." (Health Enhancement Research Organization [HERO] and Population Health Alliance)
Senate and House Leaders Introduce Bill Supporting Employee Wellness Programs (PDF)
"This Benefits Brief first provides background regarding the various laws that may apply to employee wellness programs. Second, it addresses the substantive provisions of the Bill. Finally, it provides a roadmap for potential future congressional action with respect to the Bill." (Groom Law Group)
[Opinion] How Data from Fitness Trackers, Medical Devices Could Affect Health Insurance
"Pricing risk as accurately as possible is a worthwhile endeavor, but the jump into trackables and wearables is froth. We've avoided pricing risk in healthcare on the mistaken belief that healthcare is 'special.' This is why the [ACA] disallows pricing risk on anything except the most basic parameters (location, age, family size, and smoking status).... Doing periodic fitness-test-based pricing is all the insurance industry needs and has needed for some time. Unfortunately, it's not all they want." (Vik Khanna)
Engaging Health Care Consumers: The Lowe's Experience
"In the early 2000s, to assist employees in managing chronic illnesses such as diabetes and other medical conditions and reduce overall health care costs, Lowe's became an early adopter of a disease management program managed by a health plan.... Lowe's quickly learned that third-party credibility was one of the most important things that mattered to employees, especially when it came to something as personal as health care. In retrospect, the results of Lowe's early disease management program aren't surprising." (Health Affairs)
Actuarial Model for Wellness
"The Society of Actuaries is pleased to make available research material that explores the current wellness environment. The project consisted of three phases: a literature search summarizing current research, a survey of the actuarial and vendor community, and interviews with researchers in the field." [Editor's note: page includes links to Literature Search; Survey Results; two Appendices; Researcher Interviews; and a Study Report.] (Society of Actuaries)
Beyond Wellness ROI, Part II: Case Study of a Major Self-Funded Employer
"One frequent claim is that there is almost no evidence that employer wellness programs reduce health care costs, let alone accomplish this in a manner that produces a positive return on investment.... Headquartered in Lisle IL, Navistar is a leading manufacturer of commercial trucks, buses, defense vehicles, and engines. Using an approach that ironically paid little attention to ROI calculations per se, the company nonetheless ultimately achieved huge costs savings and an excellent return on its investment. Moreover, the strides it took toward a benchmark, sustainable workplace 'culture of health' are striking." (Health Affairs)
HELP Committee Hearing: Employer Wellness Programs -- Better Health Outcomes and Lower Costs
Recording of hearing held Jan. 29, 2015. Witnesses: Dr. Gary W. Loveman, President and Chief Executive Officer, Caesars Entertainment Corporation, Las Vegas, NV; Dr. Catherine M. Baase, Chief Medical Officer, The Dow Chemical Company, Midland, MI; Dr. David C. Grossman, Medical Director for Population and Purchaser Strategy, Group Health Research Institute, Seattle, WA; James Matthew Abernathy, Nashville, TN; Jennifer Mathis, Bazelon Center for Mental Health Law, Washington, DC; and Eric S. Dreiband, Partner, Jones Day, Washington, DC. (Committee on Health, Education, Labor and Pensions, U.S. Senate)
[Opinion] Moving Beyond Wellness ROI Toward Employment-Based Cultures Of Health: Part I
"Lewis et al. are to be acknowledged for fueling the need for a sharper focus on the core challenge at hand for employers: how best to improve the value of their health care investment -- that is, how to manage health care costs while improving employee health and productivity -- in ways that are sustainable. Incremental, inconsistent and, at times, maddeningly slow progress has been made. Employment-based wellness has been at the forefront, even as the need for quality improvement continues." (Health Affairs)
Striving for 'Well-Being' Amid the Wellness Backlash
"While wellness programs may prevent a few heart attacks here [and there] and make companies feel like they're improving health, [Al Lewis and Vik Khanna] argue that it is hard to justify the $10 billion wellness industry as it currently exists. They suggest that any savings employers are promised or see are more likely to be a result of the high deductible health plans so many companies have adopted in the last decade. To some extent, their arguments are vindicated by recent research." (Healthcare Payer News)
[Opinion] The Real Savings in Onsite Wellness Programs
"[I]ncentives and penalties with regard to health insurance premiums are really a matter of semantics and presentation: both are changes relative to a baseline. For incentives, that baseline is high and meeting the requirements begets a discount (a $500 monthly premium becomes $450); for penalties, the baseline is low and not meeting the requirements begets an increase (a $450 premium becomes $500). By either meeting an incentive or avoiding a penalty the employee is taking money the employer has put on the table to participate in a wellness program." (Marathon Health)
[Guidance Overview] Wellness Programs Feeling Heat as EEOC Increases Its Efforts
"This [article] will discuss generally the wellness program landscape in light of the Americans with Disabilities Act (ADA)/Americans with Disabilities Act Amendments Act (ADAAA), the Genetic Information Non-Discrimination Act (GINA), the Patient Protection and Affordable Care Act (PPACA), and the Health Insurance Portability and Accountability Act of 1996 (HIPAA) and the Nondiscrimination Regulations. This is a 30,000-foot overview of laws and regulations that are in need of microscopic scrutiny when applying them to a wellness program." (United Benefit Advisors)
[Opinion] The Value of Workplace Health Promotion (Wellness) Programs
"It seems that too much of the debate and controversy surrounding workplace health promotion is focused narrowly on whether these programs save money. If that were the aperture by which we judged medical care in general, we would withhold treatment from almost every patient and for almost every procedure, with the exception of a few preventive services that are either cost-neutral or minimally cost-saving. That makes no sense for a compassionate society." (Ron Goetzel, in Health Affairs)
Mainstream Wellness Program Challenged in EEOC v. Honeywell
"Despite the ACA's laudable policy goals of promoting affordable health care and transforming America's workers into a healthier and more productive workforce, the EEOC decided to file the Orion and Flambeau suits, and far more surprisingly, the Honeywell suit -- after dragging its feet for 14 years on providing meaningful guidance.... [T]he lack of long-sought EEOC guidance on how to promote participation through reasonable incentives and costs, coupled with concerns stemming from undue litigation risks, may challenge the use of certain financial incentives that could make the use of wellness programs more effective." (Epstein Becker Green)
EEOC Challenges Some Employer Wellness Programs
"The EEOC's primary concern seems to be how wellness program incentives will impact people with disabilities and whether the wellness program affects people within particular protected classes under the ADA. If a wellness program neither asks for an employee's medical information nor requires medical exams, it seems relatively clear that the ADA is unlikely to be implicated and the EEOC would have no reason to challenge the wellness program under that law. However, the EEOC's complaints leave employers with a number of unanswered questions[.]" (Towers Watson)
Employees Offered Financial Incentives Were 33 Times More Likely to Participate in Wellness Programs
"The health coach program began in October 2010, and any health plan member was eligible to work with a coach. Employers began offering incentives to work with a coach in 2011.... During the 2.75-year follow-up period, 4,898 members worked with a coach, including 1,693 among the 16,961 with incentives (10%) and 3,205 among the 974,782 without (0.3%). In 2011, 2012, and 2013, being offered an incentive was strongly associated with time until uptake of health coaching[.]" (The Obesity Society)
EEOC Doubles Down, Attacking Employer Wellness Programs
"The court action taken by the EEOC raises a number of issues that may be resolved during the administrative process or in subsequent litigation.... Is HIPAA compliance a safe harbor from ADA litigation? ... Does the ADA benefit plan safe harbor have the meaning afforded to it by the Eleventh Circuit? ... Can GINA be used to undermine HIPAA-compliant wellness programs?" (Seyfarth Shaw LLP)
EEOC Loses First Round in Case That May Chill Employer Wellness Programs
"The high-profile case has already garnered much media attention because it is no secret that employers have been struggling to figure out exactly what are the lawful contours of employee wellness programs that include incentives.... Brian Marcotte, president and CEO of the NBGH, commented, '... The EEOC has had numerous opportunities to provide that guidance but has failed to do so. Their lack of clear guidance, plus the recent legal action, conflicts with the message of HIPAA and the [ACA] which encourages the adoption and expansion of programs that benefit the health of employees and their families.' " [EEOC v. Honeywell Int'l Inc., No. 14-cv-04517-ADM-TNL (D. Minn., petition filed Oct. 27, 2014)] (Wolters Kluwer Law & Business)
Court Denies EEOC Request for TRO in Wellness Lawsuit
"[On Monday, Nov. 3], Judge Montgomery asked the EEOC the question the corporate wellness world has been waiting for much more than a decade to ask: 'At what point does a monetary penalty result in a compulsion?' The EEOC responded that the agency cannot draw a clear line but that Honeywell had crossed it. At least three times during the oral argument, the Court pressed the EEOC to define the point at which voluntary wellness plan becomes involuntary because of the penalties involved. Each time, the EEOC responded that it cannot draw a line but that Honeywell had crossed it." [EEOC v. Honeywell Int'l Inc., No. 14-cv-04517-ADM-TNL (D. Minn., petition filed Oct. 27, 2014)] (Jackson Lewis)
[Opinion] American Benefits Council Applauds District Court's Denial of EEOC Petition for Injunction Against Honeywell's Wellness Program
" 'The district court's denial of the EEOC's request for a temporary restraining order and preliminary injunction relied on a finding that the program does not pose 'irreparable harm' to participants,' [American Benefits Council President James A. Klein] said.... 'Like many other Council member companies, Honeywell has devoted substantial time and resources to the development and implementation of these programs. The recent legal action by the EEOC, particularly in the absence of formal guidance on wellness programs from the commission sends the wrong message,' Klein said." (American Benefits Council)
Shocking New Wellness Plan Lawsuit Calls Into Question Typical Plan Design
"The Chicago office has filed three separate lawsuits in the past few months on wellness plans, but no other EEOC office has joined the effort. An employer which faces such a lawsuit would likely have some defenses. For example, an employer does not violate the ADA's 'no medical examination' rule if the medical examination is done to 'underwrite', 'classify' or 'administer' medical risks. An employer may also argue that its program does not violate the ADA under the 'voluntary' wellness program exception. The EEOC has acknowledged these exceptions exist, but has generally taken a narrow reading of the exceptions[.]" (Quarles & Brady LLP)
Latest Employer Wellness Plan to Draw EEOC Fire includes Biometric Screening Requirement
"In March 2010, with the President's support for an incentive-based approach to wellness and a statement of Congress' approval of such an approach to wellness, the [ACA] amended the HIPAA nondiscrimination and wellness provisions to allow employers to provide larger incentives to employees who satisfy requirements of the employer's health promotion and disease prevention (i.e., wellness program). Regulations implementing the HIPAA provision have been issued as well. They include 'bright-line' rules for determining the nature and extent of the incentives an employer may include in its wellness program.... The [EEOC] would effectively make meaningless the ACA and HIPAA provisions and regulations." (Jackson Lewis P.C.)
Wellness Programs Violate ADA, Claims EEOC in Lawsuits
"In the complaints, the EEOC emphasized that the wellness program requirements were not 'job related and consistent with business necessity.' This is the standard for many complaints under the ADA. However, if this becomes the standard for wellness programs, what wellness programs could possibly pass this test?" (Winston & Strawn LLP)
To Cut Healthcare Costs, Companies Emphasize Employee Wellness
"When companies can demonstrate that their wellness plan has encouraged a significant percent of employees to receive annual physicals, address potential health concerns and embrace healthier lifestyles, they often will experience lower increases in their health insurance costs, he says. Companies will have more leverage negotiating their health insurance costs when they have about 70 percent participation[.]" (Columbus CEO)
Wellness Programs Get a Health Check
"[E]mployers are treading carefully when it comes to toughened wellness programs, ... as two federal lawsuits raise the volume on concerns about workers' privacy and the border between voluntary and compulsory participation. The suits, and the lack of firm guidance from the Equal Employment Opportunity Commission, which brought them to court, complicates an already fraught question: How to get involved in employees' well-being without sowing discontent among the workforce or inviting legal and ethical complaints." (The Wall Street Journal; subscription may be required)
EEOC Challenges a Second Employer's Wellness Program
"The question arising from the Orion Energy and Flambeau cases is what constitutes a 'voluntary' wellness program. The EEOC has defined a voluntary wellness program as one in which the employer neither requires participation nor penalizes employees for not participating in the program. But, the EEOC has not yet taken a formal position on what would amount to a penalty.... [E]mployers should advise their employees that participation in the wellness program is voluntary, and if the employer wishes to impose a financial penalty on employees who do not wish to participate, that penalty should not exceed 30 percent of the employee's health insurance premiums (or 50 percent for tobacco-related programs)." (Pepper Hamilton LLP)
Walgreens Raises Wellness Ante
"WebMD and Walgreens are partnering to launch a series of new products and services aimed at what might be called the consumer wellness market, with the broad and difficult goal of incentivizing consumers 'to make healthier choices at home, work and on-the-go.' The two companies are bringing WebMD's virtual wellness and coaching programs to the nearly 6 million Americans who shop at some 8,000 Walgreens stores each day, and perhaps more. Walgreens is going to incorporate and co-brand WebMD content into its digital and mobile commerce platforms, while WebMD intends to offer visitors to its website -- like individuals Googling their symptoms -- Walgreens prescription refill and clinic appointment scheduling." (Healthcare Payer News)
Consumers Don't Trust Insurers or Employers as Source of Health & Wellness
"Many wellness programs could be doomed to fail based on a recent survey finding that most consumers don't trust their insurers or employers as a source of health and wellness.... [J]ust 8 percent rely on their health insurers as a source of health and wellness. And just 10 percent rely on employers....Steps that insurers can take include creating a wellness platform approach that, for example, provides health itineraries informing consumers of health activities, preventative services and location-based guidance." (FierceHealthPayer)
How Workers and Employers Diverge on Wellness Programs
"The appeal of wellness programs has much to do with the popularity of wellness benefits among employees (and a belief that they can reduce absenteeism and improve productivity). The roughly $6 billion wellness industry aggressively sells products -- and wellness programs are a far easier cost-containment strategy to sell to employees than higher cost sharing or narrower provider networks." (The Wall Street Journal; subscription may be required)
EEOC Challenges Employer's Wellness Program under ADA
"Although the alleged facts [in this case indicate the employer's] practices might be much more aggressive than in common use by most employers, the principles argued by the EEOC ... raise potential concerns for the growing number of employers relying on health risk assessment and other wellness programs to help manage health benefit costs, employee disabilities, and other concerns.... The sponsors of these arrangements often are unaware of or discount the likelihood that the EEOC might view these and other wellness benefit arrangements as violating the ADA prohibitions against medical inquiries that are not both job related and necessary to the job or other ADA disability discrimination prohibitions." [EEOC v. Orion Energy Systems, No. 1:14-cv-1019 (E.D. Wis., filed Aug. 20, 2014)] (Solutions Law Press)
Health Care Costs Follow Health Risks and Can Be Mitigated Over Time Through Incentivized Workplace Wellness Programs
"The study was designed to evaluate the impact of UPMC's health management and wellness program, MyHealth, on the health and health care costs of its own employees ... [T]here were significant improvements in health-risk status as well as increases in the use of preventive and chronic disease management services ... The findings are particularly meaningful since healthcare workers are a prime target for improving population health and mitigating rising healthcare costs." (UPMC Health Plan)
Measuring Wellness: From Data to Insights
"[A recent survey explored] the extent to which employers use health-related employee data to guide the operation and outcomes measurement of US wellness programmes.... Key findings: [1] More matters than cost effectiveness: Wellness programmes can be part of a progressive HR strategy to make the organisation an employer of choice. [2] Better data collection is needed, but what to do with it? Employers struggle to interpret the data they have and they lack sufficient insights to assess key programme objectives. [3] Leading obstacles to participation in wellness programmes are insufficient time and privacy concerns, employees say." (The Economist)
Wellness Programs and the Challenge of Pinning Down ROI
"[By] 2017 as many as 76 percent of employers could have outcome-based incentives programs in place ... Today, 18 percent of respondents already have them in place, ten percent plan to implement them in 2015, and 48 percent are considering them for either 2016 or 2017.... [L]ess than half of employers surveyed describe any specific aspect of their health and productivity programs as successful. Employers report little success in achieving goals such as lower cost, fewer employee sick days, and reduced chronic disease and lifestyle-related risks in employee and dependent populations." (ExtendHealth)
Are Wearables a Good Fit for Your Wellness Program?
"Wearables are more expensive than the typical pedometer by $10 to $15 per participant. As a result, while some companies distribute a device to every employee, others require employees to complete an activity to earn one. For example, a large financial services firm rewarded employees with a Fitbit for completing a health assessment. And for those employees who wanted to upgrade to a more expensive version, the company subsidized the cost." (HealthFitness)
Do Workplace Wellness Programs Work? Usually Not.
"The programs are generally offered not directly by insurance companies, but by specialist firms that tell employers they will reduce spending on employees' care by encouraging the employees to take better care of their health. Wellness programs have grown into a $6 billion industry because employers believe this. In fact, asked which programs are most effective at reducing costs, more firms picked wellness programs than any other approach." (The New York Times; subscription may be required)
Look Beyond ACA Wellness Regs When Designing Your Program: EEOC Sues Employer Under ADA
"[The EEOC] recently sued an employer in Wisconsin claiming the penalty the employer imposed for nonparticipation in its program was too significant, causing the medical inquiries under the program to be involuntary for purposes of the Americans with Disabilities Act (ADA).... Many employers are in the process of reviewing their medical plans ... for 2015. The focus is largely on ACA compliance, in particular the employer shared responsibility penalties. But ... employers need to also be reviewing the ACA wellness program regulations, as well as the other laws that may affect their wellness program design and administration, such as the ADA." (Jackson Lewis)
Large Wellness Penalties Can Trigger Big Problems Under the ADA
"Most employers don't shift the entire cost of coverage to employees who refuse to submit to a health risk assessment. Those that do can continue to argue that the assessment is a 'bona fide benefit plan' under the ADA safe harbor. The more strident the surcharge, however, the easier it might be for a court to conclude the surcharge is a subterfuge to evade the purpose of the ADA." (Lockton)
Wear This Device So the Boss Knows You're Losing Weight
"The adoption of wearable devices by companies and insurers is increasing as spending on corporate wellness incentives has doubled to $594 per employee since 2009 ... Technology is creating new forms of wellness programs to measure whether employees are making improvements ... Yet the moves also let employers and insurers gather more data about people's lives, raising questions from privacy advocates." (Bloomberg)
Bocce, Baseball, Bowling: A Wellness Program That Covers All the Bases
"Our wellness initiatives were intentional and strategic. Leadership made a healthy workplace culture a priority. The small but dedicated Work 'n' Well Committee was expanded and rebranded the Healthy Workplace Council with a beefed-up budget.... [T]he council focuses on all five aspects of well-being that are measured by the Gallup-Healthways Well-Being Index -- physical, social, community, financial and purpose." (International Foundation of Employee Benefit Plans [IFEBP])
Global Employers Step Up Commitment to Wellness
"Seventy-eight percent of the world's employers are strongly committed to creating a workplace culture of health, to boost individual engagement and organizational performance.... 43 percent say they created a brand identity for their employee wellness programs, 52 percent offer health insurance premium reductions, and 65 percent believe wellness programs are extremely or very important to attract and retain workers." (Buck Consultants at Xerox)
[Guidance Overview] Wellness Programs After the Affordable Care Act
"Wellness programs can be used to make employees aware of health issues that might otherwise go undetected, which might result in significant savings to the employer in terms of lost productivity and the employer's medical plan in terms of claims avoidance. Although the myriad laws impacting wellness programs may seem overwhelming, it is quite possible to design a compliant and cost-effective wellness program that has the potential for significant benefits to the employee and the employer." (Nixon Peabody LLP)
The Maker of Jumbo Jets Tries a Makeover of ACOs
"Within the half year, a large employer and three hospital systems in the Seattle area are launching an unusual accountable care experiment that removes the insurance company middleman. The arrangement is also notable because it will use practically every tactic under way in managed care: health savings accounts, value-based benefits, narrow networks and medical homes. The experiment involving large aerospace manufacturer Boeing Corp. will be closely watched not only for the ACO portion, but also for its everything-but-the-kitchen sink approach to making employees healthier while slowing down the costs of doing so." (HealthLeaders-InterStudy)
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