Amid lawsuits challenging wellness programs that penalize non-participants and general questions about the return on investment of such programs, a movement is afoot to recast wellness as well-being.
Consultants Al Lewis and Vik Khanna told Healthcare Payer News that most claims made by wellness vendors about the ability of risk assessments, primary care visits and weight loss programs to improve health and cut costs "cannot be supported."
Wellness programs are increasingly common among large employers. But they increasingly penalize non-participants, even though 74 percent of people think it's unfair for employers to make employees who don't participate in wellness programs pay higher insurance premiums.
These types of wellness programs struggle because they emphasize clinical prevention, Lewis and Khanna said, and there's little evidence to suggest that these measures demonstrably reduce healthcare costs. The likely return on investment, they added, comes from increasing employee deductibles.
Instead, Lewis and Khanna advocate "primordial prevention." This focuses on physical activity, healthy eating and good habits such as drinking only in moderation and wearing a seatbelt. In addition, this examines lifestyle choices such as long commutes, which lead to high blood pressure and lower levels of cardiovascular fitness. For example, letting employees telecommute--as about 40 percent of the workforce at Aetna does--can reduce stress.
The wellness programs that work are fun and social, Keas CEO John Stevens told U.S. News & World Report. When it's fun, it's not work, and when it's social, there's less of a stigma attached to talking about sensitive issues, said Stevens, whose company provides health management programs to large employers.
What doesn't work, Stevens said, is a top-down approach that simply gives program participants a discounted gym membership or some books to read. "Most people can't or just won't take this kind of directive."
Contests also work, he said--provided they offer good prizes. Compelling incentives for wellness programs can include MP3 players, gift cards with a health and wellness theme and kitchen appliances that make it easier to prepare healthy foods, FierceHealthPayer previously reported.