Health of worker wellness plans debated
Pittsburgh — Company wellness and weight control programs sound like a good idea, but are they good business?
A recent national journal article says no and its authors recommend that employers abandon these programs, which they call unproven and ineffective, while a Pittsburgh-area business group leader insists employers must keep looking for ways to improve the health of their workforce.
Employers "have to do something and, because they're bearing the majority of the cost, they have a right to," said Jessica Brooks, executive director of the Pittsburgh Business Group on Health. "Employers have the right idea. If they ended it all together, I don't see how that could possibly benefit anyone."
The report was posted in February on the American Journal of Managed Care website.
Programs targeting employee health with various incentives and promotions have become popular as companies try to rein in health care costs, but such programs' success or failure has not always been clear.
For example, a 2014 analysis of the University of Pittsburgh Medical Center's MyHealth program, which offered insurance deductible credits for participants, found that while financial incentives will increase the use of some preventive services, "They are less likely to move the needle on the use of chronic disease management services, a key driver of healthcare cost reductions."
The managed care journal's report concludes that most corporate weight control and wellness programs fail because, when evaluated objectively, "none have reported savings, long-term weight loss, or reduction in medical events" if the company's nonparticipants and dropouts are considered in the assessment.
The authors specifically cited a former wellness program called ShapeUp, run by Pittsburgh-based health care company Highmark, which ended in 2010.
"The program did not report weight change for non-participants, dropouts or employees who gained weight or regained the weight they lost," the report said. "Despite counting only active participants who succeeded in short-term weight gain, ShapeUp's program shifted only 163 of Highmark's 19,000 employees (0.86 percent) into lower weight categories."
Highmark takes issue with the report's findings, noting that the number of employees at the time was closer to 11,700 rather than 19,000.
But that still represents only 1.4 percent of its workforce whose weight classification went from, say, obese to overweight.
While acknowledging that "if (ShapeUp) had better results, we probably would have continued with it," Highmark's Anna Silberman, vice president of clinical client relations, said that was just one of many initiatives the insurer has launched to instill healthy habits in its workforce.
"We've learned so much more since then," she said.
Workforce health and wellness is more than one program, she said, as a company needs to cultivate a culture of health and wellness. "The workplace is the perfect opportunity to make a difference over a population of people."
At Highmark, she continued, a healthy culture starts at the top, as CEO David Holmberg is among its employees who take advantage of an onsite fitness center. But it also includes installing standing desks, screening programs to pick up early signs of problems, incentives and other programs.
In one newer initiative, Highmark makes donations on the employee's behalf to a health-related nonprofit, such as the American Cancer Society or the American Heart Association, if an employee is able to quit smoking or lose weight. "This really seems to resonate with people," she said.
Benefits specialist James McTiernan agreed. "Taking (wellness and weight control programs) in a vacuum, they're probably not worth it," he said.
But, he quickly added, "I would strongly advocate to employers not to abandon these programs" as they are an "extremely important component" to developing an overall culture of wellness.
"I don't think anybody really does a good job measuring these things," he said. "It's all long term, and you have to trust yourself that you'll be in a better place long term."
Brooks, whose business group members represent some of the region's largest employers, said workplace wellness "has become a commoditized multibillion-dollar industry versus a value-based solution that addresses the whole.
"We need to figure out how to motivate employees. Many programs today aren't strategic or focused and, more importantly, culturally integrated into how companies do business."