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January 12, 2015

Common Ground on Wellness? Not So Fast

Summary:

A prominent critic emails a prominent proponent to suggest a letter laying out the common ground -- but receives no reponse.

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[Editor’s Note: A debate about the effectiveness of corporate wellness programs began on this site in late November, with the publication of a piece arguing that rigorous analysis showed no savings. A prominent proponent of wellness responded with a piece acknowledging some common ground but pushing back on the need to have wellness programs show a return on investment (ROI). Two of the authors of the original piece then raised 11 questions for the proponent. Now, one of them, Al Lewis, forwards an email he sent to the proponent, Ron Goetzel, that does a solid job of laying out what I see as the common ground — including an agreement not to sell wellness based on claims of ROI. The hope is to forge an agreement on how wellness should be sold and administered. As of this writing, Lewis says Goetzel has not responded.

We’ve attached the email, which was sent Jan. 5.]

Ron, based on your posting I think we have enough common ground to stop arguing and sign a joint open letter like the one below.  Feel free to edit it. Let’s aim to have it out in a week. If people haven’t had a chance to sign it by then, they can add signatures. Eventually, we should get a lot because there isn’t really any major controversy left, if ROIs are no longer an issue and we agree on adherence to guidelines.

Al

 

The signatories of this note, leaders in the wellness field who have previously been unable to find common ground, now agree on many key aspects of workplace wellness and would like to share that consensus.

First, instead of what are known as “pry, poke, prod and punish” programs that require financial forfeitures (large penalties or loss of large incentives) by employees who refuse to (1) divulge personal health information on health risk assessments; (2) participate in overly frequently blood draws or (3) be sent to the doctor when they aren’t sick, we would encourage employers to adhere to USPSTF [U.S. Preventive Services Task Force] screening/checkup guidelines and frequencies (once every three to five years for most working-age adults). Aside from these infrequent screenings, we recommend that employers stay out of employees’ personal medical affairs unless they ask for help, because overdoctoring produces neither positive ROIs nor even healthier employees. There is also strong anecdotal and behavioral economics evidence that morale is adversely impacted by interference in employees’ personal medical affairs.

Second, we also all believe that employers should respect the dignity of employees not just by no longer economically forcing these programs upon them, but also by not shaming employees who can’t lose weight.

Third, we would jointly like to apologize to Penn State, Honeywell, Nebraska and others for not helping them recognize the importance of adhering to guidelines and/or of respecting employee dignity.

Finally, we recommend that future programs be undertaken without regard for return-on-investment (ROIs) in medical spending since there is too much controversy surrounding the calculation of those ROIs.  Journals and consultants supporting wellness find positive ROIs from wellness whereas other journals and consultants do not, while no vendored program has ever been validated by the industry’s gold standard, the Validation Institute, for medical claims savings, though it is possible this happens in the future.

Instead, we propose that wellness programs be done for employees rather than to them, in order to enhance the engagement and productivity of America’s workforce, which ultimately is what will keep America competitive in international markets for the foreseeable future.  Because of the importance to corporate America of having an engaged workforce, we urge the Business Roundtable and other wellness influencers to support us in this new direction.

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About the Author

Al Lewis, widely credited with having invented disease management, is co-founder and CEO of Quizzify, the leading employee health literacy vendor. He was founding president of the Care Continuum Alliance and is president of the Disease Management Purchasing Consortium.

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