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Workplace “Wellness” Programs Vitality Institute, GWU Forum February 20, 2014

Jennifer L. Pomeranz, JD, MPH, Temple University. Workplace “Wellness” Programs Vitality Institute, GWU Forum February 20, 2014. Background . Chronic disease cost ~$347 billion = 30% of total health spending, 2010 Affordable Care Act Revised → Employer “wellness programs”

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Workplace “Wellness” Programs Vitality Institute, GWU Forum February 20, 2014

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  1. Jennifer L. Pomeranz, JD, MPH, Temple University Workplace “Wellness” ProgramsVitality Institute, GWU ForumFebruary 20, 2014

  2. Background • Chronic disease cost ~$347 billion = 30% of total health spending, 2010 • Affordable Care Act • Revised → Employer “wellness programs” • Targeted setting • Growing health care costs and lost productivity • For every $1 wellness • medical costs fall ~ $3.27 • productivity increases; absenteeism costs fall ~$2.37. APHA-AHRQ 2010; Census 2011; Baicker et al., Health Affairs 2010

  3. Workplace wellness programs • Promote health or prevent disease • Participatory • No reward or no health-related standard • Health Contingent • Activity Only or Outcome Based • More large businesses, mostly participatory • Small businesses employ ~1/2 workforce Trust for America’s Health 2013; 78 FR 33158

  4. Participatory • Must be available to all similarly situated • Health Risk Assessment • Rewards = Penalties • No requirements related to efficacy • State bills and laws 78 FR 33158 (2013).

  5. Health-Contingent 5 Requirements • opportunity to qualify for reward once a year; • reward percentage allowances; • must be reasonably designed to promote health or prevent disease; • available to all similarly situated individuals; • plan materials must disclose the terms of the program, availability of a reasonable alternative to qualify for the reward or possibility of a waiver 78 FR 33158 (2013).

  6. “Reasonable Design” • Reasonable chance improve health/prevent disease, not overly burdensome, not discriminatory, not highly suspect method • No requirement evidence-based standards • Flexibility! • Innovation! • Aromatherapy? • Still not widely used 78 FR 33158 (2013); 71 FR 75014 (2006)

  7. Workplace health promotion/ disease prevention • We must move beyond “wellness” • Support evidence based research/programs • Efficacy from health and financial standpoint • Community Preventive Service Task Force • Innovate then require (and grandfather) • Build evidence base • ACA Precedent USPSTF “A” and “B” services

  8. Workplace health promotion/ disease prevention • State bills and laws • ERISA litigation warning • Best practices and program evaluation

  9. Thank you! jennifer.pomeranz@temple.edu Thank you to the Vitality Institute for funding this work as part of their broader support for a Commission on the prevention of chronic diseases among working age Americans.

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