In the United States, companies pick up a great deal of the bill for a healthcare system that spends the most but accomplishes the least among industrialized nations. Getting wise to this, more employers have rolled out wellness programs, where workers are encouraged with either a carrot or a stick to make better healthcare choices.
Now, a group of prominent CEOs including Coke’s Muhtar Kent, Aetna’s Mark Bertolini, and Bank of America’s Brian Moynihan are recommending that employers get further involved in employees’ health decisions.
In a report released yesterday through the Bipartisan Policy Center, they and other members of the group’s CEO Council on Health and Innovation advocated for a world where companies have programs to address physical activity, emotional health, and chronic conditions. Where employees have online wellness coaches, and companies provide screening at the workplace. Where people are incentivized to take health questionnaires, and to provide the company’s healthcare partners with a wide variety of data, like blood pressure readings, blood glucose measurements, and cholesterol levels, as well as markers of their weight, nutrition, and physical activity.
The report encourages companies to begin tracking, anonymizing, and sharing the data so that employers can learn from one another.
Many large employers already have some form of wellness program:
Companies led by the CEOs involved in the report are even further down this path. They’re not just adopting the programs, but actively tweaking and pushing them to make sure that employees actually engage.
Bank of America offers a $500 credit to workers who submit to a detailed biometric screening and fill out a health-risk assessment. The participants also get wellness recommendations, and those determined to be at risk get a call from a health manager. Over 80% of employees have participated.
Coca-Cola offers wellness coaching, disease management programs, and premium-reduction incentives, and it encourages employees to take 15-minute exercise breaks during the work day. Drugstore retailer Walgreen, meanwhile, offers employees free vaccines and biometric screening, often at its own in-store clinics, and has incentives in place to encourage use of its wellness program.
But do the programs actually work? According to the companies participating in the report, yes. However, evidence from academic research is mixed (paywall).
In any case, even a well designed program that saves the company money and makes employees healthier won’t necessarily address the real causes of high healthcare costs in the US, including administration inefficiencies in healthcare, inappropriately aggressive testing and treatment, and an approach that remains more focused on reactive than preventative care.
Addressing those broader concerns is a secondary and much more ambitious goal of the CEOs involved in the Bipartisan Policy Center report. The group recommends that employers and insurers examine and begin to measure provider performance on quality, cost, prevention, and patient experience, and demand more transparency from clinicians. And it suggests that employers actively look to increase the percentage of payments based on outcome and value instead of volume.
Implementing those recommendations would be significantly tougher, and more controversial, than implementing employee fitness challenges, but are far more likely to substantively reform a system many are eager to change.