Sunday, May 7, 2017

Final Conclusion on Wellness Programs

For my systems project I chose to focus on IT Based Wellness Programs. At first I didn't if I wanted to focus on the different types of programs offered, or the financial benefits companies see when implementing these programs. My goal was to show that wellness programs helped improve the health and well-being of a specific population which was supported by taking a look into multiple factors surrounding this topic. Some of the factors included the definition of wellness programs, they're inclusion in the Affordable Care Act in 2010, resistance from the Equal Employer Opportunity Commission and the American with Disabilities Act, and finally into some statistics on number of companies that have some kind of wellness program offered. I also interviewed a family friend of mine who's company offers a great wellness program just to get some real life feedback on the effectiveness of wellness programs.

The beginning of my research brought a lot of shocking news to me regarding the negative viewpoints of wellness programs. It was the EEOC and ADA that showed resistance to specific wellness programs shortly after their inclusion in the Affordable Care Act in 2010. They argued that some of the programs (outcome-based programs specifically) invaded employee's privacy and discriminated others based on their health. This was alarming to me. How could something that improves an employer's overall health and well-being be a bad thing? Yet, those employees that are considered 'overweight' probably feel targeted as an individual of low health, and sometimes penalized for not reaching health standards on a health risk assessment. Same goes for smokers who feel they are being penalized for their addiction. In order to better understand this dilemma I had to put myself in the shoes of someone with a preexisting condition or an addiction, and it was then that I could see the problem. Wellness programs aren't about rewarding the super healthy employees and penalizing the unhealthy ones, they're about promoting a healthier lifestyle all together.  I believe some of the incentive based programs in the beginning were poorly formatted and ended up penalizing those who didn't reach the right measures on the risk assessments instead of rewarding everyone for simply taking the assessment. Since then I think they have improved tremendously and now are including more activity from wearable devices like Apple Watches and Fitbits.

With 98-99% of companies with 100+ employees offering health benefits and 86-96% of companies with 50-99 employees offering health benefits, I can say with confidence that wellness programs are here to stay. The companies not only have the motive of a decreased healthcare premium but also of a potential to increase employee retention. Healthy employees are happy employees. And if companies start taking care of their employees then they are going to see results. I know that a lot of young college grads look for a company that takes care of the employee just as much as the customer, and providing additional health benefits beyond the normal healthcare is one way to do just that. Over the next couple of years I'm sure we'll see improvements to the different types of wellness programs offered in companies, and a lot less issues with discrimination against employees. Like I said before, it's all about improving the overall lifestyle individual, not forcing someone to run 5ks and eat kale. Everyone does healthy just a little bit different and that's what makes the world go round.




Sunday, April 9, 2017

Research Proposal Part 2

Draft 2

In this second draft of my research proposal, I wanted to touch on a few more topics that weren't covered extensively in my first draft. Specifically I'm going to get into some recent figures of employer-sponsored health insurance costs, and percentages of firms and employees that are covered. Understanding how much companies have to pay to cover their employees is helpful to see why so many companies are beginning to invest in wellness programs. A great study found on the Kaiser Family Foundation site gave me all sorts of stats on how many companies are currently supporting some kind of wellness program or just a health risk assessment.

Further, I wanted to get some real-life views on company wellness programs or just health benefits in general. I got the chance to talk to a family friend and my own brother who work for large companies that are known for taking care of their employees, and got to hear first hand what services/benefits are offered at the company.



Insurance Stats as of 2016
To understand why companies are beginning to venture into the world of wellness programs, I thought it would help to understand just how much employers are paying to have their employees covered by health insurance. Once we understand these numbers, we'll see why companies will do what they can to reduce their overall rates (while benefitting their employee's well-being and improving the chance they'll work for that company longer). The 2016 Employer Health Benefits survey provided by the Kaiser Family Foundation provides a fantastic record of all things involved in employer health insurance and benefits. Below are some of the statistics found in 2016 for employer-sponsored health insurance rates.


  • In 2016, the average annual premiums for employer-sponsored health insurance are $6,435 for single coverage and $18,142 for family coverage.” “The average premium for family coverage is lower for covered workers in small firms (3-199 workers) than for workers in large firms (200 or more) ($17,546 vs. $18,395)

  • On average, covered workers contribute 18% of the premium for single coverage and 30% of the premium for family coverage

  • Workers in small firms contribute a higher average percentage of the premium for family coverage (39% vs. 26%) than workers in large firms



Also in this very same document were statistics on wellness, health risk assessments, and biometric screenings in firms today. This is vital information that shows the rising interest in this topic.


  • 56% of firms offer health benefits to at least some of their workers
  • 32% of small firms and 59% of large firms provide employees with an opportunity to complete a health risk assessment

  • 54% of large firms with a health risk assessment program offer a financial incentive to encourage employees to complete the assessment
These financial incentives include:

  • Lower Premium contributions or cost sharing (51% of firms)
  • Eligibility for other wellness incentives (44% of firms)
  • Cash, contributions to health-related savings accounts, or merchandise (60% of firms)
Biometric screening:


  • Twenty percent of small firms and 53% of large firms offering health benefits offer employees the opportunity to complete biometric screening. Biometric screening is a health examination that measures an employee’s risk factors such as body weight, cholesterol, blood pressure, stress, and nutrition
Wellness Programs:

  • 46% of small firms and 83% of large firms offer a program in at least one of these areas: smoking cessation; weight management; behavioral or lifestyle coaching. 
  • 3% of small firms and 16% of large firms report collecting health information from employees through wearable devices such as a Fitbit or Apple Watch. 
  • 42% of large firms with one of these health and wellness programs offer employees a financial incentive to participate in or complete the program.


Consumer View Points

To create a better understanding of the consumer view point of wellness programs, I asked my brother and a family friend about their current workplace programs and health benefits. My brother works for McMaster Carr, an industrial and commercial facilities supplier, as a customer service representative. Although he didn't have too much to say about any sort of wellness program, the one benefit he does utilize is the gym membership subsidy the company offers. McMaster Carr will pay the majority of a gym membership fee for YMCA affiliated gyms, and local gyms in the town. So a $45 gym membership at the YMCA only costs my brother $15 (that's about a 70% coverage by the company. Not a bad deal!

A family friend of ours works at Sage Products LLC, a manufacturer and distributor of health and personal care products for hospital and retail markets. This company has a very distinguished wellness center that is run by Indiana University. A physician's assistant and registered nurse are on staff 5 days a week, and any service provided by them cost covered employees $0. Sage uses the corporate wellness program company, Strive, which offers a variety of services to the employees including wellness consulting, health coaching, biometric & health screenings, employee fitness programs, and more. Strive uses a rewards program approach where employees collect points for getting a screening or attending a health related seminar. Employees can also connect their Fitbit trackers and receive points for reaching a certain amount of steps a day. The reward points add up to a point where employees can redeem the points for incentives like gift cards! Our friend loves the convenience of the wellness center and the rewards program and says it definitely helps cut down missed work time. Sage was recently bought out by the company Stryker as well, and several of the employees were concerned that the buy-out would take away the wellness center. But a representative told the employees that they were very impressed by the center and what it was doing for their employees and so they are keeping it!

Conclusion
With the data from the Employer Health Benefits survey and real consumer data, our story of IT Wellness Programs has grown significantly. We've covered wellness programs as stated in the Affordable Care Act, the Equal Opportunity Commission and concerns of privacy and employee, recent statistics of employer-sponsored health care, and even got some feedback on company healthcare benefits and programs courtesy of family and friends. My objective with this research is to demonstrate how these IT based wellness programs improve the health and well-being of a specific population. With a little more inquiry on the health of the office space population I believe we'll have a conclusive proposal on IT based wellness programs.





References


Research Proposal Part 1

Thought I could post the first draft of my research proposal on the blog so that my second draft could easily reference the first and everyone will know what I'm talking about! Enjoy.
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Draft 1

Wellness programs have been around since the 1980’s but it wasn’t until their appearance in the 2010 Affordable Care Act document that made them popular in companies nationwide. These programs along with incentives help employees, and even consumers, take steps towards healthier lifestyles. What could be wrong with that?

What interested me about this topic was not only seeing what kinds of health programs employers are providing but also what were the overall benefits for both employers and employees? Little did I know that upon further research of those companies adopting these programs would I find that there were groups very much against these programs. I’ll go into further detail below about this very controversy that brings the Equal Employee Opportunity Committee and the Americans with Disabilities Act into the clear as they give their statements. It’s important to address the positives of negatives of these programs now as they become more widespread across major U.S. companies. These programs can do a lot of good getting people involved in healthier lifestyles while decreasing overall health costs for just about everyone involved.

Wellness Programs and the Affordable Care Act
The rise in popularity of the wellness programs came from the new Affordable Care Act enacted in 2010. However, the specific rules regarding wellness programs didn’t take effect until or after January 1, 2014. “The Affordable Care Act creates new incentives and builds on existing wellness program policies to promote employer wellness programs” (U.S. Department of Labor).  The types of programs vary from company to company but all offer a similar array of incentives for reaching certain health goals, and for providing programs that help employees reach these goals. One type is the participatory wellness program that are “generally available without regard to an individual’s health status” (U.S. Department of Labor). Some of these programs will “reimburse for the cost of membership in a fitness center or reward employees who complete a health risk assessment” (U.S. Department of Labor). Another type of program the Affordable Care Act mentions are health-contingent wellness programs. These include programs that reward users who decrease, or stop, their use of tobacco. Or provide rewards to individuals who reach a specified cholesterol level or weight (U.S. Department of Labor). While these programs have been around for quite some time before 2010, this new documentation makes adopting these types of programs more appealing for the cost savings they are producing.

Company Wellness Programs
From credit card companies to healthcare insurance giants, businesses across America are beginning to implement different types of wellness programs.  Take healthcare company, Cigna, who offers incentives to its consumers (versus employees) for improvements in their health, “customers who reach their goals receive a financial discount on health premiums or a contribution to their Health Savings Account” (Dion 2016). Cigna’s wellness programs offer a technology-human hybrid which has shown to keep employees more engaged in the program leading to higher success rates by using online coaches to motivate and engage members. The most challenging part of wellness programs is employee engagement since it takes several weeks for people to make a significant lifestyle change. Joe Mondy, director of public relations for Cigna, says “we’ve seen medical inflation fall down below 5% as a direct result of our programs…this is the way of the future in terms of solving health care costs.”

United Healthcare is another insurer expanding its wellness programs to include access to the Real Appeal weight-loss program. Real Appeal CEO, Steve Olin, reported that “United Healthcare is committed to finding new approached to helping people reduce their risk for weight-related health conditions, such as heart disease and diabetes. When employees are at a healthy weight, they are more productive and have less absenteeism.” The more Real Appeal’s program is adopted by larger employers nationwide, they estimate savings of more than $25 million in health care costs annually. The Real Appeal weight loss program is primarily technology-based using smartphones, tablets, or computers to connect with users and provide alerts and reminders, while also helping track goals. The program also offers face-to-face video conferencing and interactive messaging with online coaches.

American Express is another company that offers wellness based incentives. “Employees are offered a $100 reward just for coming in for a health assessment; the company always provides an array of free support services, including health coaching, maintenance drugs and preventative care.” These programs helped an American Express employee lose more than 40 pounds. Of course, there are many more success stories within American Express and in other companies as well. These are just a few examples of the programs offered everywhere, and the positive benefits they incur!


The Equal Employment Opportunity Commission and Privacy
Although it may seem that incentivizing employees for improving their health would be an act of greater good, there are some organizations that think otherwise. Groups like the Equal Employment Opportunity Commission and the Americans with Disabilities Act have both argued against proposed cases of privacy invasion and employee discrimination based on health. The Equal Employment Opportunity Commission has been pursuing legal actions against programs that they believe are violating federal antidiscrimination laws. The E.E.O.C “has argued, unsuccessfully in some cases, that employers have wellness programs that violate laws prohibiting them from demanding medical information from workers.” Additionally, E.E.O.C has issued proposed regulations “that would forbid companies to make health screenings a condition of insurance coverage.”
Even the Americans with Disabilities Act have been fighting companies and declaring that companies requiring employee’s

The NY Times article Could Health Overhaul Incentives Hurt Some? points out another interesting downside of wellness program incentives. Offering premium discounts to those employees that achieve certain health standards would naturally shift costs to the less healthy employees, writes the author, Roni Caryn Rabin.  “Advocates for people with chronic ailments like diabetes, cancer, and heart disease say they welcome initiatives that enable employees to incorporate exercise or weight counseling into their workday,” but this only shows the positive effects of wellness programs. People with other conditions, like asthma, may not be able to participate in some of the wellness programs, and therefore they shouldn’t be penalized with higher insurance premiums in comparison to their ‘healthier’ counterparts.

Discussion and Final Thoughts
I only barely scratched the surface of the vast amount of wellness programs out there offered in certain companies. However, I think it’s important for more employers to adopt programs like the ones that Cigna and United Healthcare have adopted. What I suggest, considering certain privacy and discrimination accusations that have been made, is that companies adopt programs that work well for their company culture. Programs that aren’t mandatory, and that don’t penalize employees for not participating, or in some case not being ‘healthy’ enough. Even employees can enjoy the benefits of these free programs offered by their work then hopefully they will take them for granted. For companies, these wellness programs are more than reducing health care costs but rather it’s an investment in their workplace talent. Happier and healthier people will ultimately perform better at their jobs which will help improve overall company performance. For me, these wellness programs offer a plethora of benefits to businesses and their employees. I think the legal action being taken by the E.E.O.C is a bit far-fetched since it seems that most companies aren’t demanding their employees to give up certain health records for them to participate in the programs. Although that committee would be considered a good guy, they seem to be attacking programs that are just trying to make people healthy. I’m a bit biased though. It will be interesting to see changing health care benefit packages in companies as I start my post-grad career search. For me, a company invested in my well-being is a top candidate, and I hope more companies begin to realize this important for more potential employees moving into the future.



References
Abelson, Redd. “Employee Wellness Programs Use Carrots and, Increasingly Sticks.” nytimes.com. N.p., 24 Jan. 2016. Retrieved from https://www.nytimes.com/2016/01/25/business/employee-wellness-programs-use-carrots-and-increasingly-sticks.html?rref=collection%2Fsectioncollection%2Fhealth

Dion, Kathy. “Tech-enabled workplace wellness programs a growing trend.” Home Health Technology News. 8 Nov. 2016. Retrieved from http://www.homehealthtechnologynews.com/payers/tech-enabled-workplace-wellness-programs-a-growing-trend/

Rabin, Roni Caryn. "Could Health Overhaul Incentives Hurt Some?" nytimes.com. N.p., 12 Apr. 2010. Web. 29 Jan. 2017. Retrieved from http://www.nytimes.com/2010/04/13/health/13land.html?rref=collection%2Fsectioncollection%2Fhealth

U.S. Department of Labor, Employee Benefits Security Administration. The Affordable Care Act and Wellness Programs. 17 Oct. 2014. Retrieved from