I recently attended a workplace wellness conference put on by a Chamber of Commerce. The conference began with a Keynote by a Medical Director of a major health plan and then had a number of breakout sessions one could attend including:
- Overcoming Barriers to Building a Wellness Program
- The Business Case for a Healthy Workforce
- The Future of Corporate Wellness
- Best Practice for Corporate Wellness
Overall the Agenda looked very good and the speakers were key people at health plans, wellness vendors and large employers.
I was able to attend the morning keynote session and had to pick two of the breakouts, so I selected The Business Case for a Healthy Workforce and The Future of Corporate Wellness.
The keynote presentation was very well presented, entertaining and a good overview of wellness programs. Unfortunately while they discussed absenteeism and presenteeism as some of the broader values of wellness programs, they also used studies that had been walked back, claimed extremely high ROI’s (truth be told they said it was in year 2 or 3), associated disease management and other chronic care savings with wellness program savings, made no mention of the RAND study showing a debatable ROI for wellness programs, nor did they mention the new article in the American Journal of Health Promotion entitled:
This article looked at savings as related to study design and found that as the study design became more rigorous, the ROI or medical savings dropped to a net loss in the gold standard of Random Control Trial. To say the least I was a bit surprised.
The panels were even worse.
In the Business Case for a Healthy Workforce, none of the panelists had any data from their programs, nor did they refer to any studies, they just stated that “wellness saves money” and most of the comments were simple ideas like, “get the CEO involved”, “build a culture of health”, “start simple”, and had no discussion on how to do these things or build evidence based programs (a phrase I never heard at the conference).
The last panel I attended was The Future of Corporate Wellness. A potentially great topic with a tremendous amount of exciting innovation going on: mHealth, Big Data, predictive analytics, machine learning, better behavioral approaches, incentive and plan design, gamification, integration with providers, on site clinics, collaboration, and on and on.
This panel unfortunately was moderated by someone who began by stating that “(he) had no background in healthcare, but fortunately we have a panel of experts.” Here to the answers from the experts were sweet with no substance.
During this panel presentation I heard no mention of mHealth, predictive analytics, machine learning, behavioral approaches, gamification or incentive and plan design. There was mention of on site clinics by the hospital wellness provider offering those services and Big Data came up, sort of when the moderator asked a very good question on Big Data and personal privacy and requested that the panel opine on what might be some of the concerns with this new approach. As most recognize, Big Data is an area fraught with issues but little guidance from the federal government (note that Apple just announced that data from their HealthKit cannot be sold by those vendors using it.) The answer given by the one panelist who chose to discuss the question was interesting to say the least.
The panelist stated the program should only “get a minimal amount of data needed to conduct the program” and she then listed those data requirements as: “claims, pharmacy and biometrics and forget anything else.” If that was her definition of Big Data, I assume that her program is probably using an Excel spreadsheet,and then, when she had to add a second tab, BINGO she had Big Data.
I shouldn’t be so harsh, but we are an industry, population health, with a practical approach to solving many of the health and healthcare quality and cost problems that exist today; but only if done right. I came away disillusioned by these real world examples of wellness programs discussed at a conference by purported wellness experts and representatives of some major employers and health plans.
This is the second conference I have attended where the presentations were clearly problematic. At the other conference, one of the presenters showed data that they claimed documented savings from their company’s wellness program. This was a large employer with 18,000 employees who made a very simple error. According to them, the savings began to show at program launch, which also happened to be when a large subset of their members (3,000) quit the plan over its new design. When questioned about these 3000 employees who left, they readily admitted they were the highest risk and cost members! So the highest risk/cost members making up 1/6th of the employees leaves your health plan and has no impact on subsequent costs in a pre/post study looking at costs per member per month?
We as an industry can and must do better. That is why membership in an organization like the Population Health Alliance (PHA) is so important. At the PHA we work to develop appropriate guidelines and standards to ensure that programs are well designed, evidence based, effectively executed, and properly evaluated. Without that wellness can be anything anyone says it is, have outcomes anyone says they have, and offer nothing worth spending anything on. The result will be Wellness landing in the same pile of fads that have been offered over the years as solutions to our health and healthcare crisis and then dropped.
In the next post I’ll discuss what works and a new article coming out in the Journal of Occupational and Environmental Medicine by some true experts in the field.