Act 2 for workforce wellness programs

With the election behind us, the Obama administration has introduced Affordable Care Act provisions intended to motivate employers and employees to partake in workplace wellness programs.

Proposed Affordable Care Act regulations, Incentives for Nondiscriminatory Wellness Programs in Group Health Planspublished Nov. 26, say “appropriately designed wellness programs have the potential to contribute importantly to promoting health and preventing disease.” According to the Department of Health and Human Services, implementing and expanding wellness programs “may” offer the opportunity to improve the health of Americans and help control healthcare spending.

For occupational health providers, that “may” is a sticking point. Historically, wellness has been a tough sell because of the need to empirically demonstrate the value of prevention at specific worksites. This is especially true in the case of small-to-mid-size companies who could benefit from health and safety interventions but whose workforces and budgets are limited in comparison to those of larger organizations.

However, employers of all types and sizes are showing an interest in a growing body of evidence that suggests comprehensive wellness programs improve workforce health and reduce costs over time. They have to pay attention: The Centers for Disease Control and Prevention reports that people with chronic conditions (many of them lifestyle-related) account for more than 75 percent of the $2.5 trillion+ spent annually on medical care – remembering that much of the burden is shifted to employer-sponsored health plans.

As regulations go, this one is on a relatively fast track. If approved, it would replace 2006 wellness provisions and apply to group health plans and coverage on or after Jan. 1, 2014, just a little over a year from now.

While the proposed rules do not specify the types of wellness programs employers should offer, they support “participatory” programs that are generally are available without regard to an individual’s health status. Examples include:

  • reimbursement for the cost of membership in a fitness center
  • reward for attending a free monthly educational seminar
  • rewards for completing a health risk assessment without requiring employees to take further action

The proposed rules also would increase the maximum permissible reward under a health-contingent wellness program from 20 to 30 percent of the cost of health coverage, or up to 50 percent for tobacco cessation. Examples of health-contingent programs include a reward for those who do not use or who decrease use of tobacco, and programs that provide a reward to individuals who achieve a specified cholesterol level or weight and also those who try but fail to meet their biometric target.

To protect consumers, the proposed regulations would require these programs to be reasonably designed to promote health or prevent disease, non-discriminatory and provide reasonable alternative means for employees to qualify for rewards.

Aside from pure ROI, workplace health programs have the potential to promote healthy behaviors; improve employees’ health knowledge and skills; help employees get necessary health screenings, immunizations and follow-up care; and reduce workplace exposure to substances and hazards that can cause diseases and injury.

The proposed rules are open for public comment…now’s the time to speak up.

UL gives workforce health and safety professionals more of the tools they need to proactively address risks, reduce costs and keep people safe, healthy and on the job.