Report to Congress on Workplace Wellness. Report to Congress on Workplace Wellness.
As Required by the Public Health Service Act,Section 2. Submitted to the. Senate Committee on Finance, Senate Committee on Health, Education, Labor, and Pensions, House Committee on Ways and Means, and House Committee on Energy and Commerce. Attachment: Workplace Wellness Programs Study Final Report (PDF- 1. CONTENTSThe Affordable Care Act includes provisions intended to encourage workplace health promotion and prevention as a means to reduce the burden of chronic illness, improve health, and slow the growth of health care costs. One provision of the Public Health Service Act (Section 2. Affordable Care Act, directs that the Secretary of the Department of Health and Human Services (HHS), in consultation with the Secretaries of the Treasury and Labor, gather relevant information from employers who provide employees with access to wellness programs, including state and federal agencies, and submit a report to the appropriate committees of Congress concerning: the effectiveness of wellness programs; the impact of such wellness programs on the access to care and affordability of coverage for participants and non- participants of such programs; the impact of premium- based and cost- sharing incentives on participant behavior and the role of such programs in changing behavior; andthe effectiveness of different types of rewards.
At the request of HHS, the Department of Labor (DOL) contracted with the RAND Corporation to help to prepare this report to fulfill this provision of the Affordable Care Act. This study consists of four parts: a) a literature review, b) a national representative employer survey, c) analysis of an existing industry- wide database (Care Continuum Alliance or CCA database) to which wellness providers contribute data anonymously, and d) five case studies. The Workplace Wellness Programs Study Final Report is attached. A wellness program is defined in section 2. A) of the Public Health Service Act, as amended by the Affordable Care Act, as a program offered by an employer designed to promote health or prevent disease. Wellness programs may include a combination of data collection on employee health risks with population- based strategies and individually- focused interventions to reduce those risks.
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Population health management; Revenue cycle management; See all. Both employers and employees view weight management. 53 percent of the largest firms offered weight-loss programs such as Weight.
Programs may be part of a group health plan or offered outside of that context. They may range from narrow offerings, such as free gym memberships, to comprehensive counseling and lifestyle management interventions.
Effectiveness of wellness programs. Employers also linked cost. The bottom line is that modest weight loss may help improve your diabetes outcomes if you are overweight or obese.http:// . Academy of Nutrition and Dietetics, All Rights Reserved.
The burden of chronic disease is growing in the United States as rising rates of obesity and physical inactivity are leading to more diabetes and cardiovascular disease. Particularly worrisome is that the onset of chronic conditions such as obesity and hypertension is shifting to younger age cohorts, who are still participating in the labor market.
This shift increases the economic burden of chronic disease, as illness- related loss of productivity is added to the cost of medical care. To counter this trend, employers are adopting health promotion and disease prevention strategies, taking advantage of their access to employees at an age where interventions directed at healthy behaviors can still change the trajectory of employees’ long- term health. These strategies range from changes to the working environment, such as providing healthy food options in the cafeteria, to comprehensive interventions that support employees in adopting and sustaining healthy lifestyles. According to the employer survey conducted for this study, approximately half of U.
S. Larger employers are more likely to offer programs than smaller employers and larger employers offer a greater variety of options. Focus group participants indicate that poor accessibility of wellness activities due to rigid work schedules and wait times limit access to wellness benefits. Effectiveness of wellness programs.
A review of the scientific literature evaluating the impact of workplace wellness programs on health- related behavior and medical cost outcomes found, consistent with previous reviews, evidence for positive effects on diet, exercise, smoking, alcohol use, physiologic markers and healthcare costs, but limited evidence for effects on absenteeism and mental health. It was not clear from the literature whether program intensity was positively correlated with impact. Positive results found in the literature review studies should be interpreted with caution as many of these programs were not evaluated with a rigorous approach, and published results tend to focus on larger employers and therefore may not be representative of the experience of a typical U. S. A RAND analysis of the CCA database, when comparing wellness program participants to statistically matched non- participants, found statistically significant and clinically meaningful improvements in exercise frequency, smoking behavior, and weight control, but not in cholesterol control.
Impact of such wellness programs on the access to care and affordability of coverage for participants and non- participants of such programs. Most employers who offer workplace wellness programs regard them as a viable strategy to contain health care costs.
A review of the literature identified randomized controlled trials that found workplace wellness programs did result in significant decreases in healthcare costs, including a savings in medical costs ranging from $1. The employer survey found that 6. But less than half of the employers reported regularly evaluating their wellness programs and only 2 percent provided actual savings estimates. About five percent of employers nationally maintain an on- site clinic.
Impact of premium- based and cost- sharing incentives on participant behavior and the role of such programs in changing behavior and the effectiveness of different types of rewards. Financial incentives have become a commonly used tool to promote employee engagement in worksite wellness programs, and employers are expanding their use. Among employers who offer workplace wellness programs, 6. Employers also linked cost- sharing incentives to health coverage for program participation and/ or attainment of health goals, including cost- sharing incentives related to the employees’ share of health plan premiums (3. Health Reimbursement Accounts (5 percent). Based on the survey, incentives are typically framed as rewards for engaging in wellness programs. Only 2 percent of employers frame their incentive offerings only as penalties, and 1.
The use of incentives targeted to achieving specific health outcomes such as smoking cessation and reductions in body- mass index remains uncommon. The survey suggests that nationally only 1. The average maximum incentive amount for these employers was less than 1.
Health Insurance Portability and Accountability Act (HIPAA). There was too little variation in the rewards offered by employers in the CCA database to be able to assess effectiveness of different types of rewards. A smaller number of employers tie incentives to achieving health standards, primarily with regard to smoking cessation. With respect to effectiveness, the analyses of employer data in the CCA database imply that incentives for HRA completion and program participation can significantly reduce weight and smoking rates and increase exercise. The size of these effects, however, is small and unlikely to be clinically meaningful. Other Factors affecting program success.
The RAND case studies and the review of the literature also highlight a number of factors that may affect wellness program success in the workplace. Effective communication with employees about program goals and benefits, accessibility and alignment with employee needs, leadership support, creative use of resources, and continuous program improvement all appear to be factors that can improve employee health and increase the effectiveness of worksite wellness programs. Rulemaking. The Affordable Care Act addresses employers' ability to reward employees who participate in certain wellness programs offered through employment- based group health plans and which require individuals to meet health goals. A number of federal laws and regulations impose requirements and regulate the use of financial incentives in certain types of wellness programs. Section 2. 70. 5(j) of the Public Health Service Act, as amended by the Affordable Care Act, raises the allowable value of wellness incentives provided through employment- based group health coverage that require satisfaction of a health- related standard from 2. DOL, HHS, and the Treasury to increase the reward to up to 5.
It also codifies in statute the HIPAA regulatory standards for health contingent wellness programs. On November 2. 6, 2.
Departments of Health and Human Services, Labor, and Treasury released a Notice of Proposed Rulemaking on the wellness program provisions of the Affordable Care Act. Final rules regarding incentives for nondiscriminatory wellness programs in group health plans were published contemporaneously with this report to Congress in early May 2. The final rule increases the maximum permissible reward under a health- contingent wellness program offered in connection with a group health plan (and any related health insurance coverage) from 2. Affordable Care Act. It also allows a maximum reward up to 5.
Section 2. 70. 1 of the Public Health Service Act if they also provide a tobacco cessation wellness program (consistent with Section 2. Public Health Service Act) that would eliminate the surcharge for participants.
Finally, the final regulation clarifies several of the consumer protections required for health- contingent wellness programs. Also relevant to workplace wellness are the preventive services for adults that are covered without cost- sharing in non- grandfathered group health plans as a result of other provisions in the Affordable Care Act.