- Broad, one-size fits all wellness programs force us to lower standards for success
- They settle for one-time participation in an activity like a health assessment or biometric screening as the engagement baseline
- This allows us to say that 75% of employees engaged in the annual health assessment
- But we don't meet more meaningful standards, like 50% of an at-risk population successfully reducing their risk for developing a chronic condition
This is from Anthony Brino writing at Healthcare Payer News:
Once much-vaunted, the broad-based workplace wellness program is coming under more skepticism, as new data suggests the prevailing models may not be achieving some main goals.
While more than 30 percent of American adults are obese, there “is little evidence to guide the design of health benefit incentive plans for weight loss,” wrote Mitesh Patel, MD, and a team of University of Pennsylvania researchers that probed one increasingly common approach in employee health plans—weight control incentive programs.
Patel and his colleagues studied the effectiveness of health plan premium adjustment for weight loss and two alternative behavioral approaches by following 200 adult, obese employees at a large health system in Philadelphia. About 80 percent the employees were female and all had a body mass index of more than 30, the threshold for obesity, with an average BMI of 36 and average weight of 227.
The employees were given the goal of losing 5 percent of their body weight and randomized into a control or one of three interventions. One was a standard where they received $550 off the next year’s premiums for meeting the goal, another was an “immediate gratification” intervention where they received $550 as soon as they met the goal, and another was a lottery, where each employee had an $18 percent chance of winning $10 and a $1 percent chance of winning $100 for each day that their weight was in decline to the 5 percent goal over the course of 12 months.
Despite these incentives—including enough money for a short vacation—no real progress was made among the participants, who on average were in their mid-forties, Patel and his colleagues found.
“Workplace wellness programs using health premium discounts were not effective for promoting weight loss,” they wrote, presenting the results at Academy Health. “A daily lottery incentive unbundled from health premiums was also not effective.” ...
After a full year, the average weight loss for the control group was less than two pounds, and there were “no significant differences compared to the standard incentive arm, the immediate gratification incentive arm, or the daily lottery incentive arm,” Patel and colleagues wrote
Their conclusion is that wellness programs using financial incentives for weight loss “need further evaluation and may need to be launched in combination with other engagement strategies.” ...
“While working at a large benefits consulting firm, I cringed every time I heard someone quote the famous movie line ‘If you build it, they will come,’ in reference to employee wellness programs,” wrote Matt Cook, a director Omada Health, a “digital therapeutics” and wellness startup.
“Perhaps a better line to describe the current state of wellness programs would be ‘If you build it, and spend a lot of money to incentivize people to use it, they will come—but they probably won’t stay or change their behavior long-term,” Cook wrote in a post on the Institute for HealthCare Consumerism.
Broad, one-size fits all wellness programs “force us to lower standards for success,” Cook argued. “As a result, we settle for one-time participation in an activity like a health assessment or biometric screening as the engagement baseline. Sure, this allows us to say that ‘75 percent of employees engaged in the annual health assessment.’ But it makes it impossible to meet more meaningful standards, like ‘50 percent of my at-risk population successfully reduced their risk for developing a chronic condition.’”
