Tip of the Day: Mandating health risk assessments is an ADA no-no

Some employers have taken the bold step in recent years to mandate employees to participate in health risk assessments to obtain group health insurance. However, a new informal letter from the Equal Employment Opportunity Commission says that such a requirement is one bold step forward but two legal steps back, writing that the mandate is a violation of the Americans with Disabilities Act.

In part, the letter reads: "Although the Equal Employment Opportunity Commission has not taken a formal position on this issue, this office believes the policy you described would violate provisions of the Americans with Disabilities Act that require disability-related questions or medical examinations of employees to be job-related and consistent with business necessity."

I understand the EEOC's position, but in this economy, if every dollar in health savings isn't "business necessity," I don't know what is. What do you think, pros? Comment and let me know.

Click here to read the full text of the EEOC's letter.

Tip of the Day: Widen your wellness tent

In a report for BenefitNews.com, Associate Editor Lydell Bridgeford writes about a study from Rutgers University that finds 46% of highly educated and affluent workers report that their employer offers a wellness program, while only 25% of employees with a high school education or less say the same.

In addition, 45% of salaried workers say they have access to some type of healthy lifestyle program through their employer, compared to 35% of hourly workers, and 45% of employees with incomes of $70,000 or more noted they have wellness benefits, compared to 21% of those making $35,000 or less.

To be effective, wellness programs need to truly be for all. I'd encourage you to take another look at your wellness offering for hourly and lower-income employees to make sure the health-fair big top is big enough.

Tip of the Day: Migraines are costing you pain and productivity

I know you're looking to save every penny these days, so I wanted to bring your attention to this month's EBN report that finds the annual cost of migraines to employers is $50 billion in absenteeism, lost productivity and medical expenses, according to the National Headache Foundation.

Read the story and download a "Five Minutes With ..." podcast for details on how to effectively reduce employees' pain and the financial drain from migraines.

News You Can Use: Are well-being indices next on the stock ticker?

Will employers soon be following indices for the Dow and disease management all at once? Quite possibly, according to an April EBN report.

Some wellness experts believe that U.S. employers eventually will have access to daily and monthly well-being indices that capture and forecast, through statistically valid numbers, the physical, psychological and social health of the American workforce.

This could create, for example, a possible scenario in which 21st-century executives will tell bankers that their company deserves a higher line of credit than its competitors, given that the organization has a higher well-being index score, demonstrating that it's more productive and likely has lower heath care costs.

Under this scenario, how would your company fare? Is this concept giving you food for thought regarding wellness? Comment and let me know.

Tip of the Day: See what 500 of your peers have to say about wellness incentives

In this month's EBN, Integrated Benefits Institute President Thomas Parry details the organization's findings after surveying more than 500 employers to document their use of incentives and disincentives to encourage health and productivity for their combined 5 million employees.

IBI examined current programs and developed much new information for employers about barriers and challenges to implementation, goals employers seek from their programs, which incentives and disincentives are used for which goals, their relative effectiveness, the amount spent on programs and what employers would do differently.

Click here to read the article and get busy applying your new/impr0ved incentives strategy.

Tip of the Day: Find just the right touch

We always hear "one size doesn't fit all" regarding benefit plans, but research reported in the February EBN is showing the same is true for wellness interventions.

Research shows that more than 125 million Americans suffer from at least one chronic illness, while 75 million have two or more. Additionally, those with three or more chronic diseases represent virtually all growth in health care spending since 1987, according to Health Management Associates.

In the face of both rising costs and number of workers suffering from diseases, employers have adopted wellness and disease management strategies to better target workers with chronic conditions, such as online health coaching, 24/7 nurse lines and combinations of these and other high-touch and high-tech interventions.

Recently, HMA examined which types of interventions were most successful in reducing costs for specific diseases, to benefit employers as they make decisions on how and where to target valuable wellness and disease management dollars. Their findings regarding three conditions - asthma, diabetes and mental illness - are outlined here.

Tip of the Day: Cash is the biggest carrot

I'm not a scientist, and I could tell you that cash is king. If you want someone to do/not do something, paying them is a good way to get the desired result.

However, for you empirical types, actual scientists have collected data on the effectiveness of cash as an incentive -- specifically when getting employees to quit smoking.

A recent Wall Street Journal article reports a study published in the current issue of the New England Journal of Medicine found smokers who were paid to quit succeeded far more often than those who got no cash reward.

Tracking 878 smokers who lit up an average of a pack of cigarettes a day, one group received up to $750 to quit, spreading out payments to encourage them to stick with it. The poor control group got bupkus.

The nonsurprising result? Ta-da: 14.7% of the folks in the paid group stopped smoking within the first year, compared with 5% of nonpaid group. And after 15 or 18 months, 9.4% in the paid group were still smoke-free, compared with 3.6% of the nonpaid group.

So perhaps the best use of wellness dollars is not in the program itself, but in the incentives? What do you think? How can employers get the best return on their wellness investments? Comment and let me know.

Tip of the Day: Help your employees keep their new year's resolutions

Strike while the iron is hot, benefit managers! Now is the time when most people resolve to lose weight, quit smoking and generally get healthier, so now also is the perfect time to engage or re-engage your empoyees in a wellness program.

According to a survey from Workplace Options, 63% of respondents want their employer to offer wellness programs to help maintain a healthy lifestyle.

And although money may be tight, Chris Boyce, CEO of Virgin HealthMiles, a Massachusetts-based wellness program provider, says now is the right time to invest in wellness.

"Investing in wellness during a tight business quarter is necessary because [employers'] health care costs have not changed that much and they are looking for ways to reduce that costs," he told EBN. Click here to read the full article on maintaining wellness during a recession.

News You Can Use: U.S. health rankings score bragging rights for small states

Congratulations, Vermont, Hawaii and New Hampshire – you’re the top three healthiest states in the nation this year. Sorry, Louisiana, Mississippi and South Carolina – you’re the bottom three states, according to “America’s Health Rankings,” a report from the United Health Foundation.

Curious about where your state falls in the rankings? Find the full list here. The rankings weigh a number of health metrics, such as the infant mortality rate, prevalence of obesity, smoking rate, access to prenatal care, proportion of uninsured residents and prevalence of binge drinking.

Tip of the Day

Have a happy and healthy Thanksgiving holiday.

Eat, drink and be merry, but to help you stay focused on wellness, click here to calculate how long you'll need to walk to burn off your Thursday feast.

The Daily Diversion will not post on Thursday and Friday. We'll resume Monday, Dec. 1.

News You Can Use: Nation's health care systems slow to embrace wellness mantra

More than 40% of hospitals and health care systems will be on the wellness bandwagon by 2010, a new survey from Meritain Health reports. Additionally, 75% are considering adding wellness programs for employees if they do not already have one in place.

At present, a mere 7% have wellness programs in place.

“These survey results reflect a significant opportunity for helping health care workers become healthier and more productive, but unfortunately also illustrate the challenges HR managers face in making wellness programs an integral part of the benefits offered to employees at our nation’s hospitals and physician’s offices,” said Laura Smith, vice president of healthcare systems accounts for Meritain Health. “In perhaps no other industry could it be more important to have employees modeling healthy behavior, while at the same time producing significant cost savings for their employers.”

Employers report barriers like overall program appeal (30%), cost (27%) and convincing C-suite executives (15%) as reasons why they have not yet gotten wellness initiatives off the ground.

“In these lean economic times, it is tempting for healthcare executives to eschew offering new employee benefits in the interest of prudent budgetary policy,” said Dr. Larry Luter, Chief Medical Officer for Meritain Health. “With the cost of healthcare continuing to rise every year, and national data regarding the number of Americans who are overweight, obese or living with diabetes doing the same, an investment in employee health is one of the most important things any company can do to secure its long-term financial future.”

Overheard At: Wellness 101

Did you miss today's Web Discussion on how to implement wellness programs? Never fear, we've got the transcript. Click here for full details.

Overheard At: Got a wellness question? We've got an answer.

We've got a top-notch Web Discussion coming up for you Thursday. Our recent Benefits Forum and Expo showed that wellness programs were one of, if not the top issue on benefit manager's minds.

So at 11 a.m. THIS Thursday, October 23, we're taking an hour to give a short presentation and answer your pressing questions about design, implementation, and compliance.

Our two speakers are Tami Graham of Intel and Mike Carter of the Hay Group. Graham is a 2007 BENNY winner and responsible for the design and implementation of Intel's wellness initiatives. Carter is a top-notch consultant who has worked with a variety of companies to implement healthy living initiatives.

Registration is limited, so sign up now:

Topic: Wellness Know-How: Designing an effective and compliant plan
Date: Thursday, October 23, 2008
Time: 11:00 am, Eastern Daylight Time (GMT -04:00, New York)

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To register for this meeting
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1. Go to https://sourcemedia.webex.com/sourcemedia/j.php?ED=109325047&RG=1&UID=0
2. Register for the meeting.

Once the host approves your request, you will receive a confirmation email with instructions for joining the meeting.

News You Can Use: Employees hopping on the wellness bandwagon

Employees want to become healthier, and they are receptive to wellness programs offered by their employers. That’s the take-home message from the National Business Group on Health’s new survey.

As a result of employer communications about health and wellness, 43% of workers have made an effort to improve their overall health. For this type of communication, e-mail is the preferred format of 77% of employees. “They want more health care communications targeted to their interests,” says Helen Darling, president of NBGH. “Employees do value communications from their employer. ”

Other key findings include:
* 74% of employees are trying to adopt healthier lifestyles today in hopes of reducing future health care costs in retirement.
* 54% of workers say they would take advantage of health-related programs sponsored by their employer, union or health plan.
* 47% of employees say work demands prevent them from leading a healthier life.
* 34% of all employees would be very likely or extremely likely to participate in a stress management program if it was offered at work.

Darling notes, “The financial meltdown will make [wellness initiatives] more important. We know we need to do better.”

Overheard At: Wellness in any Economy

Experts seem to agree that, despite tough economic times, employers remain committed to their wellness and health management programs, even though some are holding off on adding higher-cost elements.

Brian Passon, wellness consultant and director at Corporate Fitness and Health, explains why wellness programs should not take a back seat during tough economic times. For more information, visit the corresponding article in Employee Benefit News, “Belt tightening: Downward business cycle may influence how employers invest in wellness.”

Tip of the Day

Here’s a counterintuitive tip, but a tip nonetheless: Employers might do better targeting wellness and disease management programs toward younger workers, based on new survey results from EAP provider ComPsych. More than one-half of workers in their 60s have healthy diets, compared to only 17.7% of employees in their 30s. Employees in their 50s and 60s also fared better in level of exercise, outlook on life, social support and stress levels, ComPsych finds.

Scone: Actually, being fat does pay

In the “I-don’t-know-whether-to-laugh-or-cry” files, an Oregon man has successfully sued his employer to foot the bill for his gastric bypass surgery, using the state’s workers’ compensation law.

After injuring his knee on the job in 1976 and reinjuring it in 1999, his physicians told him that his obesity -- he’s 350 pounds – would prevent effective treatment for the injury. He’s elected to undergo gastric bypass surgery and sued his employer to pay for it with workers’ compensation benefits. The state workers’ comp board and an appeals court gave the greenlight.

I admit I don’t know all the facts of this case, but it seems a pretty big leap to suggest an employer caused a worker’s obesity, particularly to the point where the company would be on the hook to pay for a procedure to reverse said obesity.

Personally, I think employers are doing all they can and then some to help employees get healthy – and perhaps this case is a sign that truly no good deed goes unpunished. Wellness programs, disease management, walking trails and onsite fitness facilities, healthy vending/cafeteria options, free health risk assessments and on and on cost employers millions of dollars each year.

Not out of complete altruism, certainly, but the bottom line is that employees can benefit from the programs at no cost to them. This is the kind of case that might make employers wonder whether the effort is worth it.

News You Can Use: Healthiest Places to Live and Retire

AARP The Magazine has announced the top ten healthiest cities to live and retire in with Ann Arbor, Michigan, Honolulu, Hawaii, Madison, Wisconsin, Santa Fe, New Mexico, and Fargo, North Dakota taking the top five rankings. Featured in the September/October issue, the magazine also named five additional cities that received high marks for vitality and great living conditions including Boulder, Colorado, Charlottesville, Virginia, San Francisco Bay Area, Minneapolis-St. Paul, Minnesota, and Naples-Marco Island, Florida.

Are you on the list?

Wellness: Where's the ROI?

I just returned from Blue Cross Blue Shield's press briefing "How America's Employers are Promoting Health and Wellness Programs in the Workplace," and it's really sparked some thinking.

Read the "Reporter's Notebook" post here.

Benefit managers are talking big about how they are putting programs in place to control chronic disease and how they're trying to actively engage their employee population, but very few have data to back it up -- at least not initially. So in today's cash-pressed economy, how are they able to convince their CFO's and CEO's that such programs will be effective, particularly if said programs are going to cost big bucks?

It's common sense that controlling disease through prevention is more effective than point-of-care treatment ... or at least it is in our office. But very little is ever said about how benefit managers are actually making the case to the c-suite that wellness is necessary. I know we're all hoping that benevolent executives will realize the soft-dollar benefits of such programs and see that they'll outweigh hard-dollar costs in the short term, but it surely seems logical not every executive will feel comfortable with the possibility of a return five years down the road.

So here's my question for this morning: how are the benefit managers out there making the argument that short term cost equals long term gain? Where are you searching for your data, and what sorts of time frames are you setting? What research is going into evaluating your population before programs begin, and what sorts of budgets are you asking for?

Share your thoughts. After all, beginning the conversation is the first key to finding a solution.
-McLean Robbins

Are employers leading with the wrong suit on wellness?

PricewaterhouseCoopers has come out with some research on larger employer wellness programs. The study shows that just about half of the folks surveyed think the programs aren't doing what they're supposed to -- driving down costs and boosting productivity. Putting that aside, another half of those surveyed say they're going to step up the wellness activity over the next two years.

I got on the horn with some of the researchers -- including Holly Bialek, pictured above -- and batted some of the concepts around. One thing keeps bugging me. It seems employers are leading with the wellness as health cost cutter, which I think may be what is keeping workers at arm's length -- just 30% or so of employees use the programs when offered according to PWC.

It seems to me that the employer's stronger line is on productivity, no? I mean a company is in the business of making sure Johnny Employee is productive, churning out a lot of good widgets. I think Johnny's likely to be much more receptive to that than the company fat cats taking away dependent health care to make sure executive comp doesn't feel the pinch. And why not position wellness as the savior of rich group medical. Tell the employees that they need to grow their way to a healthier workforce, a healthier bottom line, which will ensure Johnny a job and good benefits for years to come.
--Robert L. Whiddon