June 5, 2008 — Health plan initiatives to promote health and wellness among workers are now commonplace, despite an acknowledged lack of evidence in an investment payoff, according to a study released today by the Center for Studying Health System Change (HSC).
Much of the momentum for health and wellness initiatives has come from large employers looking for long-term strategies to address rising costs and to support their consumer-based strategy of giving employees more responsibility for healthcare decisions and costs, the study found.
The investment payoff for health and wellness initiatives has been difficult to demonstrate, according to the study. Because many of the health and wellness activities in existence today have only been introduced recently and not yet evaluated, there is little credible evidence regarding return on investment.
Health and wellness activities are premised on the idea that healthier people will use fewer medical resources and be more productive. Health and wellness initiatives go beyond screening activities, such as mammograms and colonoscopies that detect disease, and differ from disease management and case management interventions, which are used once a disease is diagnosed.
The study’s findings are detailed in a new HSC Issue Brief — Health and Wellness Initiatives: The Shift from Managing Illness to Promoting Health — available here. The study is based on HSC’s 2007 site visits to 12 nationally representative metropolitan communities: Boston; Cleveland; Greenville, S.C.; Indianapolis; Lansing, Mich.; Little Rock, Ark.; Miami; northern New Jersey; Orange County, Calif.; Phoenix; Seattle; and Syracuse, N.Y. HSC has been tracking change in these markets since 1996. The site-visit research is funded by the Robert Wood Johnson Foundation.
Other key study findings include:
Across the 12 communities studied, health plans are packaging, branding, and marketing health and wellness activities as a way of differentiating themselves in the market. Often these activities are marketed as a key component of a comprehensive approach to care management.
Engaging enrollees is challenging because participation in health and wellness activities is typically voluntary. Most respondents believed some type of incentive is needed to engage people, not only to get them involved initially, but also to encourage them to actually improve their health. Where incentives exist, they tend to vary widely in size and design. They include, for example, small cash payments for the completion of a health risk assessment, gift cards, discounts off of gym memberships, and reimbursement for weight management programs.
Source: Center for Studying Health System Change, www.hschange.com
