Six Health Groups Tackle Wellness Incentives

Guidance published in the July issue of the Journal of Occupational and Environmental Medicine aims to ensure programs are effective, fair to all employees, and improve health results.

Six health-focused organizations have collaborated on a document meant to guide managers of workplace wellness programs that utilize incentives. The document is published in the July issue of the Journal of Occupational and Environmental Medicine, and the organizations say it aims to ensure programs use outcomes-based incentives and are effective, fair to all employees, and improve health results.

The organizations are the Health Enhancement Research Organization, the American College of Occupational and Environmental Medicine, the American Cancer Society, the American Cancer Society Cancer Action Network, the American Diabetes Association, and the American Heart Association. They said the use of outcomes-based incentives (defined as rewarding an employee financially for meeting a specific health outcome or penalizing him or her for failing to meet it) will become more common in U.S. workplaces because the Patient Protection and Affordable Care Act encourages their use. The U.S. Supreme Court upheld that law as constitutional last month; many of its provisions take effect in 2014.

Their news release said the six organizations compared their varying approaches and opinions and identifies key areas of consensus that are explained in "Guidance for a Reasonably Designed Employer-Sponsored Wellness Program Using Outcomes-based Incentives."

"Employers play a significant role in influencing the health behaviors of their workforce, and increasingly they realize that a healthy workforce can reduce health care costs, disability, and absenteeism while increasing productivity," said Jerry Noyce, president and CEO of the Health Enhancement Research Organization. "As employers seek new ways to engage employees in programs that change health behaviors, their interest in outcomes-based incentives has grown considerably, as has the need for a unified voice on the issue."

The document discusses the elements of a wellness program incorporating outcomes-based incentives and explains how employers using them can ensure their programs comply with the Health Insurance Portability Accountability Act (HIPAA) guidelines for a "reasonable alternative standard" for those who cannot meet the health standard.

"In order to achieve and maintain good health, employees need insurance coverage that includes basic preventive care, as well as effective treatments for chronic conditions," said Nancy Brown, CEO of the American Heart Association. "Workplace wellness programs can provide the tools and opportunities to improve health and wellness, but they should not be used in ways that undermine an employee's ability to obtain adequate and affordable health insurance coverage. By following this guidance, these unintended consequences can be avoided."

"Incentives can be an effective way to motivate some employees to participate in workplace wellness programs and to begin behavior changes," said Larry Hausner, CEO of the American Diabetes Association. "If not implemented carefully, however, incentives can also operate as penalties — imposing financial or other burdens on employees which may be counterproductive. One of our goals with this paper is to provide a framework for helping employees make healthy lifestyle changes while providing adequate protection and accommodation for those with disabilities and other barriers."

"Incentives are just one tool employers need to consider when implementing workplace wellness. To be effective, the incentive strategy must be part of a comprehensive workplace health improvement plan," said Dr. Ron Loeppke, MD, FACOEM, president-elect of ACOEM and vice chair of U.S. Preventive Medicine. "The guidance established by this collaborative reflects cutting-edge wellness research, innovative program design, forward-looking health care policy, and the real-world experience of practitioners across the country. It is our hope that employers who are considering outcomes-based incentives put this guidance into practice, and that this collaborative continues to help monitor and define the evolution of incentives in workplace wellness programs."

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