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Corporate wellness programs fail both companies and patients

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desk treadmill rendezblue-1 (Photo credit: healthiermi)

 

Corporate wellness programs fail both companies and patients.

 

From the 9 September 2013 article by Kevin Pho at KevinMD.com

 

This column was published in USA Today on September 9, 2013.

More patients are coming to my primary care clinic with forms from their employer, asking me to measure their blood pressure, or check their sugar and cholesterol levels. Companies requesting medical data drive employee wellness programs, a booming $6 billion business, with approximately half of large employers offering such plans.

Coaching and financial incentives are often offered to help employees meet certain health metrics, such as losing weight, lowering cholesterol or quitting smoking. The results of these tests are often tied to the cost of health insurance, with less healthy workers paying more. Under the Affordable Care Act, up to 30% of an employee’s premium in 2014 can be influenced by these programs, an average of$1,620 annually per worker.

 

Wellness programs are designed to lower costs for employers and keep workers healthy, but do they accomplish either goal?

True health cost savings?

Wellness plans are often promoted as saving $3 or more for every dollar invested. But a recent RAND Corporation analysis found that fewer than half of companies took the time to calculate whether these programs saved them money. If they did, the numbers might have startled them. That same study also concluded that wellness programs did not significantly reduce employer health costs.

Why? Health screenings generally promote more doctor visits, prescription medications or further tests. While this might benefit workers’ health, it doesn’t necessarily save money.

If there are no measurable savings, employers pass on the cost of these programs, as much as $500,000 per year, to workers by raising their insurance premiums.

Whether wellness programs improve health is also dubious. This year, the California Health Benefits Review Program, which advises the state’s legislature, found that employees’ blood pressure, blood sugar or cholesterol did not improve by participating in a corporate wellness plan. Weight loss was minimal, with the RAND researchers finding that workers lost about 1 pound annually for three years.

Furthermore, there was no improvement in the rate of hospitalizations and emergency room visits.

Some short-term benefits

While there was a short-term gain in the rate of smokers quitting, it came with a qualification. Fewer than half of employees participate in wellness programs, which are mostly voluntary. Those who participate are often the most motivated, making it hard to tell whether their smoking cessation was due to the wellness program or the employees’ motivation.

Wellness programs also require tests more frequently. For instance, many require blood sugar and cholesterol screens every year in healthy adults, far in excess of recommended guidelines, which call for checking these levels once every three and five years, respectively. Such over-testing doesn’t necessarily make patients any healthier and contributes to the $210 billion our health system spends annually in unnecessary care.

Because I want my patients to save money on their insurance premiums, I dutifully fill out their wellness forms and order the requested screening tests that might not be needed. But it’s doubtful I’m saving these companies money or making my patients healthier by doing so.

Kevin Pho is an internal medicine physician and co-author of Establishing, Managing, and Protecting Your Online Reputation: A Social Media Guide for Physicians and Medical Practices. He is on the editorial board of contributors, USA Today, and is founder and editor, KevinMD.com, also on FacebookTwitterGoogle+, and LinkedIn.

 

 

 

October 26, 2013 Posted by | health care | , , , , , | Leave a comment

Why you should avoid the temptation of drug coupons

 

From the 10 December 2012 article by Kevin Pho at KevinMD.com

Why you should avoid the temptation of drug coupons

A version of this column was published on October 24th, 2012 in USA Today.

As the cost of prescription drugs soar, more patients are turning to online coupons or discount cards from drug companies or promotional offers in magazines. In the past year, it is estimated that 19 million Americans whom took prescription drugs used such incentives to save money. The healthcare industry has witnessed a five-fold increase since 2009, with 395 medications today offering a promotional savings program.

In most cases, drug coupons can expose patients to potentially higher long-term costs, increase health spending, and mainly exist to protect the profits of drug companies….

….“An individual patient who receives a coupon might not realize that, although that particular prescription may cost less that month, overall what it does is to raise costs for everyone, including themselves,” according to Susan Pisano, a spokeswoman for the industry trade group America’s Health Insurance Plans.

It is also important to consider that the terms of drug coupon programs are completely at the whim of drug manufacturers. Some limit how many times the coupons may be used. Others require patients to jump through hoops and regularly visit drug company websites in order to renew. Most patients are unaware of the potential privacy concerns, as they are usually required to divulge their personal information—sometimes including their home address and even part of their medical history—before receiving coupons or discount cards.

Worst of all, drug coupon programs can end abruptly. When this happens, patients whose chronic diseases are managed by expensive brand name drugs are left to financially fend for themselves. If they don’t proactively change their medication regimen to generic alternatives with their doctors, their annual drug costs can easily rise by several hundred dollars or more.  I’ve seen patients simply stop taking their drugs once their costs rise suddenly, which in the case of diabetes, hypertension or high cholesterol, can lead to severe, and more expensive medical complications….

……Patients should collaborate with their doctors and do the math. Most conditions can be treated just as effectively with less expensive generic medications. Even with drug coupons, co-pays for brand name drugs generally exceed those of generics.

For a very small minority of patients, drug coupons may make sense. It may make sense in the few diseases where only brand name drugs are effective or in cases of extreme financial hardship where even generic medications are unaffordable.

The majority of patients should avoid the temptation of exploring drug coupons.

 is an internal medicine physician and on the Board of Contributors at USA Today.  He is founder and editor of KevinMD.com, also on FacebookTwitterGoogle+, and LinkedIn.

 

 

 

December 15, 2012 Posted by | health care | , , , | 1 Comment

   

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