A RAND Report on “Workplace Wellness” Is Quietly Buried for Five Months—Why?

Did you know that in the U.S. “Workplace Wellness” has become a $6 billion industry?  That’s how much employers pay vendors who sell workplace wellness programs designed to encourage employees to lose weight, lower their cholesterol, or stop smoking..  

Today, firms lay out an average of $521 per employee per year on ‘wellness incentives’ such as gift cards for employees who shed pounds. That is more than double the $260 they spent in 2009 according to a recent survey by Fidelity Investments and the National Business Group on Health. 

 At first blush, this sounds like progress: Enlightened employers are doing their best to encourage employees to take care of themselves.  There is just one catch: we have no hard evidence that these programs either improve health or lower health care bills.

Even Bruce Elliott, manager of compensation and benefits at the Society for Human Resource Management, the largest professional organization that represents benefits managers, is concerned. As employers chase Wellness, “the one things that does worry me is the utter lack of metrics and really, the utter lack of thought” Elliott recently told Bloomberg News, pointing to the “herd mentality” that seems to have overtaken the idea of “workplace wellness.”  

      A Rand Report Appears Briefly Online—and Disappears                   

Two weeks ago, Reuters broke a story about a RAND report on Wellness programs that was supposed to come out last winter. The report was mandated by the Affordable Care Act, and RAND delivered the analysis to the U.S. Department of Labor and the Department of Health and Human Services last fall. 

 According to Reuters’ reporter Sharon Begley, “Two sources close to the report expected it to be released publicly this past winter.”  She added that “Reuters read the report when it was briefly posted online by RAND before being taken down because the federal agencies were not ready to release it, said a third source with knowledge of the analysis.”

RAND had collected information about wellness programs from about 600 businesses with at least 50 employees and analyzed medical claims collected by the Care Continuum Alliance, a trade association for the health and wellness industry.

Reuters revealed that the results were disappointing:  “The programs that try to get employees to become healthier and reduce medical costs have only a modest effect. Those findings run contrary to claims by the mostly small firms that sell workplace wellness to companies ranging from corporate titans to mom-and-pop operations.”
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The Health IT Scandal the NY Times Didn’t Cover

Below, a guest-post by Michael L. Millenson, president of Health Quality Advisors LLC.  An early, and vocal quality-of-care evangelical, Millenson is the author of the critically acclaimed book, Demanding Medical Excellence: Doctors and Accountability in the Information Age.

As health information technology honchos gather for the annual HIMSS trade show and schmoozefest, it’s a safe bet the industry “scandal” the New York Times placed on page one recently will breed more bored yawns than buzz. The real scandal in health IT involves the customers, not just the vendors, but that’s a topic for quiet conversations journalists can’t cover.

In case you missed it, the shocking news was that health IT companies that stood to profit from billions of dollars in federal subsidies to potential customers poured in ­– well, actually, poured in not that much money at all when you think about it ­– lobbying for passage of the HITECH Act in 2009. This, putatively, explains why electronic health records (EHRs) have thus far failed to dramatically improve quality and lower cost, with a secondary explanation from athenahealth CEO Jonathan Bush that everything would be much better if the HITECH rules had been written by Jonathan Bush of athenahealth.

Next up: corporate lobbying for passage of the 1862 Pacific Railroad Bill is blamed for Amtrak’s dismal on-time record in 2013.

The actual scandal is more complicated and scary.  It has to do with the adamant refusal by hospitals and doctors to adopt electronic records no matter what the evidence. Way back in 1971, for example, when Intel was a mere fledgling and Microsoft and Apple weren’t even gleams in their founders’ eyes, a study in a high-profile medical journal found that doctors missed up to 35 percent of the data in a paper chart. Thirty-seven years later, when Intel, Microsoft and Apple were all corporate giants, a study in the same journal of severely ill coronary syndrome patients found virtually the same problem: “essential” elements to quality care missing in the paper record.

That clinical evidence and the way in which the world outside medicine had been transformed by computers did almost nothing to change health care. Computerized medical records were available: before there was “Watson,” the IBM computer helping doctors make decisions, there was “Watson,” the IBM chairman, vainly trying to sell electronic records to doctors as early as 1965. But well into the 21st century, most providers only trusted computers to send out the bills.
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