Promoting Wellness With Weight-Management Benefits
Just a few weeks into 2016, most of your employees who resolved to go on a diet and lose weight this year already have fallen off the wagon and onto the food truck. And those who haven’t likely will have put on hold their plans to drop a dress or belt size until after an upcoming Super Bowl party.
The gap between intention and execution isn’t solely symptomatic of workers. It’s also symptomatic of employers that incent employees to lose weight but don’t give them the tools to make it happen.
That’s my takeaway from the results of a new survey on efforts by employers to improve the health and productivity of their workforces by focusing on weight-related wellness activities.
Obesity is one of the country’s most prevalent and worsening public health issues. According to new data from the National Center for Health Statistics, 37.7 percent of adults age 20 or older were obese in 2014, up from 30.5 percent in 2000 (1.usa.gov/1MrNcbo). The Centers for Disease Control and Prevention defines obesity as having a body mass index of 30 or greater.
The adult obesity rate in Minnesota is 26 percent and ranges from 22 percent to 34 percent by county, according to the latest County Health Rankings & Roadmaps report from the University of Wisconsin Population Health Institute and the Robert Wood Johnson Foundation (see chart).
Obesity is linked to a number of chronic medical conditions and illnesses, including heart disease, hypertension, strokes, diabetes and cancer. It makes sense, then, that employers would want to do whatever they could to reduce the obesity rate in their rank and file. Fewer obese workers mean fewer workers with health problems, which mean less absenteeism and lower health care costs.
What doesn’t make sense is what the aforementioned survey found (bit.ly/1NeRgw3). The survey of nearly 7,000 employed adults conducted by Pittsburgh-based ConscienHealth and published in a special edition of the American Journal of Managed Care revealed that:
- 16 percent of employers required employees to participate in a wellness program as a condition of receiving their full complement of health benefits.
- 17 percent of the wellness programs featured incentives or penalties based on weight or BMI.
- 70 percent of the employers’ health plans didn’t cover FDA-approved obesity drugs.
- 68 percent of the employers’ health plans didn’t cover bariatric surgery.
- 47 percent of the employers’ health plans didn’t cover medical weight management services.
- 40 percent of the employers’ health plans didn’t cover visits to a registered dietician.
Essentially, many employers are pressuring workers to lose weight in hopes of saving money on health care, but they aren’t ponying up the money for benefits that would help them lose the weight. My guess is employers consider weight and weight loss a personal choice that employees make by virtue of controllable diet and exercise decisions. Why pay for something workers should do on their own?
I get the point. But if reducing obesity is the secret to a healthier workforce, then I think employers would be wise to offer health benefits to those serious about getting their weight under control. It’s a smart investment. Or, as the researchers concluded: “Wellness programs may have little impact on costs driven by severe obesity in the absence of access to effective treatment for this chronic disease.”
As a native of Illinois who went to school in Indiana, vacations in Wisconsin and works for a publishing company in Minnesota, I know the pecking order. Minnesota looks down on Wisconsin, Wisconsin looks down on Illinois, and Illinois looks down on Indiana. (I’ve never been to Iowa.) That lesson from the residents of each state added a touch of irony to the results of a new study that ranked the efficiency of the health care systems in each state (bit.ly/1IQn9t5). The study defined efficiency as the ratio of inputs (hospital beds and health care workers) to outputs (quality, access and outcomes). States whose health care systems produced more outputs for fewer inputs were deemed more efficient than others. The efficiency of a state’s health care system is important to employers, the study said, because it can be “a major driver in terms of attracting or repelling entrepreneurs and corporations considering new operations or expansion within a particular state.” In rank order, here are the five states with the most efficient health care systems:
Hawaii | Iowa | Wisconsin | Minnesota | Massachusetts
Indiana came in at 15th, and Illinois ranked 26th. The study was done by an economics professor at the University of Wisconsin-Whitewater and supported by the Wisconsin Hospital Association. (I’ve never been to Whitewater.)
In the June 2015 column, we talked about why it was important for the business community to start paying attention to proposed hospital mergers and acquisitions of medical practices in their market. Specifically, we recommended that employers ask hospital administrators whether their proposed merger with another hospital or purchase of a medical practice will lead to higher prices for the services they provide. It’s an uncomfortable question for business leaders to ask, and it’s uncomfortable for health care executives to answer. But, as the people who pay the bills, asking the question is crucial.
A new study in the Journal of the American Medical Association explains why (bit.ly/1GfzXgR). About 7.4 million commercially insured patients in 240 urban markets spent an average of $75 more per person each year between 2008 and 2012 on outpatient care provided by physicians for no reason other than higher prices for the same care, the study found. The researchers linked higher prices to markets with higher concentrations of hospital-owned physician practices. If you don’t want to pay more for care provided to your workers by doctors, start asking some questions before you start getting bigger bills.
David Burda (twitter.com/@davidrburda, firstname.lastname@example.org) is editorial director, health care strategies, for MSP-C, where he serves as the chief health care content strategist and health care subject matter expert.