“Workplace wellness” is a big and burgeoning movement. But is it a bubble?
If you work in a company of any size, chances are you know the “wellness” drill. Your employer is getting killed by health care costs, and tries to bring them down by motivating workers to get healthier. The wellness program offers you incentives — as much as several hundred dollars a year — to fill out a questionnaire on your health risks, get medical tests, lose weight, quit smoking, lower your cholesterol.
What could be bad, right? You win, your company wins. The idea is so appealing that it’s enshrined in the national health overhaul best known as Obamacare, and in the latest groundbreaking health reform moves in Massachusetts. And it has fast become the norm: Most companies that offer health insurance benefits now also offer some sort of wellness plan as well.
So when Al Lewis takes on the $6-billion wellness industry in his recent book, “Why Nobody Believes The Numbers,” he’d better be packing some good ammo. And he is: Fifth-grade math. Well, sometimes fourth-grade.
Lewis — an expert in “care management” across populations and measuring efforts to improve it — argues that yes, wellness is a bubble, because much of the movement carries a fatal flaw: Its potential economic benefits have been outrageously oversold.
Many wellness program vendors promise companies that they can quickly and cheaply cut their workers’ health costs — and back their claims with numbers that could not survive the most elementary scrutiny, he says. (Lewis titles Chapter 3, “Case Studies That Flunk Every Plausibility Test Known To Mankind.”)
One example of many, his helpful analogy from the housing world: “If you insulate your house, you should save money overall, but you won’t save money on insulation.”
The health care equivalent is that you need to spend money to save money overall. If you get your workers to go to the doctor more and take more of the drugs they need, you may save money by avoiding hospital stays and ER visits. But — contrary to what some wellness experts claim — you’re not going to see your spending on drugs and doctors go down, too, Lewis says. That would be like saving money on insulation.
“What are these people thinking?” he asks. (On his Website here, he bestows “Intelligent Design Awards” to some of the more egregious overpromisers for “setting back the evolution of the wellness field.”) In essence, he argues, virtually all the data on the wellness Return on Investment — “The entire economic justification for wellness, is made up.” Continue reading