Employer based wellness programs

The rest of the provisions of the rule, which simply clarify existing obligations, apply both before and after publication of the final rule. The effective date is the date on which the rule will be in the Code of Federal Regulations, the official publication for federal regulations. The applicability date is the date on which employers have to comply with the requirement to provide a notice and the provisions limiting incentives. This rule says that employers may offer limited inducements incentives for an employee's spouse to participate in a wellness program.

Background 1. What is a wellness program? ADA Protections 2. What is the ADA and how does it apply to wellness programs? Purpose of the Rule 3. Why did EEOC issue this final rule? Does this rule apply to wellness programs that are not part of an employer's group health plan? What is the ADA's "safe harbor" provision, and does it apply to wellness programs that include disability-related inquiries or medical examinations?

What standards apply to wellness programs that ask employees to provide medical information? What are some examples of wellness programs that meet the "reasonably designed" standard? When is an employee's participation in a wellness program considered "voluntary"? Specifically, an employer: may not require any employee to participate; may not deny any employee who does not participate in a wellness program access to health coverage or prohibit any employee from choosing a particular plan; and may not take any other adverse action or retaliate against, interfere with, coerce, intimidate, or threaten any employee who chooses not to participate in a wellness program or fails to achieve certain health outcomes.

Does an employer have to create a new notice to comply with this rule? Incentives Permitted Does this rule apply to all wellness programs that offer incentives based on participation or health outcomes? How much of an incentive may an employer offer to encourage employees to participate in a wellness program or to achieve certain health outcomes when a wellness program is offered as part of a particular health plan?

How does an employer calculate incentive limits when an employer has more than one group health plan but offers a wellness program that does not require employees to participate in a particular plan? May an employer offer an incentive to employees to participate in a wellness program if it does not offer health insurance? What is the second lowest cost Silver Plan, and why does the rule use this plan to calculate wellness program incentives where an employer does not offer health insurance?

Why does the rule set the incentive limit at 30 percent of the cost of self-only coverage? Are the incentive limits related to smoking cessation programs the same as for all other wellness programs? Confidentiality What confidentiality requirements apply to the medical information employees provide when they participate in wellness programs? Are there any other federal laws that protect the confidentiality of medical information obtained through a wellness program?

Coordination with Other Federal Agencies Applicability Date When do employer wellness programs have to comply with this rule? What is the difference between the rule's effective date and its applicability date? The analysis, the first peer-reviewed, large-scale, multisite randomized controlled trial of a workplace wellness program, shows that people who worked at sites offering the program exhibited notably higher rates of some healthy behaviors, but no significant differences in other behaviors compared to the control group.

Employees working at sites offering the program did not have better clinical measures of health such as body mass index, blood pressure or cholesterol after 18 months, nor did they exhibit lower absenteeism, better job performance or lower health care use or spending. Worksites offering a wellness program had an 8. The motivation for employer-based wellness programs is straightforward. In addition to private investment in workplace wellness program, the Affordable Care Act allocated public funding for wellness programs.

In the broader context of health system reform, wellness programs are part of a suite of ideas that encourage preventive medicine, coordinated care and wellness education as ways to keep people healthy and reduce medical costs. Past research has suggested workplace wellness programs might be a good investment.

In , Song, Baicker and David Cutler, the Otto Eckstein Professor of Applied Economics at Harvard, published a meta-analysis of prior research on wellness programs that found a roughly three to one return on investment for such interventions.

However, as the authors noted in that meta-analysis, much of the prior literature was limited by the lack of a robust control group, leaving open the possibility that estimates could be biased by confounding factors, and by limited sites, sample sizes and outcome measures. To help improve the evidence on wellness programs, Song and Baicker decided to implement a large-scale controlled experiment. To eliminate the unwanted effects of self-selection and other biases inherent in nonrandomized studies, Song and Baicker randomized wellness program offerings across different worksites and tracked outcomes among all workers.

The firms that choose to have a program may have employees who are already more health-conscious than those at firms without a program. This allowed the researchers to capture the effects that the program might have in changing workplace culture as well as individual behavior. Among eligible worksites across the Eastern United States, the wellness program was implemented at 20 randomly selected sites with a total of 4, employees—the test group. The remaining sites and a total of 28, employees represented the control, or comparison, group.

The wellness program comprised eight modules on topics such as nutrition, physical activity and stress reduction implemented by registered dietitians and administered by Wellness Workdays, a commercial operator of such services to corporate customers.

The month evaluation ran from January through June If phases 1 and 2 suggest that Wellness Coaching has a positive effect on outcomes, phase 3 will use a randomized trial to compare the effectiveness of 3 outreach methods letters, interactive voice—response telephone messages, and secure e-mail on increasing rates of Wellness Coaching participation among approximately 30, patients with impaired fasting glucose IFG.

Within KPNC, the Regional Perinatal Service Center offers supplemental care via telephone counseling for women with pregnancies at high risk for adverse outcomes such as preterm birth , including pregnancies complicated by GDM.

Referral to the centers has been associated with decreased risk of macrosomia excessive birth weight and increased postpartum screening for diabetes Beginning in , the center has used a step-wise approach to ensure that all patients have a glucose test standard oral glucose tolerance test [OGTT] and appropriate educational and referral follow-up if postpartum glucose levels are elevated diagnostic for IFG, impaired glucose tolerance, or diabetes.

These increases in screening and the shift to the more sensitive OGTT should lead to greater detection of prediabetes and earlier detection of type 2 diabetes. We will evaluate whether the incidence of diabetes is decreasing because of these earlier detection and prevention efforts and because of treatment efforts launched after detection. We will compare the cohort of women with GDM who gave birth during through with the cohort who gave birth during through for subsequent diabetes incidence.

For each cohort, follow-up begins at childbirth and continues until the diagnosis of diabetes, to the end of the study period 5 years follow-up for each person , or censoring because of leaving the health plan.

Health systems, employers, and health plan purchasers recognize the urgency of determining whether their population-oriented infrastructure can be adapted to address primary prevention of chronic conditions such as diabetes. Given the large numbers of people at increased risk for these conditions, efficient approaches are needed to identify and support patients and providers in effecting lifestyle changes.

Evaluating these approaches will be useful to policy makers dealing with questions of benefit designs and to public health officials seeking to understand the roles that health systems and employers can play in preventing chronic disease. Health care policy initiatives emphasizing the patient-centered medical home and accountable care organizations 24,25 are being promoted as ways to enhance the integration of US health care delivery.

Systems with high levels of integration such as KPNC offer real-world opportunities for natural experiments to assess the effect of health-plan and employer-based prevention and wellness programs on population health within this context. U58 DP Drs Schmittdiel, Ferrara, and A. Corresponding Author: Julie A. Telephone: E-mail: Julie. Schmittdiel kp.