Wellness bill debate highlights privacy vs. results
While most eyes were glued to the American Health Care Act debate and ultimate withdrawal, another healthcare bill that seeks to resolve a long-standing public policy conundrum for workplace wellness programs is expected to gain its share of attention from benefits professionals.
Allison R. Klausner, a principal and government relations leader for Conduent’s HR Services Knowledge Resource Center, recently testified at a congressional hearing in support of the Preserving Employee Wellness Programs Act (PEWPA). She chairs the American Benefits Council’s board and appeared on behalf of the organization.
The Council’s public policy strategic plan, “A 2020 Vision: Flexibility and the Future of Employee Benefits,” urges lawmakers to “proceed in a consistent, collaborative manner that support participatory and outcomes-based wellness initiatives.”
PEWPA was recently introduced by Rep. Virginia Foxx (R-N.C.) as H.R. 1313 and in the Senate as far back as 2015 by Sen. Lamar Alexander (R-Tenn.) as S.620. The bill stipulates that wellness programs complying with the Health Insurance Portability and Accountability Act and the Affordable Care Act would not violate the Americans With Disabilities Act or Genetic Information Nondiscrimination Act merely by offering a reward. Critics argue that it invades the right to privacy of wellness plan participants.
Klausner told lawmakers it’s important to have a consistent federal policy with regard to workplace wellness programs that are in place at most large U.S. companies. If the bill passes, she says employee benefit brokers or advisers “would have an opportunity to work with their clients to find where their culture and risk tolerance can now be matched with the flexibility and the opportunity for a wellness program.”
A better approach, however, would be to include employee health literacy in wellness programs, according to Al Lewis, a seasoned health and wellness expert and author of a book on outcomes measurement who runs Quizzify.
“While there are many arguments — privacy, expense, ineffectiveness — against genetic testing in wellness programs, there is no argument in favor of ignorance,” he noted in a statement opposing PEWPA. “Wiser employees make healthier choices.”
Lewis is concerned that the bill imposes “an Orwellian intrusion into employees’ private lives,” dismissing genetic testing as “completely ineffective as part of wellness programs at either improving health or saving money.”
As is usually the case with hastily written legislation that may appear well-intentioned, the devil is lurking in the details, cautions Dinesh Sheth, founder and CEO of Green Circle Health, which offers a health data tracking platform. His chief concern is eroding patient privacy protections and using data in a discriminatory way that could lead to employers not hiring employees with a genetic predisposition for certain health conditions.
“There is a serious potential for abuse of the rules,” he says.
But Klausner says PEWPA “would result in less absenteeism and allow people to become more productive at work,” she says, as well as “maximize behavioral economics in terms of designing incentives, rewards, or penalties and surcharges.”
She also sees the potential to transform more traditional workplace wellness programs into more robust and holistic efforts that also manage concerns about behavioral health and financial wellbeing. The thinking is that it would pay higher dividends in terms of helping employees reduce stress, save for retirement, become more productive and stay in the workforce.
Regardless of whether or not the PEWPA passes, there are helpful resources that workplace wellness sponsors can incorporate into their programs with the help of brokers or advisers. Jason Langheier, M.D, founder and CEO of the digital nutrition company Zipongo, for example, cites a 2012 scientific statement from the American Heart Association. “It does a nice job of listing what incentives work and those that have not,” he says.
The tendency to “focus on what sells through brokerage channels” more than likely will be supplanted by more value-based solutions, Langheier predicts. That means wellness platforms will need to deliver “sustained engagement and retention specifics that actually deliver a change in behavior” or employers will switch vendors, he adds.
Producers can assume a leadership role in helping move the needle on workplace wellness. “A well-informed broker, consultant or adviser definitely can help employers structure these programs” and deliver any missing links, according to Sheth. “With the latest tools and technology in the health space, such a broker can be tremendously valuable to keep the employer informed and help them keep moving forward.”