Prevention is considered a key to effecting health care reform. Chronic diseases – such as heart disease, cancer, stroke, and diabetes – are responsible for 7 of 10 deaths among Americans each year and account for 75% of the nation’s health spending. Often due to economic, social, and physical factors, too many Americans engage in behaviors – such as tobacco use, poor diet, physical inactivity, and alcohol abuse—that lead to poor health. The Patient Protection and Affordable Care Act (PPACA) created the Prevention and Public Health Fund to lead the initiative to focus on prevention and early intervention.
A starting point is the workplace. Section 10408 of the PPACA allows HHS to provide grants to small businesses – those with fewer than 100 employees — to create comprehensive workplace health programs (WHP) based on evidence-based research and best practices. The provision authorizes the appropriation of $200 million for fiscal years 2011 through 2015.
In June, it was announced that $10 million is available to certain organizations through the Department of Health and Human Services to establish and evaluate WHPs that address physical activity, nutrition, and tobacco use in the workplace.
Health promotion in the workplace is defined as preventing, minimizing and eliminating health hazards, and maintaining and promoting work ability. Examples of these types of health programs include establishing tobacco-free worksites, promoting flextime to allow employees to be more physically active, and offering more healthy food choices in worksite cafeterias and vending machines.
Employers, of course, worry about how such programs will increase their costs. Some worry that those costs will get passed onto employees in the form of increased deductibles and out-of-pocket expenses. But the real goal of the prevention program is not to figure out who gets the bill: it is to create a better approach to managing healthcare that can actually improve individual health, thus avoiding the bill altogether.
Investing in wellness programs has been likened to the annual expenses any organization incurs maintaining equipment each year to make sure it operates at peak efficiency. Understanding that a breakdown of equipment directly affects productivity means it makes good sense to pay for preventative maintenance and avoid expensive breakdowns. A similar philosophy can apply to how companies take care of their employees.
By providing health screenings, risk assessments, and other wellness programs, employees are incentivized to live healthier lifestyles, which will reduce their need to access medical services. This not only lowers employer healthcare costs, it can improve productivity and increase morale.
A 2010 Harvard study concluded that employer-adopted wellness programs see substantial ROI, even with in the first few years of adoption. Medical costs fall about $3.27 for every dollar spent, and absenteeism costs fall by about $2.73 for every dollar spent. Another research article published in May 2011 surveyed literature to determine if workplace health promotion programs might prove effective at improving presenteeism in workers. “Presenteeism,” defined as being present at work, but limited in some aspect of job performance by a health problem, is an expensive and common problem for employers. Potential risk factors contributing to presenteeism include being overweight, a poor diet, lack of exercise, high stress, and poor relations with co-workers and management. The study indicated a positive effect of WHPs. Successful programs offered organizational leadership, health risk screening, individually tailored programs, and a supportive workplace culture.
Health care reform seeks to reduce health care-related costs, but prevention programs may offer greater gains by improving on-the-job productivity. The trick will be in finding WHPs that really work. Employers don’t need lip service or check-the-block programs—they need guidance in implementing programs that are effective, proven, and will deliver results. The HHS initiative to implement and evaluate effective WHPs will help employers to select WHPs that work.
