To say last week was notable for workplace health programs would be an understatement. A new RAND Corporation study sponsored by the U.S. Department of Labor (DOL) and the U.S. Department of Health and Human Services (HHS) was released. This came on the same day of the announcement of the final workplace wellness rules allowing employers to require healthy efforts from employees to qualify for lower premiums by the Internal Revenue Service, DOL and HHS. Like all such transitions, this one comes both with new opportunity and with greater responsibility. The regulations are likely to spur innovation among employers, practitioners, and academics in the field; but they also place an appropriate burden of accountability and fairness on programs which claim to improve health.
With clear direction from the federal government and the enormity of the challenge we are facing with the major threats to the continued health of our nation, now is the time to move forward with effectively designed health promotion and disease prevention programs that motivate and support people to adopt healthy behaviors, leading to better health outcomes and lower health care costs over the long term. Accomplishing this task requires the collective action of public and private stakeholders.
For CEOs this presents an opportunity to re-examine and elevate the standards for workplace programs, choosing the ones based on science-based evidence of measurable impact. For those in the "wellness" industry, this lays down both a challenge and opportunity to improve the quality and sustainability of interventions -- especially those aimed at reducing obesity, tobacco use, physical inactivity and mental health.
The final set of rules is welcomed by the industry as it brings certainty to the regulatory framework surrounding workplace health promotion and disease prevention. The regulations will go a long way to helping well designed workplace health programs assume an important place in the fight against chronic diseases.
The new RAND study underpins the needs for urgency in implementing effective workplace programs. What we know from the RAND report, and our own research is 1) there is an urgent need to improve health as the impact of chronic conditions is not sustainable; 2) "wellness" programs as a whole, although showing signs of promise, are still not effective enough and consistently well evaluated; and (3) senior executive support and the right economic incentives are both key ingredients to successful programs.
What the report does not address is as important as what it highlights. Workplace wellness programs operate within communities, towns and cities. The role of government at the local, state and Federal levels is critical to the ability of workplaces to have sustained impacts on complex areas of behavior so deeply shaped by environmental factors. Greater synergy between government actions and those in the workplace could lead to better outcomes.
Further, the very field of workplace "wellness" includes a very wide variation in the content and quality of programs. Some target specific risks (i.e. tobacco or obesity); some address screening or disease management; and a large group include interventions aimed to improve general morale, non-specific feelings of wellbeing and more. The current practice of lumping them all together undervalues those with impacts on major causes of death, disease and cost. RAND cited several extremely well designed studies that each developed clear criteria for interventions used. In most workplaces however, the actual practice is likely to differ from ideal practice. Better norms for interventions based on the type of research RAND recommends is required to enhance effectiveness.
With the enormity of the challenge that lies ahead and the devastating implications to our health and U.S. economy if we fail, we can't afford NOT to succeed. Success will require all participants to seize this opportunity and use the new regulations and the direction provided by the RAND research to develop more effective programs and ultimately improved health. This is the coming of age for our industry and there is great promise for workplace health to grow into maturity.
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