|Penn State's mascot goes on the|
prowl for a good wellness program
What can wellness architects and service providers learn from this imbroglio?
Here's the facts:
Penn State provides health benefits to over 45,000 employees and dependents. It's self-insured (administered by Highmark), which means the University, not some remote insurer, is on the hook for any unanticipated health care costs.
Those costs have led to a whopping $217 million health care budget for 2013-2014 and a long term $3 billion pension liability. In response to the threat of budgetary "crowd out," the University made some important changes to the insurance benefit that included a high deductible option and value-based benefits.
It also hatched a health promotion initiative. It checked in with the Faculty Benefits Committee in the early spring of 2013 and then used the summer to unveil a "comprehensive wellness-focused strategy." This included the "Take Care of Your Health" program that packaged biometric screening (some labs, weight blood pressure), an on-line WebMD wellness survey and preventive health exam. Failure to complete that screening, survey and exam will result in a $100 per month payroll deduction in 2014.
The plan didn't sit well with everyone. Faculty members Matthew Woessner fretted about privacy and penned a "call for action and civil resistance," Barry Ickes doubted the economics and Larry Backer invoked eugenics, human dignity and sinister profit-motives. Brian Curran used the Change.Org website to post an anti-wellness petition for "employees, alumni and friends" that has reached 2000 signatories. Naturally, wellness gadflies Vik Khanna and Al Lewis were unable to resist and used The Health Care Blog to pile on any wellness program with the temerity to not use their consulting services.
The Disease Management Care Blog speculates on lessons learned......
Lesson: Health promotion programs should tread lightly in times of organization turmoil. This is no time for "big bang" multidimensional interventions, especially if they involve a $100 per month penalty.
Lesson: If you're fighting high health care cost trends, don't let the positive return on investment (ROI) from health promotion take the lead. It won't work that well, and employees will think this about reducing your costs, not about increasing their well-being.
Lesson: If there are two employee groups with a special talent for indignant paranoiac outrage over any employer-sponsored health initiative, it's medical providers and university faculty. There are plenty of reasons, but the DMCB suspects both are victims of the decades-long twin cultures of 1) autonomy and 2) abundance in health care and higher education. Stopping by a Faculty Benefits Committee is not enough to secure buy-in.
Lesson: Search for and engage employee subgroups that can be your allies in launching a health promotion initiative. Their advocacy may really help.
Lesson: There's nothing wrong with preferring to "build" over "buy," but only if both options are carefully considered at the outset. External wellness providers are often subject to financial performance and recruitment standards. If the petition gains traction, the latter would sure come in handy here.
Lesson: The science is still evolving, but here is one answer to that criticism: it's not wellness per se but our society's love of technology. Wellness programs can use initiatives like Choosing Wisely to develop even better programs.
Lesson: Now would not be a good time for Penn State's administration to point that out.