Sunday, August 25, 2013

The Danger of Wellness Programs: Don't Become the Next Penn State

This is Tom Emerick and Al Lewis writing for the Harvard Business Review:

Penn State University's wellness program has become every human resources director's worst nightmare: national news. Partly this is because two of the school's professors — Matthew Woessner and Brian Curran — did a much better job organizing their colleagues in opposition to the wellness program than, for example, CVS employees did when they were subject to a similarly intrusive program.

But also partly this was because Woessner and Curran struck a chord with millions of employees everywhere who have started posting similar stories of invasion of privacy, misinterpreted lab values, unnecessary test expenses, and even loss of low-cost insurance. As these disempowered employees see it, wellness has become another tool to bludgeon them into toeing the corporate line.

Wellness is supposed to "empower" employees but instead did just the opposite at Penn State. Ironically, the only thing that has empowered Penn State employees has been fighting back against this misdirected wellness tyranny. Instead of creating what one of Penn State's health care suppliers called a"culture of wellness," Penn State has created a culture of resentment.

This whole slow-motion debacle would have been completely avoidable at many points in the last week or two... if only Penn State's administration had had access to a search engine and a calculator.

The search engine would have told it that even the major academic proponentsof conventional wellness programs don't think they save money, that vendors make up savings numbers, that the screens they insisted upon can't even theoretically save money and a whole body of research opposes them, and that all the extra preventive doctor visits they required were useless. (The search engine also would have told the school's administrators that this scheme washighly unpopular among their employees.)

The calculator would have told them that their 43,000 covered lives probably incurred a total of only about 100 wellness-sensitive medical inpatient events, like heart attacks, of which a few might have taken place in people who were not previously diagnosed and were therefore at least theoretically avoidable, saving the tiniest fraction of their healthcare spending. But we'll never know because they embarked on a prevention jihad against their employees without knowing the value of what they were trying to prevent.

Ironically the worst thing that could have happened to Penn State financially would have been if all the employees did exactly what Penn State wanted them do to — go to the doctor and get more preventive medical care, leading to more diagnoses, testing, and procedures.

How to Avoid Penn State's Mistakes

Here are two clip-and-save questions that, if answered and addressed correctly, will keep your wellness program off the front page:

    1. If you're a general, would you rather have troops with high morale or low cholesterol?
    2. Should wellness be something you do TO your employees or FOR your employees?

    If not already self-evident, the answer to the second question becomes obvious in the context of the answer to the first. As an HR department head, don't be distracted by your benefits consultants or wellness vendors, who advocate more medical activity, yielding them more profits by making your department the center of attention. Your job is to enhance performance, not to interfere with it. Sure, sometimes you should interfere — when there is a major issue or major money on the line. This is exactly the opposite situation: There is no upside in playing doctor with your employees.

    With these two questions in mind, catalog everything you are doing in the name of wellness. Are these initiatives being done "to" or "for" your employees? Your initiatives should be offers, not threats. Subsidizing healthy cafeteria choices, matching personal fitness expenditures, and sponsoring company sports teams are offers. Making people complete intrusive forms and line up to get blood drawn to be diagnosed by non-physicians are threats.

    This wellness mania now affecting most companies suggests that HR departments need more C-suite supervision. The C-suite would never undertake any initiative without an internet search, a calculator, or concern about the impact on employee morale. It's time that HR departments operated the same way.