ERIC News Release
For Immediate Release: February 24, 2011
Washington, D.C. -- Gretchen Young, Senior Vice President for Health Policy at The ERISA Industry Committee (ERIC), spoke today before a meeting by the Department of Health and Human Services on Incentive-Based Worksite Wellness Programs, where she urged regulators to support policies that encourage the creation of workplace wellness programs.
Young participated on a panel entitled Standards for "Reasonably Designed" Wellness Programs to explore features of wellness programs that provide rewards or penalties for health status. Karen Pollitz of the Center for Consumer Information and Insurance Oversight of the Centers for Medicare & Medicaid Services moderated the panel.
"While we are encouraged by [the Affordable Care Act's] public recognition of the value of wellness programs, including supportive remarks by the president as well as members of his Administration, we continue to be concerned by the treatment of wellness programs in the regulatory arena over the last couple of years and worry about the focus of regulators now as they create new rules," said Young.
She explained that large employers view wellness programs as an effective way to partner with their employees to encourage healthier lifestyles, and that they are not sponsoring wellness programs to penalize or cull employees from their health plans.
As to the government's role in what gives a wellness program a "reasonable chance" of improving health or preventing disease in participating individuals, Young pointed to the Hippocratic Oath, saying "abstain from doing harm" in urging regulators to provide employers the latitude they need to establish wellness and prevention programs tailored to the needs of that employer's workforce.
As an example of a regulatory obstacle, Young pointed to the inability of wellness programs to offer an incentive to employees to provide family medical history (FMH) as part of a health risk assessment (HRA).
"Family medical history is a critical piece of information; the absence of this information seriously undermines the effectiveness of health risk assessments, depriving workers and their families of a potentially valuable tool for improving their health," said Young. She added that many companies have eliminated the FMH section from the HRA rather than sacrifice the financial incentive to encourage employees to participate.
She further explained that, even if plans did not give their participants a financial incentive to complete an HRA, they would not be able to use any FMH obtained from the HRA to guide these individuals into disease management programs. "Experience has shown that without the encouragement of a health professional, many participants who would benefit from participation in a disease management program will never enroll," said Young.
She also expressed concern that the Equal Employment Opportunity Commission (EEOC) may find a wellness program to violate the Americans with Disabilities Act (ADA) if the program provides a financial incentive to participate, even if the program fully complies with the limit on incentives and other Health Insurance Portability and Accountability Act (HIPAA) requirements.
"We urge you to clear away any regulatory obstacles that would prevent a program from incentivizing participants to provide FMH on an HRA and from using FMH as one basis for identifying participants eligible for a disease management or similar voluntary program," she said.
Young concluded by contending that, "Wellness programs are one of the few remaining avenues to help rein in spiraling healthcare costs, and it would be a shame if this avenue were narrowed to the point where it no longer would constitute an efficient use of employer resources."
A link to Gretchen Young's remarks appears below.
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The ERISA Industry Committee (ERIC) is a non-profit association committed to representing the advancement of the employee retirement, health, and compensation plans of America's largest employers. ERIC's members provide benchmark retirement, health care coverage, compensation, and other economic security benefits directly to tens of millions of active and retired workers and their families. ERIC has a strong interest in proposals affecting its members' ability to deliver those benefits, their cost and their effectiveness, as well as the role of those benefits in the American economy.