Worksite Wellness Programs
Achieving Significant Health and Fiscal return on Investments
In a speech to the American Medical Association (AMA) in 2009 President Obama said: “Building a health care system that promotes prevention rather than just managing diseases will require all of us to do our part… It will take employers following the example of (work)places … that are rewarding workers for taking better care of their health while reducing health care costs in the process.”
The Patient Protection and Affordable Care Act (PPACA) supports health and wellness by mandating preventive health care and providing provisions to empower employers to reward their employees for living a healthy lifestyle.
Beginning in 2010, anyone providing a group health plan, or any insurance issuer who offers group health coverage, must provide coverage for services recommended by the United States Preventive Services Task Force and may not impose any cost sharing requirements (copayment, coinsurance, or deductible). The exception to this rule includes those who have “grandfathered” their plan from the prior year.
Medicare has also been mandated to cover all services recommended by the United States Preventive Task Force, with no cost sharing for beneficiaries. In addition to their “Welcome to Medicare” exam, Medicare will also cover wellness visits based on personalized prevention plan services (PPPS). The visit and prevention plan will be free.
The health care law validates the role that incentives play in workplace wellness programs. As the president stated in his speech to AMA, he encourages workplace practices that reward workers for taking better care of their health. Starting January 1, 2014, group health plans will be able to increase their wellness discounts by allowing reductions of up to 30 percent of the cost of premiums to those who participate in wellness programs. This incentive may expand to 50 percent at the discretion of the Secretary of Health and Human Services.
To assist employers in effectively implementing evidence- based workplace health promotion programming, the director of the Centers for Disease Control and Prevention (CDC) must provide employers with technical assistance, consultation, tools and other resources for evaluating employer based wellness programs and to train employers on how to evaluate their programs.