While the National Business Group on Health has forecasted a 5% increase in the cost of healthcare benefits, others are expecting employers to dedicate more resources to health and wellness. More emphasis will also be placed on the use of digital tools to identify lower cost providers and boost employee engagement. Experts say the trend is in response to more and more employees looking to their employers to help them better manage their personal health.
A study based on several years of data, published in the Journal of Human Nutrition and Dietetics,showed that increasing water consumption by one to three cups a day decreased total calorie intake by between 68 and 205 calories. Intake of sugar and cholesterol were also reduced as a result of drinking more water.
Some physicians believe that drinking more water before sitting down for breakfast, lunch or dinner will curb the appetite. With other benefits such as better brain function, improved digestion and the ability to maintain energy levels, the old adage of drinking eight to ten glasses of water a day just may be more appropriate then ever.
Healthcare professionals that aren’t utilizing text communications are failing to meet their patients where they are. A 2018 survey found 11% of patients would rather communicate via text message, a number that is expected to grow as the Millennial population begins to outnumber Boomers. Text alerts and communications can be used for a variety of services, including preventative care such as periodic appointments and flu shots, post-treatment care information, remote health monitoring and chronic disease management.
According to preliminary government data, U.S. deaths involving fentanyl and other synthetic opioids fueled a 21% jump in annual drug overdose deaths during 2017. The increase from 9,945 opioid deaths in 2016 to 20,145 during 2017 reflected the sharpest one-year increase since the U.S. began experiencing a widespread opioid addiction. CDC data shows that deaths involving heroin and prescription painkillers such as oxycodone, are also increasing.
According to a Medscape survey of more than 19,000 physicians, the average patient spends between 13 and 16 minutes with their physician during an office visit. Given the short amount of time, it is probably best to focus on two or three things you want your doctor to address. It may also help to prepare a list of questions ahead of time. Here are a few you may want to consider.
- Which health websites do you trust?
- What is this medication I’m taking and why am I taking it?
- If you’re a smoker, how can I get help to stop?
- Are my screenings and vaccinations up to date?
- What is a healthy weight for me and how can I get to that?
- What do you do to stay in shape?
- If you’re taking a prescribed opioid painkiller, ask if it’s really necessary and what else you might take?
- What are some things I can do before my next appointment to make me healthier?
- If a test is ordered, ask what it is for and what are you trying to learn from it.
- When a specific treatment is recommended, don’t hesitate to ask about other alternatives
The majority of employers now educate employees about health and wellness through apps and portals – a practice expected to increase significantly in the year ahead. As a result, more and more health-related smartphone apps and wearables are coming on the scene.
The movement should come as no surprise, since poor diet is a major problem in the U.S. and technology is doing more to help employees make behavioral changes. It makes sense that employers become part of the solution. As health plan sponsors, they want to do everything possible to help employees improve their overall health and keep healthcare costs in check.
One app designed to improve employee nutrition is called Zipongo, created in 2011 by a physician named Jason Langheier. The app presents the healthiest options via a mobile device, whether the user is grocery shopping or eating out. It offers healthy recipes and highly personalized solutions based on the user’s biometric data, while considering existing food allergies and personal preferences. Zipongo’s solutions are currently in use at more than 150 companies, including Google and IBM.
Now is the time for employers to intervene for better health among employees. With a wide-ranging number of health-related apps to choose from, employers should investigate their options thoroughly and be sure that the ones they select work as advertised and are a good match for their organization and their employees.
Employers that offer certain programs designed to improve employee health must be mindful that such programs are subject to a number of different laws–and as recent guidance makes clear, compliance with one law does not necessarily mean that a wellness program will comply with other federal (or state) requirements.
Wellness Programs and HIPAA Nondiscrimination Rules
The federal Health Insurance Portability and Accountability Act (HIPAA) imposes several requirements on health-contingent wellness programs, i.e., those that require an individual to satisfy a standard related to a health factor to obtain a reward. Participatory wellness programs, which comprise a majority of wellness programs, are generally available without regard to an individual’s health status.
Among other things, health-contingent wellness programs must be reasonably designed to promote health or prevent disease and must limit the maximum permissible reward to 30% of the cost of coverage (or 50% for wellness programs designed to prevent or reduce tobacco use). A new set of FAQs explains what it means for a health-contingent wellness program to be “reasonably designed.” The FAQs also caution that compliance with HIPAA does not determine compliance with other federal or state laws.
The ADA and Wellness Programs
The federal Americans with Disabilities Act (ADA) restricts covered employers from obtaining medical information from employees, but allows medical examinations of employees and inquiries about their health if they are part of a “voluntary employee health program.”
A new proposed rule provides that a wellness program is considered an employee health program within the meaning of the ADA when it is reasonably designed to promote health or prevent disease (similar to the standard currently applicable to health-contingent wellness programs). In addition, the proposed rule:
- Details several requirements that must be met in order for participation to be considered voluntary, and requires employers to provide employees with a notice clearly explaining what medical information will be obtained, who will receive it, how it will be used, and how it will be kept confidential.
- Allows employers to offer limited incentives for employees to participate in wellness programs or to achieve certain health outcomes. The total allowable incentive available under all wellness programs (i.e., both health-contingent and participatory programs) may not exceed 30% of the total cost of employee-only coverage.
- Addresses the confidentiality requirements that apply to the medical information employees provide when they participate in wellness programs.
- Requires employers to provide reasonable accommodations that enable employees with disabilities to participate and to earn whatever incentives the employer offers.
Due to the changing law and the complexity of the requirements that apply to employment-based wellness programs, employers are advised to check with a knowledgeable employment law attorney to ensure that any program complies with all applicable federal and state laws.
Our section on Wellness Programs provides additional details.