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A contrarian’s take on “wellness programs”: Excess testing, diagnoses & costs

Corporate wellness programs get a lot of buzz for their potential to create healthier, more productive and less costly employees. But in a post over at The Health Care Blog, Al Lewis is taking jabs at some of those programs. Lewis, the president of Disease Management Purchasing Consortium International who and author of a book […]

Corporate wellness programs get a lot of buzz for their potential to create healthier, more productive and less costly employees. But in a post over at The Health Care Blog, Al Lewis is taking jabs at some of those programs.

Lewis, the president of Disease Management Purchasing Consortium International who and author of a book called Why Nobody Believes the Numbers, suggests that wellness programs are actually leading to more unnecessary preventive screenings, more diagnoses, more medication and in the end more costs.

[…] The publicly reported outcomes data of these programs are made up — often to a laughable degree, starting with the fictional Safeway wellness success story that inspired the original Affordable Care Act wellness emphasis.  None of this should be a surprise:  in addition to HRAs and blood draws, wellness programs urge employees to go to the doctor, even though most preventive care costs more than it saves.  So workplace medicalization saves no money — indeed, it probably increases direct costs with these extra doctor visits.

In the post, Lewis equates “wellness programs” with health risk assessments, a key component of an annual wellness visit for a Medicare beneficiary as defined by the Patient Protection and Affordable Care Act. As evidence, he tells of recommendations from health risk assessments he took through a few different vendors. One HRA platform recommended tests that he thought were inapplicable and missed potential problems, like the fact that he reported taking 7 or more prescription drugs despite listing only one diagnosis – insomnia. That should have flagged a potential addiction issue, he proposed.

The contraindicated screens and tests recommended by these HRA vendors, consultants and employers will, statistically speaking, eventually cause early deaths, due to all the radiation and high-risk procedures associated with overdiagnosis and overzealous cancer follow-up, not to mention the high likelihood of being sucked into the ‘treatment trap’ as a result of overscreening for lipids.

One thing about this post that jumps out to me is the antiquated definition of “wellness programs,” used synonymously with HRAs. It seems that today, corporate wellness has taken on such a bigger meaning than just preventive screenings

Lewis’ proposed alternative to “wellness programs” is that companies should instead work on creating a culture of wellness, and “take steps to encourage healthy lifestyles.” Interesting, that’s what so many of the newer companies that I would label “corporate wellness” companies are doing — using incentives, social elements and educational tools to prevent the need for those screenings to begin with.

I’m left wondering, how is the corporate world interpreting the call for more preventive care and wellness?