Originally posted January 02, 2014 by Alan Pollard on http://ebn.benefitnews.com
With all the implications that the Affordable Care Act has on employer’s health insurance obligations, it’s easy to overlook its effects on workplace wellness programs. Yet these programs are very much affected by Obamacare.
Now that privacy and equality guidelines that previously only applied to insurers and providers are being applied to all sponsors of health promotion and prevention programs, the feedback we’re hearing is that many employers are either unaware or don’t understand what’s expected of them vis a vis their wellness programs in this new legal environment.
Some organizations that led the charge in workplace wellness in the last decade have mature programs targeting specific conditions such as obesity or smoking. These types of programs in particular face new hurdles presented by the final ruling, yet many companies don’t understand exactly what is needed to become compliant.
Further, some companies that have taken steps to modify their programs to be compliant are finding out firsthand just how complex re-engineering can often be — and how vocal some highly informed employees can be against changes.
For example, the protection of privacy of personal health information afforded by the Health Insurance Portability and Accountability Act has been legislated for a long time, but now puts additional restrictions on workplace wellness programs. How does a company that has long collected this type of information as proof of qualification for a reward or a premium subsidy handle this new obligation?
Other scenarios: How does an employer set up simple employee fitness events like a 5k walk or even a step test to obey the requirements for a reasonable alternative standard for those who cannot participate due to a physical disability or a physician’s recommendation? Or, how do you reward your employees for losing weight in a way that doesn’t alienate them by pressuring them to share sensitive information?
Whatever the structure, you must be able to prove your wellness program is, as the new law phrases it: “reasonably designed to promote health or prevent disease; has a reasonable chance of improving the health of, or preventing disease in, participating individuals; is not overly burdensome; is not a subterfuge for discriminating based on a health factor; and is not highly suspect in the method chosen to promote health or prevent disease.”
After spending more than two decades in the wellness industry, I’m very encouraged by the ACA’s strong recognition of the important role well-designed wellness programs play in promoting health, preventing disease and controlling the rising cost of care. However, the new regulations also include many important design requirements and consumer protections that raise the bar for wellness providers to deliver more professional and evidence-based programs, and for employers to be more aware of privacy issues, fairness and quality outcomes.
For CEOs this presents an opportunity to re-examine and elevate the standards for workplace programs, choosing the ones based on science-based evidence of measurable impact. For those in the wellness industry, this lays down both a challenge and opportunity to improve the quality and sustainability of interventions — especially those aimed at reducing obesity, tobacco use, physical inactivity and mental health.
We urge all responsible parties to thoroughly examine their wellness offerings for the ability to deliver all that the new law demands — and promises. And for employers, it’s important to make sure your business partners can ensure the ACA compliance of their programs.