Sign Up for Email Alerts Visit us on Twitter Visit us on Facebook Visit us on YouTube Subscribe to RSS Feeds

Home > Past Briefings > Briefing Detail Page

Briefing Detail Page

Change Text Size:   Smaller Text Size   Larger Text Size   Default Text Size    

Worker Wellness Programs: Do They Work?

Friday, May 31, 2013

Starting in 2014, employers will be allowed to charge their workers up to 30 percent more for health insurance premiums if they don't meet certain health goals, under the Patient Protection and Affordable Care Act (ACA). An Alliance for Health Reform briefing, "Worker Wellness Programs: Do They Work?" explained the provisions in the law, and examined employer efforts to improve worker wellness, along with evidence about savings.

Nearly half of large companies offer wellness programs to their employees in an effort to promote healthier lifestyles and control growing medical costs. These programs can take different forms, ranging from smoking cessation programs to penalties for employees who fail to meet employer-defined health targets in such areas as cholesterol, blood pressure, and Body Mass Index (BMI). The ACA encourages businesses to promote healthier behaviors through workplace wellness incentives, and many employers are already moving in this direction. But questions remain about the overall impact of such policies.

What effect can tying wellness incentives to premiums have on workers, and especially less healthy workers? What does the evidence say about wellness programs and costs? Can wellness programs be linked to better health outcomes? What does the ACA say about employer wellness programs? Under the proposed agency rules related to the ACA provisions, what would be permitted and not permitted in wellness program design and practice? What are key concerns about implementing such programs?

A distinguished panel of experts addressed these and related questions.

Paul Dennett, senior vice president for health policy at the American Benefits Council, provided an overview of the ACA provisions.

Mary Grealy, president of the Healthcare Leadership Council, provided an overview of what different employers are doing, and what the evidence is showing in terms of health outcomes and savings.

Troy Brennan, executive vice president and chief medical officer of CVS Caremark, described his firm's implementation of a worker wellness program.

Jill Horwitz, professor of law at UCLA, highlighted questions about the overall savings and record of wellness programs as raised in her recent Health Affairs article.

Karin Feldman, benefits policy specialist at the AFL-CIO, presented workers' views and concerns about workplace wellness programs.

Ed Howard of the Alliance and David Colby of RWJF co-moderated.

The briefing took place on Friday, May 31 at the Columbus Club in Union Station.

Contact: Marilyn Serafini 202/789-2300

The event is sponsored by the nonpartisan Alliance for Health Reform and The Robert Wood Johnson Foundation.


Paul Dennett, American Benefits Council, Speaker
Mary Grealy, Healthcare Leadership Council, Speaker
Troyen Brennan, CVS Caremark, Speaker
Jill Horwitz, UCLA School of Law, Speaker
Karin Feldman, AFL-CIO, Speaker
David Colby, Robert Wood Johnson Foundation, Moderator

Transcript, Event Summary and/or Webcast and Podcast

Transcript: Worker Wellness Transcript (Word Document), 5/31/2013
Full Webcast/Podcast: Video recording via C-SPAN

Speaker Presentations

Dennett Presentation (Adobe Acrobat PDF), 5/31/2013
Grealy Presentation (Adobe Acrobat PDF), 5/31/2013
Horwitz Presentation (Adobe Acrobat PDF), 5/31/2013
Feldman Presentation (Adobe Acrobat PDF), 5/31/2013

(If you want to download one or more slides from these presentations, contact us at info@allhealth or click here for instructions.)

Source Materials

Agenda (Adobe Acrobat PDF), , 5/31/2013
Speaker Biographies (Adobe Acrobat PDF), , 5/31/2013
Selected Experts List (Adobe Acrobat PDF), , 5/31/2013
Materials list (Adobe Acrobat PDF), , 5/31/2013

Offsite Materials (briefing documents saved on other websites)

2012 Employer Health Benefits Survey, Kaiser Family Foundation, 9/11/2012
Structuring Legal, Ethical, and Practical Workplace Health Incentives: A Reply to Horwitz, Kelly and DiNardo, Health Affairs Blog, 4/23/2013
Guidance for a Reasonably Designed Employer Sponsored Wellness Program Using Outcomes –Based Incentives, Health enhancement organization, the American College of Occupational and Environmental Medicine, American Cancer Society Cancer Action Network, American Diabetes Association and American Heart A, 11/7/2012
Incentives for Nondiscriminatory Wellness Programs in Group Health Plans: Final Rule (Adobe Acrobat PDF),The U.S. Department of Labor and the U.S. Department of Health and Human Services, 5/29/2013
Workplace Wellness Programs Study Final Report (Adobe Acrobat PDF),Rand Corporation, 5/1/2013
Wellness Programs: Evaluating the Promises and Pitfalls (Adobe Acrobat PDF),Families USA, 6/1/2012
The Experts: What Role Should Government Play in Combatting Obesity?, The Wall Street Journal, 4/15/2013
A Study Raises Doubts that Workplace Wellness Programs Save Companies Money, The Washington Post, 3/18/2013
Wellness Programs and Nondiscrimination under Employer-Sponsored Group Health Plans: Testimony of Karen Pollitz before the Equal Employment Opportunity Commission, Kaiser Family Foundation, 5/8/2013
Volpp, Kevin et al. Redesigning Employee Health Incentives – Lessons from Behavioral Economics, The New England Journal of Medicine, 8/4/2011
Companies Get Strict on Health of Workers, The New York Times, 3/25/2013
The Ethics of Not Hiring Smokers, The New England Journal of Medicine, 4/11/2013
Premium Incentives to Drive Wellness in the Workplace: A Review of the Issues and Recommendations for Policymakers, Georgetown University Health Policy Institute and the Robert Wood Johnson Foundation, 2/1/2012
Mass. Advocates Want to Snuff Out Higher Premiums For Smokers, Kaiser Health News, 5/24/2013
Pathway to Health and Productivity: 2011/2012 Staying@work Survey Report, National Business Group on Health and Towers Watson, 12/1/2011
Obama Administration Continues Moving Forward to Implement Health Care Law by Releasing Final Rules on Employment-Based Wellness Programs, United States Department of Labor, 5/29/2013
Do I Look Fat in this Insurance Plan?, American Enterprise Institute, 4/4/2013
Value of Employee Wellness Programs, The Huffington Post, 3/18/2013
Workplace Wellness Programs, Health Affairs Policy Brief, 5/10/2012
Wellness Incentives in the Workplace: Cost Savings Through Cost Shifting to Unhealthy Workers, Health Affairs, 5/1/2013
Working toward Wellness: Creating Consumer-Friendly Workplace Wellness Programs (Adobe Acrobat PDF), Families USA, 7/1/2012


Uwe Reinhardt Questions Bundled Payment Savings Prospects

Video (2:58)

A new Alliance for Health Reform video features Princeton’s Uwe Reinhardt questioning whether bundling payments for medical services might actually lead to higher – not lower – costs.

"The ACO's, the accountable care organizations, could create local monopolies that could dictate to you what that bundled price would be, and some of us fear that bundled prices might be even more than what the fee-for-service for that bundle would be today. … You really should align all the payers and say, 'Let us jointly negotiate with the ACOs what those bundles should be so that they cannot divide and rule and sort of make us on the buy side weak.'"


Read More 

Sister Carol Keehan on Health Law Enrollment Challenges this Year

Video 3:00

A new Alliance for Health Reform video features Sister Carol Keehan of the Catholic Health Association of the United States addressing the challenges of quickly enrolling millions of Americans for health insurance this fall. Open season begins October 1 of this year, yet she says that up to 85 percent of those who will be newly eligible for Medicaid or for subsidies to buy private insurance in state-based exchanges don't know it.  FULL TRANSCRIPT

Read More 

Jonathan Blum on CMS Efforts to Keep Medicare Spending Growth Down

Video (2:54)

Jonathan Blum, acting principal deputy administrator and director of the Center for Medicare at the Centers for Medicare and Medicaid Services (CMS), addresses the slower growth of Medicare spending over the last few years, and what his agency is doing to try and continue the trend. “There are promising signs that this strategy to change the payment system, to change the payment models, to focus on waste and abuse, is paying off," he said. "We are taking a whole new approach to addressing fraud in the program. Much more data resources, much more on the ground reaction. We have seen dramatic spending declines in areas of spending, such as home health and durable medical supplies that historically fueled lots of the fraud.”  FULL TRANSCRIPT

Read More 

Two Former Medicare Administrators Discuss How to Save the Program

A new Alliance for Health Reform video features two former Medicare administrators -- Gail Wilensky and Bruce Vladeck -- on their ideas about how to save the program.

Ms. Wilensky, who ran Medicare in a Republican administration, argued for increasing the eligibility age of Medicare for future retirees, while still making the program available at age 65 for those who are disabled.

Watch at

Read More 

Douglas Holtz-Eakin: Health Care Spending Lull Only Temporary

Video (3:11)

A new Alliance for Health Reform video features Douglas Holtz-Eakin of the American Action Forum, and a former director of the Congressional Budget Office, arguing that recent slower spending growth in health care won’t continue.

"We also saw a slowdown in the mid-90s, and we all declared victory and it came right back. I think next year we’ll see a noticeable uptick. There will be lots of new people entering the insurance markets because of the exchanges and the subsidies that come along with them, and those subsidies are very generous. … These are an invitation for people to get coverage and to buy more health care. I think that’ll place a lot of pressure on spending."


Read More 

Marketplace Enrollment Helpers Toolkit

Beginning October 1, insurance marketplaces open for enrollment, and millions of people will be eligible to purchase plans. To guide them in the application process, the federal government has invested in programs to train community organizations and hired staff.

Read More 

The Employer Mandate of the Patient Protection and Affordable Care Act

The Toolkit, available here, details the ACA’s employer requirements and penalty. It also includes information about the delay in the mandate to 2015, and analysis about its impact on employer-based coverage.

Read More 

Toolkit: Training the Workforce for a Changing Health System

A new Alliance for Health Reform toolkit addresses concerns about whether newly-trained physicians are adequately prepared for today's evolving health care delivery system. Does training adequately emphasize care coordination, team-based care, costs of care, health information technology, cultural competence and quality improvement? Does it encourage students to practice in a primary care setting?

Read More 

Toolkit: Emergency Preparedness in the U.S.: The Ebola Threat

Is the U.S. prepared for a potential virulent pandemic? This new Alliance toolkit examines public health infrastructure, funding and policy levers that deal with these kinds of health crises in America.

Read More 

Copyright 1997-2014 Alliance for Health Reform
1444 Eye Street, NW, Suite 910 Washington, DC 20005-6573      202-789-2300      202-789-2233 fax      Sitemap