Wellness Initiatives Are Going Down the Drain

In the news this week: Workplace wellness initiatives aren't paying off, Sebelius finds her zen, and hospital staff still aren't washing their hands.

Wellness programs have long been eyed with skepticism.

Now, just in time for the final rule on wellness incentives from the Department of Health and Human Services, we have some data. Employers who offer such programs will be displeased to learn that subsidizing weight loss programs and gym memberships has been found not to be cost-effective.

RAND Corp. researchers released a federally funded report on workplace wellness programs last week with discouraging data: The numbers just don't add up for wellness initiatives.

The RAND report, now available despite its fumbled release (it was apparently released prematurely and temporarily yanked from the Internet), is raising red flags for employers.

According to the HHS final rule [PDF], starting in 2014 employers may reward employees for participating in wellness programs at 30% of the cost of their average insurance premiums, or almost $1,620 annually. But RAND researchers were unable to prove statistically significant cost savings for these programs.

RAND says participation in wellness programs for more than five years is "associated" with lower health care costs and utilization, but with an average annual savings of $157, (that's $3.46 per month, per employee in the fifth year of a wellness program) the change was not statistically significant, so it couldn't be isolated to be a result from the wellness program itself.

So who's the real "the biggest loser" here? In the workplace, employees seem to be winning the benefits game, but without significant changes to their health and wellness. Meantime employers are patting themselves on the back for their largesse.

Soap Opera

Like a long-running daytime drama in which promising advances abound, but satisfactory resolutions seem perpetually out of reach, getting hospital staff to wash their hands remains a vexing problem.

Even with awareness campaigns and advances like hand-sanitizing gel in patient rooms to make hand washing quick and instant, without reminders and encouragement, hospital staff washes their hands only 30% of the time.

Hospitals are investing in everything from data-collecting motion sensors to alarms and iPad apps to get hospital staff to comply with the most basic of healthcare quality and patient safety initiatives: Wash your hands. With soap and water. For 15 seconds.

An article last week in The New York Times describes many tactics to get staff to comply, from high-tech "Big Brother-" style monitoring to low-tech "prizes" of gold stars and pizza. The efforts are part of a desperate attempt by hospitals to counter the $30 billion dollars spent annually combating hospital acquired infections, attributed to this basic, neglected task.

With multiple superbugs spreading and Medicare reimbursements on the line, hospital leaders are highly motivated to get staff to wash up. Physicians are, surprisingly, the most likely to go without hand washing, perhaps in rebellion to these omnipresent rules and regulations.

Incentives, disincentives, and humiliation have all been tested and tried, but it seems to all boil down to an overwhelmed staff that can't handle an expanding workload.

Sebelius Shares Work-Life Balance Strategies

Responsible for implementing one of the most complicated and politically incendiary pieces of American legislation in decades, U.S. Secretary of Health and Human Services Kathleen Sebelius has a lot on her plate.

As the head of the federal branch that oversees the $17 billion healthcare industry, Sebelius landed the number 25 spot on Forbes's 2013 list of The World's 100 Most Powerful Women and is the 68th most powerful person in the world.

In the Forbes interview, Sebelius, a former state governor, offers glimpses into how she manages to balance the demands of her work with her desire for a fulfilling family and personal life.

"Finding a balanced situation, even for young women and whether you have kids or not, tends to be all the more important for women. Because not only does it make sense to find a balance that allows you to perform the best work, but also it is a way you're judged in the workplace differently than your male colleagues," says Sebelius.

With the most powerful person in the world as her boss, she says the keys to striking that harmonic chord between stressful job and fulfilling family life are finding, and keeping, a supportive spouse and friends. She also recommends making time for things in your life that calm you down and "center" you.

"Find that way to put yourself at peace and being able to say I've done enough for today, I'm going to go to sleep, wake up tomorrow, and start all over again. Because if you don't do that, it's pretty easy to drive yourself crazy right away," she says.