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Health Economist Blasts Wellness Programs

Chelsea Rice, for HealthLeaders Media, July 15, 2013

To summarize the case against industry: Epidemiology is all wrong; the concept of HRAs is advice opposite of what doctors tell you to do. The arithmetic can't save money. Every vendor lies.  

HLM: How do you explain the reports where wellness companies show savings?

Lewis: Participants will always out-perform non-participants because they are motivated. Even without a program, participants do better and wellness programs split people into actively motivated participants and non-participants.  

Throughout the industry, every study, except for a couple, compares active participants with people who are so unwilling that they are willing to forgo an incentive not to be involved in a program. You can't compare these two groups to determine savings.

HLM: Why don't incentives work to change behavior?  

Most behavioral economists will tell you [that] you can't pay someone at work to make changes to behaviors that developed where they do not work. Think about 'stop smoking' incentives. You pay someone $300 to stop smoking, but mentally it costs them $3,000 to not smoke.  

You can't pay someone to overcome an addiction. With weight management, think about the junk food industry and how they are spending billions on brain science to figure out how to addict people more. Meanwhile the wellness industry is countering this highly sophisticated, molecular level science—and spending more is the only tool they have, so incentives keep going up and up and up.

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6 comments on "Health Economist Blasts Wellness Programs"


Bryan Noar (7/17/2013 at 8:12 PM)
This was just published today ... based on the numbers, perhaps it should be considered for workplace wellness programs: http://markets.cbsnews.com/cbsnews/news/read/24655964/Workplace_Wellness_Cost_Analysis

Al Lewis (7/16/2013 at 7:35 PM)
Thank you for the thoughtful comments. Mr. Broner, perhaps it won't surprise you to know that many hospitals serve junk in their cafeterias AND have wellness programs. The goal of the hospital is for employees to eat on-site rather than spend time going elsewhere, so they serve what people like to eat.

Steve Lippert (7/16/2013 at 2:52 PM)
Author paints with such a broad brush. After telling us what a waste most wellness programs are, he then suggest building trails, workout facilities etc. Now who benefits from that? Of course, all the motivated healthy people that probably aren't your problem anyway. Bottom line to me is that if people choose to live unhealthy, no amount of coaxing may change that. But at least they can PAY more for their unhealthy behavior. Our author doesn't seem to consider/understand that.