Journal of Healthcare Management - September/October 2015 - (Page 316)

P O P U L A T I O N H E A L T H Worksite Wellness: Culture and Controversy David B. Nash, MD, dean, Jefferson College of Population Health, Thomas Jefferson University, Philadelphia, Pennsylvania I n my previous column (see the Population Health column in the July/August issue of JHM), I wrote about the emergence of population health as a major trend on the American healthcare landscape. Over the past decade, we have witnessed the practical applications of population health tenets give rise to substantial changes in how healthcare is perceived, delivered, and financed. One such change is the fundamental shift in employer attitudes toward employee health. Who among us hasn't felt a pain in the wallet as employers reacted to spiraling health insurance costs by reducing benefits coverage and increasing copayments and deductibles? Who hasn't considered the potential demise of our uniquely American system of employer-sponsored health insurance? But this is only a part of the ongoing change in healthcare. Even before passage of the Affordable Care Act (ACA), employers had begun to recognize the value of a healthy workforce. As they adopted strategies to reduce costs of employee healthcare, large private employers and public agencies were beginning to create cultures of health and wellness in their workplaces. A workplace culture of health and wellness is characterized by an environment, policies, and cues that encourage healthy choices; these choices, in turn, lead to reduced absenteeism and improved productivity, collective improvement in quality of life, and reduction in morbidity for the employee population. Changing culture takes time, but a growing number of employers are implementing workplace programs that promote wellness and prevention to reduce the risk of chronic illnesses (e.g., diabetes, hypertension), reward healthy behaviors (e.g., smoking cessation, weight loss), and encourage employees to identify a patientcentered medical home for their overall healthcare. The ACA encouraged workplace wellness by permitting employers to align group health plan premiums with employee participation in wellness programs. According to the U.S. Equal Employment Opportunity Commission (EEOC) (2013), 94% of employers with more than 200 employees and 63% with fewer employees currently use wellness programs to incentivize their staff to adopt healthier lifestyles. Although the EEOC monitors the use of wellness programs, it has issued no regulations regarding the design or administration of these programs. Herein lay the seeds of controversy. In 2014 (Goff), the EEOC filed three federal lawsuits arguing that an individual employer's wellness program violates the Americans with Disabilities Act (ADA) or the Genetic Information Nondiscrimination Act (GINA). 316

Table of Contents for the Digital Edition of Journal of Healthcare Management - September/October 2015

Journal of Healthcare Management - September/October 2015
Interview With Richard J. Umbdenstock, FACHE, President and CEO of the American Hospital Association
A Rapidly Adaptable Management System
Worksite Wellness: Culture and Controversy
Integrating Strategic and Operational Decision Making Using Data-Driven Dashboards: The Case of St. Joseph Mercy Oakland Hospital
What Determines the Surgical Patient Experience? Exploring the Patient, Clinical Staff, and Administration Perspectives
A Review of Electronic Hand Hygiene Monitoring: Considerations for Hospital Management in Data Collection, Healthcare Worker Supervision, and Patient Perception
Using Hybrid Change Strategies to Improve the Patient Experience in Outpatient Specialty Care

Journal of Healthcare Management - September/October 2015