14 ms·

Employee Wellness Programs Yield Little Benefit, Study Shows

150 points by mlthoughts2018 8y ago

RobertRoberts 8y ago
I really like the idea of encouraging health in any form. But it seems that when the health care systems feed you green jello, white bread and skippy peanut butter sandwiches when you are sick isn't a system worth solely relying upon to guide us. Also, it seems percentage wise, the best results for the investment should be on extreme health risk areas. (like help people quit smoking)
- mises 8y ago
  I'm also not sure hospitals serving cheap calories when better options are available ought to disqualify the entire medical system. The people who make the decision to do that are corporate types and nurses, whereas the people who do medical research are doctors and those who do things of the sort mentioned in the article may be data scientists. It's not fair to disqualify the entire system based on one bad choice, and were it the greatest flaw of the medical system, we ought to thank God.
  - maxxxxx 8y ago
    It definitely feels to me that the medical system is not really about "health" but about fixing things. A lot of doctors don't live particularly healthy lifestyles, hospitals feed junk food and so on. I am not saying they can't do their job but generally I think it would be better if part of working in the medical profession were to have a healthy lifestyle. For example a doctor who doesn't exercise himself or doesn't eat healthy food or is sleep deprived can sort of give advice to people but somebody who has first hand experience with a wholesome lifestyle can give much better, realistic advice. A while ago we had a nutritionist in the company lobby giving nutrition advice but the fact that she was quite overweight herself definitely didn't help her credibility.
  - FiddlyPack 8y ago
    Not sure where “and nurses” is coming from in your comment. Nursing research is predominately on long-term patient outcome, whereas MD education is predominately on the disease / underlying cause. The nurses I know are more focused on and better educated on how holistic care serves the long-term outcomes of the patients, while docs are better educated to attend to the acute problems. I would expect a change to quality of calories provided in a hospital to originate from a DNP before a MD.
    - mises 8y ago
      It is coming from exactly what you said, I would also expect a change to nutrition to originate from a DNP. My point is they have more control over day-to-day intake.
  - nradov 8y ago
    Most hospitals now employ Registered Dieticians for meal planning. Nurses usually have little or no input.
- taneq 8y ago
  I thought the whole justification for the U.S.' ridiculous health care costs was that it provided a "better quality of care"? The last couple of times I've encountered hospital food (in Australia, a knee reconstruction which cost $500 and having a baby which cost $2k or so) it was a very well balanced meal.
  - dahart 8y ago
    I've heard some people justify it that way, but I keep seeing report after report about the US ratio of dollars to positive outcomes being very bad and getting worse. https://www.commonwealthfund.org/publications/issue-briefs/2015/oct/us-health-care-global-perspective https://www.commonwealthfund.org/publications/issue-briefs/2... https://interactives.commonwealthfund.org/2017/july/mirror-mirror/ https://interactives.commonwealthfund.org/2017/july/mirror-m... https://news.harvard.edu/gazette/story/2018/03/u-s-pays-more-for-health-care-with-worse-population-health-outcomes/ https://news.harvard.edu/gazette/story/2018/03/u-s-pays-more... etc
    - zdragnar 8y ago
      > Higher spending appeared to be largely driven by greater use of medical technology and higher health care prices, rather than more frequent doctor visits or hospital admissions. In contrast, U.S. spending on social services made up a relatively small share of the economy relative to other countries. Despite spending more on health care, Americans had poor health outcomes, including shorter life expectancy and greater prevalence of chronic conditions. From your first link. It gloms all spending together without accounting for the lifestyle of our population- obesity rates, exercise, etc. Treatments are available to everyone- that means expensive care for even the elderly, who would otherwise me deemed "not worth the cost" to government budgets. https://www.bma.org.uk/connecting-doctors/b/the-bma-blog/posts/there-are-things-you-lose-with-age-equality-should-not-be-one-of-them https://www.bma.org.uk/connecting-doctors/b/the-bma-blog/pos... https://www.google.com/amp/s/amp.smh.com.au/business/workplace/cost-cutting-and-understaffing-of-aged-care-homes-leads-to-rationing-and-neglect-20171010-gyxn7b.html https://www.google.com/amp/s/amp.smh.com.au/business/workpla... No, not everything over here is perfect. The takeaway is that there is much more to care than spending / "outcome".
- chillwaves 8y ago
  I feel like this is outdated, at least in respectable facilities. I stayed in a hospital for a week over a very bad accident. The food wasn't great but I had a lot of healthy choices. This was in NoVA which is a wealthy place and the hospital is very nice. The issue would be more substandard care nationwide than what the worst of hospitals have to offer.
  - RobertRoberts 8y ago
    It's likely location specific. West coast tends to have a lot of health conscience people, but the south east it's a lot of fried food and junk.
- pkaye 8y ago
  Is that what you were getting? I was in the Kaiser hospitals for 2 weeks and they gave me lots of good options. They had a tablet where you pick one item and it narrows down the remaining items to match your overall nutritional needs (calories, protein, etc.)
Krasnol 8y ago
Oh you mean "do some yoga" (F500) won't help? Paint me surprised!
- derrida 8y ago
  Look at the faces of people that have dedicated their life to yoga (or christian monk, or sufism or whatever), and then people who have dedicated their life to the profit motive & been successful (billionares). Who's happier?
  - Krasnol 8y ago
    I'm sure it's quite nice if you can make a living giving yoga courses to office slaves who work their asses off in open office cubicals in fear of being fired tomorrow for shitty money and so on....Yoga won't help them.
    - derrida 8y ago
      There's a lot of livelihoods that do not involve offices or even working for a company out there in the world today. But I can understand how it seems that if you were raised in the United States and aren't either really poor or wealthy.
      - Krasnol 8y ago
        I was not and it doesn't touch the issue at hand. Those employee wellness programs are being used as cheap place holder to cover up anti-social working conditions. Unpaid overtime and unhealthy working environment won't go away with Yoga. Even if it helps some to forget the actual issues, it doesn't solve them.
        derrida 8y ago
        > Those employee wellness programs are being used as cheap place holder to cover up anti-social working conditions. Unpaid overtime and unhealthy working environment won't go away with Yoga. Even if it helps some to forget the actual issues, it doesn't solve them. Absolutely. We need unions (or if that's a dirty word, some organization/democracy at the point of production) in order to ensure equitable society and also that people's contribution to society through their work & their productivity is adequately valued - that people are working because they see their place in the whole & on a voluntary basis - what's occuring right now is work based on fear and necessity, the false scarcity means people have to chose to put up with injustice at work in order to survive & the hours mean the working poor are mostly silent. Look at Finland, look at Norway.
psds2 8y ago
I think a lot of factors come in to play, and this finding does not surprise me for an employer such as BJs wholesale. Compare that workforce vs IBM, where employees remain with the company longer and have much more sedimentary jobs, and wellness programs are probably providing better ROI.
doctorpangloss 8y ago
Wellness programs don't need to have positive outcomes to make sense for insurers. Instead, they need to use enough superfluous technology to discourage older people from signing up for them. Hence, from a linked point in the article: > AARP, the consumer advocacy group for older Americans, sued the federal government in 2016, arguing that the rules governing the [wellness programs] violated anti-discrimination laws aimed at protecting workers’ medical information. That lawsuit against Kaiser was over individual coverage. Kaiser realizes all its savings by carefully maintaining very health (i.e., young) pools. The medical information stuff is the legal argument, but it was really a lawsuit about making people do stuff that disproportionately negatively affects old people. If you try the wellness program for people whose enrollment is through their employer, and your employees are disproportionately not college educated or young, the wellness program of the kind you and I are familiar with will not be effective at either lowering costs or improving health outcomes. That's why this program was sort of doomed to fail. There exists an as-of-yet unobserved program that gives people money in exchange for behavior modification with positive health and cost savings outcomes. It will probably look more consuming entertainment--stuff that has evidence people will do over long periods of time. We're a long ways off from finding the appropriate design of such a program.
- awkward 8y ago
  I've seen it done in a much more brutal (if less discriminatory) fashion - everyone who doesn't get a full fluids screening in done 2 months sees their premium jump. Employees are responsible for booking their lab appointment, receiving the lab sample, and then submitting it manually. So that's 2-3 weeks to schedule and make an appointment, followed by at least 4 weeks for the lab's turnaround, followed by time to submit the paperwork from the lab. Great way to raise some rates.
  - dahart 8y ago
    That is pretty harsh. I'm personally scared of the future liability and privacy implications of deep screens, especially if it's employment related. Is that irrational or justified? On the other hand, my life insurance company asked for an update on my health, and after I had a blood test, they came back and said I was so healthy they were going to have to cut my rates, and they did massively, by like half. They weren't threatening to raise rates or offering to reduce them, so I guess it felt like a very positive thing. Still worried that somehow the data will be used against me to reject claims when I get old.
Shivetya 8y ago
You cannot even pay people to do them because the first remark back among my coworkers is, they //the company// aren't giving us enough to participate. There were even prizes for some categories for wellness categories, like the steps counting programs for which they gave up counters to weight loss. of course there are other self defeating attitudes available too, from those who won't contribute more than the match for 401k, again the company's fault, to those who take more smoke breaks because of the extra cost on their premiums. I am not sure if its a product of the education system or television. I think schools should focus a bit more on instructing students to better themselves for no other purpose than to improve themselves. that waiting for someone to make you improve yourself is the first step in failing
- rorykoehler 8y ago
  You couldn't pay me to participate because I categorise it as BS. It's way overstepping the jurisdiction of the employer. FWIW I don't have a problem with weight, diet or exercise.
- utnick 8y ago
  Maybe paying more is something that should be explored... I think for $500-$1,000 a month per person you would have widespread behavior change in most companies, and it wouldn't really even be that expensive in the context of total healthcare+wellness program spending.
  - citrablue 8y ago
    Knock 5% off my insurance premium for every trip to the gym and you better believe I'm going to the gym every day...
    - chillwaves 8y ago
      Seriously. My premium is prob ~$250 a month for a single 30s male. I will go to the gym 3 days a week for a 60% discount. I'll stop eating sugar for the other 40%.
hombre_fatal 8y ago
Some interesting bits to counter the title's face value: > Researchers followed thousands of BJ’s Wholesale Club employees for a year > Nearly all the studies to date had been observational and have largely concluded that the programs save some money for employers. But this study randomly assigned employees to a wellness program and compared their results with those of employees who were not enrolled in such efforts. > Employers looking for a quick reduction in their health care spending will be disappointed It makes sense to me that benefits come on a longer time scale and when employees join the specific programs that interest/apply to them (rather than random assignment).
- mirimir 8y ago
  Yes. Following people for just a year is ~meaningless. If someone quits smoking, for example, the benefit of reduced lung cancer incidence will show up on decade scale.
  - jnwatson 8y ago
    I’m sure the biggest intervention they are hoping for is weight loss. The reduction in insulin/metformin prescriptions would be evident if the program was effective.
    - tomjen3 8y ago
      If they need to lose 30-40 pounds (or more) that might not happen in the 1 year time frame. And don't bother replying and telling me you lost that much weight in less time, I am aware that can be done, but not by small tweaks which these incentives normally give.
- 0xcde4c3db 8y ago
  > when employees join the specific programs that interest/apply to them (rather than random assignment) The problem with this from a study standpoint is that it introduces self-selection bias. A complication for exercise programs in particular is that avoidance of exercise can be caused by cardiovascular and metabolic dysfunction.
iamthepieman 8y ago
the only people i know who take advantage of wellness programs are people who are already doing things well beyond the wellness program requirements. They participate in a variety of sports in all seasons, run 5ks or marathons, ski, bike hike or play organized sports. For them it's just a way to subsidize things they are already doing, maybe get a free fitness tracker or gym membership.
- unsignedint 8y ago
  I don't think wellness program alone won't be able to make people change their lifestyle. To me, thing that made big difference was access and motivation; particularly for me, easy access to on-site gym (especially with a group class) I transitioned from hating-to-workout to doing 5 days a week in gym, engaging in activities ranging from Yoga to HIIT. I don't know how typical I am, though...
  - tlarkworthy 8y ago
    Blood pressure and stamina bump is within days of giving up (I switched to vaping, the feeling of increased vitality was noticable).
- coleca 8y ago
  Not to mention that these programs are notoriously difficult to actually use as an employee. Some require getting monthly receipts from your gym, then faxing to your healthcare provider, waiting for a check to come in the mail, etc. Look for companies like https://myleon.co/ https://myleon.co/ to disrupt this space and make these programs more effective.
gwern 8y ago
The most interesting thing about this is not that wellness programs don't work (this is the null hypothesis for all interventions, behavioral interventions particularly, and diet/exercise interventions especially) but that it offers a direct examination of 'correlation!=causation': they did the cluster randomized trial, but they also did the naive correlational analysis ignoring the randomization to see how misleading the estimates would be. They compare the estimates side by side in the supplement https://www.gwern.net/docs/statistics/causality/2019-song-supplement2.pdf#page=45 https://www.gwern.net/docs/statistics/causality/2019-song-su... You can see that the estimates are... different. Frequently, the point estimates aren't even the same sign. Self-selection and 'healthy user bias' are very much things. --- This parallels an earlier workplace wellness randomized experiment: https://www.gwern.net/docs/statistics/causality/2018-jones.pdf https://www.gwern.net/docs/statistics/causality/2018-jones.p... which comes with nice graphs/tables comparing & contrasting the correlational vs actual causal effects: https://www.gwern.net/images/causality/2018-jones-table5-nyt-randomizedvscorrelation.png https://www.gwern.net/images/causality/2018-jones-table5-nyt... https://www.gwern.net/images/causality/2018-jones-figure8-randomizedvscorrelationliterature.png https://www.gwern.net/images/causality/2018-jones-figure8-ra... https://www.gwern.net/images/causality/2018-jones-supplement-randomizedvscorrelation-tablea3-ac.png https://www.gwern.net/images/causality/2018-jones-supplement... https://www.gwern.net/images/causality/2018-jones-supplement-randomizedvscorrelation-tablea3-de.png https://www.gwern.net/images/causality/2018-jones-supplement... https://www.gwern.net/images/causality/2018-jones-supplement-randomizedvscorrelation-tablea3-fg.png https://www.gwern.net/images/causality/2018-jones-supplement... https://www.gwern.net/images/causality/2018-jones-table5-correlationvsrandomized.png https://www.gwern.net/images/causality/2018-jones-table5-cor... (I collate a bunch more of these kinds of correlation!=causation results in https://www.gwern.net/Correlation https://www.gwern.net/Correlation as a way of making the point that, empirically and especially when it comes to humans, correlation frequently is not causation, and this is not merely some carping pedantic statistician's complaint, but normal.)
draw_down 8y ago
Heck, maybe it's sort of perverse that employers need to concern themselves with the "wellness" of their employees.
droithomme 8y ago
It's not particularly convincing to track people for only one year on behavior changes that are known from many other studies to yield long term health benefits. And the researchers in this study would know that.
diogenescynic 8y ago
Just give employees more time off. Wellness starts with having work-life balance.
- tomjen3 8y ago
  Wellness is a corp-term for losing weight, exercising and stop smoking.
  - collyw 8y ago
    All three of these are considered to be part of a healthy lifestyle.
sonnyblarney 8y ago
Wellness is incorporated into the daily grind, not some 'other' thing. So decent stress levels, the right kinds of breaks, proper vacays, good managers, not worrying about stuff all the time.
kadendogthing 8y ago
What if we just had less stress and less overall working hours. Which is totally doable given our economic productivity?
homerhomer 8y ago
I'm pretty certain most would benefit from working less, but that's not what these programs offer.
currry 8y ago
I really don't want another game in my life to micromanage my behavior. Diet and exercise are their own rewards. I got a rewards program for everywhere I eat. A miles program got every airline I fly. A tax code with a million subsidies and loopholes. Auto insurance companies who want to stick telematics in my car. Now I have health insurance companies gamifying literally what I eat and how I spend my free time. Just fuck off already.
- ruperp 8y ago
  Totally agree, it's gotten out of hand. We have too many people with too little to do. And too much money to pay them to do useless things. So they come up with more programs.
- collyw 8y ago
  On the other hand I look after my health reasonably well. I take very few sick days as a result. It would be nice if my employer showed some sort of recognition of that.
  - octokatt 8y ago
    Unfortunately, we don't have a good way to measure the difference between "few sick days due to good health" and "few sick days because came into office sick". Or, for that matter, "many sick days due to unsolvable chronic illness but doing their best" and "many sick days due to eating an entire bag of Doritos during lunch and feeling ill".
  - currry 8y ago
    Yeah they'll give you recognition alright - for saving them money by allowing them to pry into your personal life. Maybe it's just working for an international megacorp, but I can tell you with absolute certainty they don't give a shit about my health - except to the extent it affects the bottom line. I'll get my positive recognition from my doctor because it means something from them.
  - piva00 8y ago
    You don't need a participation medal in taking care of yourself. Right now you aren't earning more money or being directly rewarded by being healthy but this is a personal investment in your own future, why should anyone else show any form of recognition to a very personal life choice? I do the same, I'm healthy, I go to the gym, I bike to work, my reward is getting older fit while I see people on my age group having more and more issues. Yup, you might be more productive than someone that is unhealthy and taking sick days, etc., at the same time you don't use your paid time off (or have days discounted from your salary, such as here in Sweden) for when you got sick.
WalterBright 8y ago
Place the employee parking lot a mile away from the office.
bariswheel 8y ago
3 day weekends. Solved. 50% longer, 100% better. Treat the disease, not the symptoms.
- tonyedgecombe 8y ago
  As long as it doesn’t come with 12 hour days.
  - collyw 8y ago
    I Honestly think 3 x 12 hour days would be better than 5 * 7.5.
    - cheschire 8y ago
      The amount of creative work that can be accomplished in a day is finite, regardless of the length of the workday. The only way you could shift a work schedule that much is if you substantially change the type of work being done, and accept that you would get less creative work per week while gaining more resources in other areas such as rote tasks or physical labor.
      - xfitm3 8y ago
        Not everyone can produce creative work every day, either.
      - collyw 8y ago
        The vast majority of my work is not particularly creative. Documentation, meetings, replying to emails answering someones question. When get to do some coding its not usually especially complex. Occasionally it is, but I imagine having longer days would be easier to get 4 hours "in the zone", something which happens rarely at present.
    - night815 8y ago
      The problem with only working 3 days is the first day back will be mostly spend getting back in the groove / remembering what you were working on. I am a fan of 5 x 6 hours and 4 x 8 hours.
jamisteven 8y ago
The people who conducted this study should be embarrassed. First off they chose BJ's wholesale, which I would venture to say doesnt have the healthiest of employees on the planet and doesnt represent a good sample. Second, they didnt actually track what the individuals were actually doing, were they eating a diet high in greens and low in processed foods? Were they getting cardio in daily? Were they smoking, drinking excessively? How anyone serious about health, nutrition, or even cost spending could take this study seriously, beyond me.
- coleca 8y ago
  Why would the study want to target "the healthiest employees on the planet"? That would bias the study. Seems to me they chose a random company (that would agree to participate) with average workers. The whole point would be to see if these programs improve healthcare. Honestly, the majority of BJ's workers work in a giant warehouse store and get a lot of walking in daily as part of their job. (*Source: I'm a former BJ's Wholesale 'team member' although I worked in the office in IT)
C1sc0cat 8y ago
I thought it was to improve peoples health and catch conditions earlier - though I suspect given US health care only healthy people would apply.
loblollyboy 8y ago
No shit
xfitm3 8y ago
I've never worked for an employer that had a program which required you to share data. I have always been able to expense things like gym, mattresses, copays, whatever as part of TC but never data collection.
- kaikai 8y ago
  You’ve been able to expense things like mattresses at multiple companies? Where are you based?
  - xfitm3 8y ago
    Yes, a good nights rest is related to health and wellness. US.
matt_s 8y ago
If employers want to reduce US health care spending, why don't they band together and lobby Congress to introduce legislation to reduce health care costs? I have a gut feeling it is the insurance companies that set ever increasing rates which drive up costs overall. And then they cover less forcing patients to pay out of pocket for anything more than a flu shot. There are other countries with the same quality services for much cheaper costs. Maybe even better quality. Employers would save more money getting the insurance companies to lower rates (via legislation likely) than trying wellness programs.
knightofmars 8y ago
The only employee wellness program that works is one that actually has a time slot (not lunch) during work hours for an employee to exercise. Where the employee is literally being paid to exercise. Be it cycling, weights, walking, etc.

I really like the idea of encouraging health in any form. But it seems that when the health care systems feed you green jello, white bread and skippy peanut butter sandwiches when you are sick isn't a system worth solely relying upon to guide us. Also, it seems percentage wise, the best results for the investment should be on extreme health risk areas. (like help people quit smoking)

mises 8y ago
I'm also not sure hospitals serving cheap calories when better options are available ought to disqualify the entire medical system. The people who make the decision to do that are corporate types and nurses, whereas the people who do medical research are doctors and those who do things of the sort mentioned in the article may be data scientists. It's not fair to disqualify the entire system based on one bad choice, and were it the greatest flaw of the medical system, we ought to thank God.
- maxxxxx 8y ago
  It definitely feels to me that the medical system is not really about "health" but about fixing things. A lot of doctors don't live particularly healthy lifestyles, hospitals feed junk food and so on. I am not saying they can't do their job but generally I think it would be better if part of working in the medical profession were to have a healthy lifestyle. For example a doctor who doesn't exercise himself or doesn't eat healthy food or is sleep deprived can sort of give advice to people but somebody who has first hand experience with a wholesome lifestyle can give much better, realistic advice. A while ago we had a nutritionist in the company lobby giving nutrition advice but the fact that she was quite overweight herself definitely didn't help her credibility.
- FiddlyPack 8y ago
  Not sure where “and nurses” is coming from in your comment. Nursing research is predominately on long-term patient outcome, whereas MD education is predominately on the disease / underlying cause. The nurses I know are more focused on and better educated on how holistic care serves the long-term outcomes of the patients, while docs are better educated to attend to the acute problems. I would expect a change to quality of calories provided in a hospital to originate from a DNP before a MD.
  - mises 8y ago
    It is coming from exactly what you said, I would also expect a change to nutrition to originate from a DNP. My point is they have more control over day-to-day intake.
- nradov 8y ago
  Most hospitals now employ Registered Dieticians for meal planning. Nurses usually have little or no input.
taneq 8y ago
I thought the whole justification for the U.S.' ridiculous health care costs was that it provided a "better quality of care"? The last couple of times I've encountered hospital food (in Australia, a knee reconstruction which cost $500 and having a baby which cost $2k or so) it was a very well balanced meal.
- dahart 8y ago
  I've heard some people justify it that way, but I keep seeing report after report about the US ratio of dollars to positive outcomes being very bad and getting worse. https://www.commonwealthfund.org/publications/issue-briefs/2015/oct/us-health-care-global-perspective https://www.commonwealthfund.org/publications/issue-briefs/2... https://interactives.commonwealthfund.org/2017/july/mirror-mirror/ https://interactives.commonwealthfund.org/2017/july/mirror-m... https://news.harvard.edu/gazette/story/2018/03/u-s-pays-more-for-health-care-with-worse-population-health-outcomes/ https://news.harvard.edu/gazette/story/2018/03/u-s-pays-more... etc
  - zdragnar 8y ago
    > Higher spending appeared to be largely driven by greater use of medical technology and higher health care prices, rather than more frequent doctor visits or hospital admissions. In contrast, U.S. spending on social services made up a relatively small share of the economy relative to other countries. Despite spending more on health care, Americans had poor health outcomes, including shorter life expectancy and greater prevalence of chronic conditions. From your first link. It gloms all spending together without accounting for the lifestyle of our population- obesity rates, exercise, etc. Treatments are available to everyone- that means expensive care for even the elderly, who would otherwise me deemed "not worth the cost" to government budgets. https://www.bma.org.uk/connecting-doctors/b/the-bma-blog/posts/there-are-things-you-lose-with-age-equality-should-not-be-one-of-them https://www.bma.org.uk/connecting-doctors/b/the-bma-blog/pos... https://www.google.com/amp/s/amp.smh.com.au/business/workplace/cost-cutting-and-understaffing-of-aged-care-homes-leads-to-rationing-and-neglect-20171010-gyxn7b.html https://www.google.com/amp/s/amp.smh.com.au/business/workpla... No, not everything over here is perfect. The takeaway is that there is much more to care than spending / "outcome".
chillwaves 8y ago
I feel like this is outdated, at least in respectable facilities. I stayed in a hospital for a week over a very bad accident. The food wasn't great but I had a lot of healthy choices. This was in NoVA which is a wealthy place and the hospital is very nice. The issue would be more substandard care nationwide than what the worst of hospitals have to offer.
- RobertRoberts 8y ago
  It's likely location specific. West coast tends to have a lot of health conscience people, but the south east it's a lot of fried food and junk.
pkaye 8y ago
Is that what you were getting? I was in the Kaiser hospitals for 2 weeks and they gave me lots of good options. They had a tablet where you pick one item and it narrows down the remaining items to match your overall nutritional needs (calories, protein, etc.)

Krasnol 8y ago

Oh you mean "do some yoga" (F500) won't help? Paint me surprised!

derrida 8y ago
Look at the faces of people that have dedicated their life to yoga (or christian monk, or sufism or whatever), and then people who have dedicated their life to the profit motive & been successful (billionares). Who's happier?
- Krasnol 8y ago
  I'm sure it's quite nice if you can make a living giving yoga courses to office slaves who work their asses off in open office cubicals in fear of being fired tomorrow for shitty money and so on....Yoga won't help them.
  - derrida 8y ago
    There's a lot of livelihoods that do not involve offices or even working for a company out there in the world today. But I can understand how it seems that if you were raised in the United States and aren't either really poor or wealthy.
    - Krasnol 8y ago
      I was not and it doesn't touch the issue at hand. Those employee wellness programs are being used as cheap place holder to cover up anti-social working conditions. Unpaid overtime and unhealthy working environment won't go away with Yoga. Even if it helps some to forget the actual issues, it doesn't solve them.
      - derrida 8y ago
        > Those employee wellness programs are being used as cheap place holder to cover up anti-social working conditions. Unpaid overtime and unhealthy working environment won't go away with Yoga. Even if it helps some to forget the actual issues, it doesn't solve them. Absolutely. We need unions (or if that's a dirty word, some organization/democracy at the point of production) in order to ensure equitable society and also that people's contribution to society through their work & their productivity is adequately valued - that people are working because they see their place in the whole & on a voluntary basis - what's occuring right now is work based on fear and necessity, the false scarcity means people have to chose to put up with injustice at work in order to survive & the hours mean the working poor are mostly silent. Look at Finland, look at Norway.

psds2 8y ago

I think a lot of factors come in to play, and this finding does not surprise me for an employer such as BJs wholesale. Compare that workforce vs IBM, where employees remain with the company longer and have much more sedimentary jobs, and wellness programs are probably providing better ROI.

doctorpangloss 8y ago

Wellness programs don't need to have positive outcomes to make sense for insurers. Instead, they need to use enough superfluous technology to discourage older people from signing up for them. Hence, from a linked point in the article: > AARP, the consumer advocacy group for older Americans, sued the federal government in 2016, arguing that the rules governing the [wellness programs] violated anti-discrimination laws aimed at protecting workers’ medical information. That lawsuit against Kaiser was over individual coverage. Kaiser realizes all its savings by carefully maintaining very health (i.e., young) pools. The medical information stuff is the legal argument, but it was really a lawsuit about making people do stuff that disproportionately negatively affects old people. If you try the wellness program for people whose enrollment is through their employer, and your employees are disproportionately not college educated or young, the wellness program of the kind you and I are familiar with will not be effective at either lowering costs or improving health outcomes. That's why this program was sort of doomed to fail. There exists an as-of-yet unobserved program that gives people money in exchange for behavior modification with positive health and cost savings outcomes. It will probably look more consuming entertainment--stuff that has evidence people will do over long periods of time. We're a long ways off from finding the appropriate design of such a program.

awkward 8y ago
I've seen it done in a much more brutal (if less discriminatory) fashion - everyone who doesn't get a full fluids screening in done 2 months sees their premium jump. Employees are responsible for booking their lab appointment, receiving the lab sample, and then submitting it manually. So that's 2-3 weeks to schedule and make an appointment, followed by at least 4 weeks for the lab's turnaround, followed by time to submit the paperwork from the lab. Great way to raise some rates.
- dahart 8y ago
  That is pretty harsh. I'm personally scared of the future liability and privacy implications of deep screens, especially if it's employment related. Is that irrational or justified? On the other hand, my life insurance company asked for an update on my health, and after I had a blood test, they came back and said I was so healthy they were going to have to cut my rates, and they did massively, by like half. They weren't threatening to raise rates or offering to reduce them, so I guess it felt like a very positive thing. Still worried that somehow the data will be used against me to reject claims when I get old.

Shivetya 8y ago

You cannot even pay people to do them because the first remark back among my coworkers is, they //the company// aren't giving us enough to participate. There were even prizes for some categories for wellness categories, like the steps counting programs for which they gave up counters to weight loss. of course there are other self defeating attitudes available too, from those who won't contribute more than the match for 401k, again the company's fault, to those who take more smoke breaks because of the extra cost on their premiums. I am not sure if its a product of the education system or television. I think schools should focus a bit more on instructing students to better themselves for no other purpose than to improve themselves. that waiting for someone to make you improve yourself is the first step in failing

rorykoehler 8y ago
You couldn't pay me to participate because I categorise it as BS. It's way overstepping the jurisdiction of the employer. FWIW I don't have a problem with weight, diet or exercise.
utnick 8y ago
Maybe paying more is something that should be explored... I think for $500-$1,000 a month per person you would have widespread behavior change in most companies, and it wouldn't really even be that expensive in the context of total healthcare+wellness program spending.
- citrablue 8y ago
  Knock 5% off my insurance premium for every trip to the gym and you better believe I'm going to the gym every day...
  - chillwaves 8y ago
    Seriously. My premium is prob ~$250 a month for a single 30s male. I will go to the gym 3 days a week for a 60% discount. I'll stop eating sugar for the other 40%.

hombre_fatal 8y ago

Some interesting bits to counter the title's face value: > Researchers followed thousands of BJ’s Wholesale Club employees for a year > Nearly all the studies to date had been observational and have largely concluded that the programs save some money for employers. But this study randomly assigned employees to a wellness program and compared their results with those of employees who were not enrolled in such efforts. > Employers looking for a quick reduction in their health care spending will be disappointed It makes sense to me that benefits come on a longer time scale and when employees join the specific programs that interest/apply to them (rather than random assignment).

mirimir 8y ago
Yes. Following people for just a year is ~meaningless. If someone quits smoking, for example, the benefit of reduced lung cancer incidence will show up on decade scale.
- jnwatson 8y ago
  I’m sure the biggest intervention they are hoping for is weight loss. The reduction in insulin/metformin prescriptions would be evident if the program was effective.
  - tomjen3 8y ago
    If they need to lose 30-40 pounds (or more) that might not happen in the 1 year time frame. And don't bother replying and telling me you lost that much weight in less time, I am aware that can be done, but not by small tweaks which these incentives normally give.
0xcde4c3db 8y ago
> when employees join the specific programs that interest/apply to them (rather than random assignment) The problem with this from a study standpoint is that it introduces self-selection bias. A complication for exercise programs in particular is that avoidance of exercise can be caused by cardiovascular and metabolic dysfunction.

iamthepieman 8y ago

the only people i know who take advantage of wellness programs are people who are already doing things well beyond the wellness program requirements. They participate in a variety of sports in all seasons, run 5ks or marathons, ski, bike hike or play organized sports. For them it's just a way to subsidize things they are already doing, maybe get a free fitness tracker or gym membership.

unsignedint 8y ago
I don't think wellness program alone won't be able to make people change their lifestyle. To me, thing that made big difference was access and motivation; particularly for me, easy access to on-site gym (especially with a group class) I transitioned from hating-to-workout to doing 5 days a week in gym, engaging in activities ranging from Yoga to HIIT. I don't know how typical I am, though...
- tlarkworthy 8y ago
  Blood pressure and stamina bump is within days of giving up (I switched to vaping, the feeling of increased vitality was noticable).
coleca 8y ago
Not to mention that these programs are notoriously difficult to actually use as an employee. Some require getting monthly receipts from your gym, then faxing to your healthcare provider, waiting for a check to come in the mail, etc. Look for companies like https://myleon.co/ https://myleon.co/ to disrupt this space and make these programs more effective.

gwern 8y ago

The most interesting thing about this is not that wellness programs don't work (this is the null hypothesis for all interventions, behavioral interventions particularly, and diet/exercise interventions especially) but that it offers a direct examination of 'correlation!=causation': they did the cluster randomized trial, but they also did the naive correlational analysis ignoring the randomization to see how misleading the estimates would be. They compare the estimates side by side in the supplement https://www.gwern.net/docs/statistics/causality/2019-song-supplement2.pdf#page=45 https://www.gwern.net/docs/statistics/causality/2019-song-su... You can see that the estimates are... different. Frequently, the point estimates aren't even the same sign. Self-selection and 'healthy user bias' are very much things. --- This parallels an earlier workplace wellness randomized experiment: https://www.gwern.net/docs/statistics/causality/2018-jones.pdf https://www.gwern.net/docs/statistics/causality/2018-jones.p... which comes with nice graphs/tables comparing & contrasting the correlational vs actual causal effects: https://www.gwern.net/images/causality/2018-jones-table5-nyt-randomizedvscorrelation.png https://www.gwern.net/images/causality/2018-jones-table5-nyt... https://www.gwern.net/images/causality/2018-jones-figure8-randomizedvscorrelationliterature.png https://www.gwern.net/images/causality/2018-jones-figure8-ra... https://www.gwern.net/images/causality/2018-jones-supplement-randomizedvscorrelation-tablea3-ac.png https://www.gwern.net/images/causality/2018-jones-supplement... https://www.gwern.net/images/causality/2018-jones-supplement-randomizedvscorrelation-tablea3-de.png https://www.gwern.net/images/causality/2018-jones-supplement... https://www.gwern.net/images/causality/2018-jones-supplement-randomizedvscorrelation-tablea3-fg.png https://www.gwern.net/images/causality/2018-jones-supplement... https://www.gwern.net/images/causality/2018-jones-table5-correlationvsrandomized.png https://www.gwern.net/images/causality/2018-jones-table5-cor... (I collate a bunch more of these kinds of correlation!=causation results in https://www.gwern.net/Correlation https://www.gwern.net/Correlation as a way of making the point that, empirically and especially when it comes to humans, correlation frequently is not causation, and this is not merely some carping pedantic statistician's complaint, but normal.)

draw_down 8y ago

Heck, maybe it's sort of perverse that employers need to concern themselves with the "wellness" of their employees.

droithomme 8y ago

It's not particularly convincing to track people for only one year on behavior changes that are known from many other studies to yield long term health benefits. And the researchers in this study would know that.

diogenescynic 8y ago

Just give employees more time off. Wellness starts with having work-life balance.

tomjen3 8y ago
Wellness is a corp-term for losing weight, exercising and stop smoking.
- collyw 8y ago
  All three of these are considered to be part of a healthy lifestyle.

sonnyblarney 8y ago

Wellness is incorporated into the daily grind, not some 'other' thing. So decent stress levels, the right kinds of breaks, proper vacays, good managers, not worrying about stuff all the time.

kadendogthing 8y ago

What if we just had less stress and less overall working hours. Which is totally doable given our economic productivity?

homerhomer 8y ago

I'm pretty certain most would benefit from working less, but that's not what these programs offer.

currry 8y ago

I really don't want another game in my life to micromanage my behavior. Diet and exercise are their own rewards. I got a rewards program for everywhere I eat. A miles program got every airline I fly. A tax code with a million subsidies and loopholes. Auto insurance companies who want to stick telematics in my car. Now I have health insurance companies gamifying literally what I eat and how I spend my free time. Just fuck off already.

ruperp 8y ago
Totally agree, it's gotten out of hand. We have too many people with too little to do. And too much money to pay them to do useless things. So they come up with more programs.
collyw 8y ago
On the other hand I look after my health reasonably well. I take very few sick days as a result. It would be nice if my employer showed some sort of recognition of that.
- octokatt 8y ago
  Unfortunately, we don't have a good way to measure the difference between "few sick days due to good health" and "few sick days because came into office sick". Or, for that matter, "many sick days due to unsolvable chronic illness but doing their best" and "many sick days due to eating an entire bag of Doritos during lunch and feeling ill".
- currry 8y ago
  Yeah they'll give you recognition alright - for saving them money by allowing them to pry into your personal life. Maybe it's just working for an international megacorp, but I can tell you with absolute certainty they don't give a shit about my health - except to the extent it affects the bottom line. I'll get my positive recognition from my doctor because it means something from them.
- piva00 8y ago
  You don't need a participation medal in taking care of yourself. Right now you aren't earning more money or being directly rewarded by being healthy but this is a personal investment in your own future, why should anyone else show any form of recognition to a very personal life choice? I do the same, I'm healthy, I go to the gym, I bike to work, my reward is getting older fit while I see people on my age group having more and more issues. Yup, you might be more productive than someone that is unhealthy and taking sick days, etc., at the same time you don't use your paid time off (or have days discounted from your salary, such as here in Sweden) for when you got sick.

WalterBright 8y ago

Place the employee parking lot a mile away from the office.

bariswheel 8y ago

3 day weekends. Solved. 50% longer, 100% better. Treat the disease, not the symptoms.

tonyedgecombe 8y ago
As long as it doesn’t come with 12 hour days.
- collyw 8y ago
  I Honestly think 3 x 12 hour days would be better than 5 * 7.5.
  - cheschire 8y ago
    The amount of creative work that can be accomplished in a day is finite, regardless of the length of the workday. The only way you could shift a work schedule that much is if you substantially change the type of work being done, and accept that you would get less creative work per week while gaining more resources in other areas such as rote tasks or physical labor.
    - xfitm3 8y ago
      Not everyone can produce creative work every day, either.
    - collyw 8y ago
      The vast majority of my work is not particularly creative. Documentation, meetings, replying to emails answering someones question. When get to do some coding its not usually especially complex. Occasionally it is, but I imagine having longer days would be easier to get 4 hours "in the zone", something which happens rarely at present.
  - night815 8y ago
    The problem with only working 3 days is the first day back will be mostly spend getting back in the groove / remembering what you were working on. I am a fan of 5 x 6 hours and 4 x 8 hours.

jamisteven 8y ago

The people who conducted this study should be embarrassed. First off they chose BJ's wholesale, which I would venture to say doesnt have the healthiest of employees on the planet and doesnt represent a good sample. Second, they didnt actually track what the individuals were actually doing, were they eating a diet high in greens and low in processed foods? Were they getting cardio in daily? Were they smoking, drinking excessively? How anyone serious about health, nutrition, or even cost spending could take this study seriously, beyond me.

coleca 8y ago
Why would the study want to target "the healthiest employees on the planet"? That would bias the study. Seems to me they chose a random company (that would agree to participate) with average workers. The whole point would be to see if these programs improve healthcare. Honestly, the majority of BJ's workers work in a giant warehouse store and get a lot of walking in daily as part of their job. (*Source: I'm a former BJ's Wholesale 'team member' although I worked in the office in IT)

C1sc0cat 8y ago

I thought it was to improve peoples health and catch conditions earlier - though I suspect given US health care only healthy people would apply.

loblollyboy 8y ago

No shit

xfitm3 8y ago

I've never worked for an employer that had a program which required you to share data. I have always been able to expense things like gym, mattresses, copays, whatever as part of TC but never data collection.

kaikai 8y ago
You’ve been able to expense things like mattresses at multiple companies? Where are you based?
- xfitm3 8y ago
  Yes, a good nights rest is related to health and wellness. US.

matt_s 8y ago

If employers want to reduce US health care spending, why don't they band together and lobby Congress to introduce legislation to reduce health care costs? I have a gut feeling it is the insurance companies that set ever increasing rates which drive up costs overall. And then they cover less forcing patients to pay out of pocket for anything more than a flu shot. There are other countries with the same quality services for much cheaper costs. Maybe even better quality. Employers would save more money getting the insurance companies to lower rates (via legislation likely) than trying wellness programs.

knightofmars 8y ago

The only employee wellness program that works is one that actually has a time slot (not lunch) during work hours for an employee to exercise. Where the employee is literally being paid to exercise. Be it cycling, weights, walking, etc.