[{"innerBlocks":[],"name":"core\/freeform","postId":2851,"blockType":{"name":"core\/freeform","keywords":[],"attributes":{"content":{"type":"string","source":"raw"},"lock":{"type":"object"}},"providesContext":[],"usesContext":[],"selectors":[],"supports":{"className":false,"customClassName":false,"reusable":false},"styles":[],"variations":[],"apiVersion":3,"title":"Classic","description":"Use the classic WordPress editor.","category":"text"},"originalContent":"Employer-sponsored wellness programs are getting high praise for helping to motivate employees to make healthier lifestyle choices, thereby preventing serious illnesses and reducing healthcare costs. However, critics say privacy protections for some employees are being violated by these programs, which are predicated on workers sharing their health data.

On Thursday, the Senate Health, Education, Labor and Pensions Committee conducted a hearing to determine how successful these programs are in enabling employees to lead healthier lives and to figure out how they can be improved as well as expanded. However, privacy issues surrounding health information remain a vexing issue, experts say.

\u201cMany employers have developed wellness programs to incentivize people to make healthier choices,\u201d said Sen. Lamar Alexander (R-Tenn.), chairman of the committee. \u201cThese programs may reward behaviors such as exercising, eating better or quitting smoking, or offer employees a percentage off their insurance premiums for doing things like maintaining a healthy weight or keeping their cholesterol levels in check.\u201d

As part of the Affordable Care Act, Alexander pointed out that employers can offer financial incentives to their employees to encourage participation in wellness programs\u2014in fact, he added \u201cit was one of the only parts of the ACA on which nearly everyone agreed.\u201d

With about 60 percent of insured Americans getting health coverage from their employers, Alexander concluded that \u201cit is hard to think of a better way to make a bigger impact on the health of millions of Americans than to connect the consensus about wellness to employer-based insurance for 178 million people.\u201d

Also See<\/b>: UnitedHealthcare expands device wellness program to 40 states<\/a>

Michael Roizen, MD, chief wellness officer at the Cleveland Clinic, told the committee that nine years ago the healthcare organization began an \u201cambitious experiment\u201d to improve the health and wellness of its employees and their families. Under the Cleveland Clinic\u2019s Healthy Choice incentive program, he said employees choose to voluntarily participate and are rewarded for reaching several wellness and medical outcomes.

\u201cWe pay employees\u2014that is, we incentivize employees,\u201d testified Roizen, noting that not only is the program voluntary but it also decreases income inequality caused by the rise in out-of-pocket and employer insurance costs.

\u201cThe 62 percent of Clinic employees who voluntarily participate in the program have seen their healthcare costs and premiums decrease now by $600 for individuals and $2,000 annually for families,\u201d he added. \u201cIt\u2019s entirely voluntary.\u201d

Steve Burd, CEO of healthcare solutions vendor Burd Health and former CEO of supermarket chain Safeway, also emphasized that the wellness program he helped to implement was \u201ccompletely voluntary\u201d and that 85 percent of the company\u2019s employees and 70 percent of spouses opted into program. \u201cWe rewarded on outcomes, not participation,\u201d added Burd.

However, ranking member Sen. Patty Murray (D-Wash.) and other Senate committee members expressed their concerns that employer-sponsored wellness programs could impose significant financial penalties on workers who do not wish to share their protected health information.

In particular, she took the Equal Employment Opportunity Commission to task for its 2016 regulations on employee wellness programs which provided that an employee\u2019s decision not to participate in a wellness program was voluntary \u201cso long as the employee did not have to pay a penalty greater than 30 percent of the cost of health insurance\u2014in other words, thousands of dollars.\u201d

Murray said that high of a penalty is a \u201cproblem\u201d for the millions of employees and their spouses who choose to exercise their privacy rights and decline to provide sensitive health information such as the existence of a disability or genetic disorder.

\u201cWhat the law says is that revealing information has to be voluntary\u2014and, telling people that it will cost you $1,500 if you don\u2019t reveal very sensitive medical information, I think stretches the bounds of what constitutes voluntary,\u201d exclaimed Sen. Elizabeth Warren (D-Mass.).

According to Jennifer Mathis, director of policy and legal advocacy at the Bazelon Center for Mental Health Law, employees who want to participate in these wellness programs are asked \u201cabout all manner of health and medical information on a variety of levels of detail.\u201d Mathis said employers ask employees about diagnoses for cancer, heart disease, high blood pressure, sexually transmitted diseases and stroke, as well as pregnancy status and treatments for depression or bipolar disorder.

\u201cWe need to make sure we find the right balance for wellness programs that protects workers\u2019 rights under the Americans with Disabilities Act (ADA), HIPAA and the Genetic Information Nondiscrimination Act (GINA)\u2014three laws that were written and passed by this committee,\u201d added Murray.

While the ACA allows employers to offer premium discounts to employees who participate in wellness programs, Warren cautioned that Obamacare does not eliminate the protections already in federal law. Employers \u201ccannot discriminate against their employees on the basis of genetic information, health status, or disability.\u201d

Likewise, Mathis argued that workplace protections\u2014especially privacy protections\u2014provided by the ADA and GINA must be enforced.

\u201cPeople with disabilities need these protections,\u201d said Mathis, who also testified on behalf of the Consortium for Citizens with Disabilities. \u201cIt is particularly important to ensure that employer-based wellness programs are implemented in ways that promote healthy behaviors without eroding longstanding and critical workplace protections for people with disabilities.\u201d

However, she pointed out that the EOC last year \u201csignificantly rolled back\u201d protections it had previously enforced ensuring that employers could not penalize employees for declining to provide their health information as part of a wellness program.

\u201cThe agency instead permitted steep financial penalties for employees who choose to keep their health information private and more steep penalties if their spouses chose to keep their health information private, making this choice far from a voluntary one for many people,\u201d added Mathis.

According to Mathis, a federal judge has since ruled that the EEOC violated the law and failed to provide a reasoned justification for this change in position.

\u201cThe agency now has an opportunity to revisit its regulations and do the right thing to afford people the rights guaranteed by the ADA and GINA,\u201d she concluded. \u201cThe most important thing for the EEOC to remember is that their job is to apply the ADA and not to rewrite it.\u201d

For his part, Burd said that Safeway employed 10,000 people with disabilities out of a total workforce of 185,000 employees, of which 2,000 participated in the wellness program. \u201cThe HIPAA regs, when I say they\u2019re well thought out, allow for\u2014and frankly require\u2014that if the standard that you\u2019ve set is judged to be too difficult, that you adopt a different standard and even provide a waiver,\u201d he said, adding that about 3 percent to 4 percent of Safeway\u2019s disabled employees received a waiver or alternative standard.

When pressed by Warren, Burd insisted that Safeway had never been accused of discrimination during the 10-year life of the program.

David Asch, MD, a professor at the University of Pennsylvania\u2019s Perelman School of Medicine and executive director of Penn\u2019s Center for Health Care Innovation, presented a more mixed view of such employee wellness programs. According to Asch, these programs are often overstated and risk treating some employees unfairly.

\"Most large companies are using financial incentives to encourage healthy behaviors\u2014the vast majority of them do so by adjusting the premiums their employees pay for their health insurance,\u201d Asch testified. \u201cIn general, the key fairness question is this: How much can the behaviors we most want to target be modified through incentive programs and how much are we just punishing the people with those behaviors?\u201d

Nonetheless, Asch said he remains \u201coptimistic about these programs, because we are learning how to design them to be much more effective and much more fair.\u201d","saveContent":"Employer-sponsored wellness programs are getting high praise for helping to motivate employees to make healthier lifestyle choices, thereby preventing serious illnesses and reducing healthcare costs. However, critics say privacy protections for some employees are being violated by these programs, which are predicated on workers sharing their health data.

On Thursday, the Senate Health, Education, Labor and Pensions Committee conducted a hearing to determine how successful these programs are in enabling employees to lead healthier lives and to figure out how they can be improved as well as expanded. However, privacy issues surrounding health information remain a vexing issue, experts say.

\u201cMany employers have developed wellness programs to incentivize people to make healthier choices,\u201d said Sen. Lamar Alexander (R-Tenn.), chairman of the committee. \u201cThese programs may reward behaviors such as exercising, eating better or quitting smoking, or offer employees a percentage off their insurance premiums for doing things like maintaining a healthy weight or keeping their cholesterol levels in check.\u201d

As part of the Affordable Care Act, Alexander pointed out that employers can offer financial incentives to their employees to encourage participation in wellness programs\u2014in fact, he added \u201cit was one of the only parts of the ACA on which nearly everyone agreed.\u201d

With about 60 percent of insured Americans getting health coverage from their employers, Alexander concluded that \u201cit is hard to think of a better way to make a bigger impact on the health of millions of Americans than to connect the consensus about wellness to employer-based insurance for 178 million people.\u201d

Also See<\/b>: UnitedHealthcare expands device wellness program to 40 states<\/a>

Michael Roizen, MD, chief wellness officer at the Cleveland Clinic, told the committee that nine years ago the healthcare organization began an \u201cambitious experiment\u201d to improve the health and wellness of its employees and their families. Under the Cleveland Clinic\u2019s Healthy Choice incentive program, he said employees choose to voluntarily participate and are rewarded for reaching several wellness and medical outcomes.

\u201cWe pay employees\u2014that is, we incentivize employees,\u201d testified Roizen, noting that not only is the program voluntary but it also decreases income inequality caused by the rise in out-of-pocket and employer insurance costs.

\u201cThe 62 percent of Clinic employees who voluntarily participate in the program have seen their healthcare costs and premiums decrease now by $600 for individuals and $2,000 annually for families,\u201d he added. \u201cIt\u2019s entirely voluntary.\u201d

Steve Burd, CEO of healthcare solutions vendor Burd Health and former CEO of supermarket chain Safeway, also emphasized that the wellness program he helped to implement was \u201ccompletely voluntary\u201d and that 85 percent of the company\u2019s employees and 70 percent of spouses opted into program. \u201cWe rewarded on outcomes, not participation,\u201d added Burd.

However, ranking member Sen. Patty Murray (D-Wash.) and other Senate committee members expressed their concerns that employer-sponsored wellness programs could impose significant financial penalties on workers who do not wish to share their protected health information.

In particular, she took the Equal Employment Opportunity Commission to task for its 2016 regulations on employee wellness programs which provided that an employee\u2019s decision not to participate in a wellness program was voluntary \u201cso long as the employee did not have to pay a penalty greater than 30 percent of the cost of health insurance\u2014in other words, thousands of dollars.\u201d

Murray said that high of a penalty is a \u201cproblem\u201d for the millions of employees and their spouses who choose to exercise their privacy rights and decline to provide sensitive health information such as the existence of a disability or genetic disorder.

\u201cWhat the law says is that revealing information has to be voluntary\u2014and, telling people that it will cost you $1,500 if you don\u2019t reveal very sensitive medical information, I think stretches the bounds of what constitutes voluntary,\u201d exclaimed Sen. Elizabeth Warren (D-Mass.).

According to Jennifer Mathis, director of policy and legal advocacy at the Bazelon Center for Mental Health Law, employees who want to participate in these wellness programs are asked \u201cabout all manner of health and medical information on a variety of levels of detail.\u201d Mathis said employers ask employees about diagnoses for cancer, heart disease, high blood pressure, sexually transmitted diseases and stroke, as well as pregnancy status and treatments for depression or bipolar disorder.

\u201cWe need to make sure we find the right balance for wellness programs that protects workers\u2019 rights under the Americans with Disabilities Act (ADA), HIPAA and the Genetic Information Nondiscrimination Act (GINA)\u2014three laws that were written and passed by this committee,\u201d added Murray.

While the ACA allows employers to offer premium discounts to employees who participate in wellness programs, Warren cautioned that Obamacare does not eliminate the protections already in federal law. Employers \u201ccannot discriminate against their employees on the basis of genetic information, health status, or disability.\u201d

Likewise, Mathis argued that workplace protections\u2014especially privacy protections\u2014provided by the ADA and GINA must be enforced.

\u201cPeople with disabilities need these protections,\u201d said Mathis, who also testified on behalf of the Consortium for Citizens with Disabilities. \u201cIt is particularly important to ensure that employer-based wellness programs are implemented in ways that promote healthy behaviors without eroding longstanding and critical workplace protections for people with disabilities.\u201d

However, she pointed out that the EOC last year \u201csignificantly rolled back\u201d protections it had previously enforced ensuring that employers could not penalize employees for declining to provide their health information as part of a wellness program.

\u201cThe agency instead permitted steep financial penalties for employees who choose to keep their health information private and more steep penalties if their spouses chose to keep their health information private, making this choice far from a voluntary one for many people,\u201d added Mathis.

According to Mathis, a federal judge has since ruled that the EEOC violated the law and failed to provide a reasoned justification for this change in position.

\u201cThe agency now has an opportunity to revisit its regulations and do the right thing to afford people the rights guaranteed by the ADA and GINA,\u201d she concluded. \u201cThe most important thing for the EEOC to remember is that their job is to apply the ADA and not to rewrite it.\u201d

For his part, Burd said that Safeway employed 10,000 people with disabilities out of a total workforce of 185,000 employees, of which 2,000 participated in the wellness program. \u201cThe HIPAA regs, when I say they\u2019re well thought out, allow for\u2014and frankly require\u2014that if the standard that you\u2019ve set is judged to be too difficult, that you adopt a different standard and even provide a waiver,\u201d he said, adding that about 3 percent to 4 percent of Safeway\u2019s disabled employees received a waiver or alternative standard.

When pressed by Warren, Burd insisted that Safeway had never been accused of discrimination during the 10-year life of the program.

David Asch, MD, a professor at the University of Pennsylvania\u2019s Perelman School of Medicine and executive director of Penn\u2019s Center for Health Care Innovation, presented a more mixed view of such employee wellness programs. According to Asch, these programs are often overstated and risk treating some employees unfairly.

\"Most large companies are using financial incentives to encourage healthy behaviors\u2014the vast majority of them do so by adjusting the premiums their employees pay for their health insurance,\u201d Asch testified. \u201cIn general, the key fairness question is this: How much can the behaviors we most want to target be modified through incentive programs and how much are we just punishing the people with those behaviors?\u201d

Nonetheless, Asch said he remains \u201coptimistic about these programs, because we are learning how to design them to be much more effective and much more fair.\u201d","order":0,"get_parent":{},"attributes":[],"attributesType":{"content":{"type":"string","source":"raw"},"lock":{"type":"object"}},"dynamicContent":""}]

Employee wellness programs under fire for privacy concerns

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