Letters to the Editor
To the Editor:
In their article, Goetzel and colleagues offer a defense of workplace wellness programs. Because much of their discussion is based on a critique of our previous work, we wanted to comment on their assessment. First and foremost, we do agree that the workplace is an appropriate place to try and improve health-related behaviors. Our research mainly suggests that the current approach that many employers take does achieve this goal, but it does not make good business sense.
Wellness programs today rely heavily on identifying individuals at risk through biometric screening and questionnaires and counseling those individuals on behavior change. We have shown that program participants indeed accomplish significant reductions in health risks, albeit of a modest magnitude.1 But we have also found repeatedly that those changes do not translate into gross savings in the form of lower health care cost or reduced absenteeism, even after 7 years, let alone into net savings in the form of return on investment.2
Our interpretation of the findings is that the effect of the prevailing identification and counseling programs on health risk is too small and the ensuing effect on health care cost too distant to generate savings. Simply speaking, many programs try to address a public health issue with a medicalized intervention. At the same time, we agree with the authors that a systematic effort to instill a culture of health into the workplace has the potential to improve health and reduce cost, but caution that this theoretically attractive proposition has not been validated through empirical research.
In summary, we encourage employers to offer evidence-based and well-implemented wellness programs, but caution that they should watch program cost in relation to program effect closely, just as they do with every other investment.
Soeren Mattke, MD, DSc
Hangsheng Liu, PhD
RAND Health Advisory Services
RAND Corporation, Boston, Mass.
1. Osilla KC, Van Busum K, Schnyer C, Larkin JW, Eibner C, Mattke S. Systematic review of the impact of worksite wellness programs. Am J Manag Care. 2012;18:e68–e81.
2. Liu H, Harris KM, Weinberger S, Serxner S, Mattke S, Exum E. Effect of an employer-sponsored health and wellness program on medical cost and utilization. Popul Health Manag. 2013;16:1–6.