Viewpoint: 3 Questions to Ask Wellness Program Providers

Verify claims about program effectiveness

By Linda K. Riddell July 19, 2019
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A growing number of wellness program vendors are making sweeping claims about how their offerings will increase productivity, lower absenteeism, reduce medical claims and vastly improve employees' health. Buyer beware.

To help sort fact from fiction, here are three questions to ask wellness program providers.

1. Validating Results
Question: Can you show how this program has led to the results you are promising?

Tip: Demand objective proof from an independent source such as a peer-reviewed journal.

Conventional wisdom—especially when it comes to wellness programs—is often at odds with science. For example, the conventional wisdom is that because early cancer detection leads to more-successful treatment and lower costs for the patient, then the more screening the better. The science says that widespread screening, especially testing more often than experts recommend, not only can be harmful to health but also generates medical bills for unnecessary care.

The lesson here is: Don't rely on conventional wisdom to tell you what the results should be. Ask for peer-reviewed, published articles on the program or on a similar program.

Even if a program claims to be new and cutting-edge, few programs are truly unique, and chances are something similar has been studied. Consider a program that claims to have a new way to deliver patient education. While the avenue of delivery may not have been studied, the effect of having better-educated patients has been widely researched.

Using those studies, you can determine that educated patients are more likely to choose noninvasive care, but you will be hard-pressed to find research showing that patient education leads them to be more productive at work or more loyal to their employer.

2. Gathering Data
Question: What data are you gathering to measure your results?

Tip: A superior wellness program has a plan for gathering data that is directly tied to the results being measured.

Lots of programs claim to boost productivity or reduce costs but have no data to prove this. Unless no one will be asking you to justify the program's cost, you'll want data to demonstrate results. And that means having a data-gathering plan.

Data gathering can be as simple as sending a two-question survey to employees and asking if they've changed their behavior after participating in a wellness program. Or it can be as complex as amassing medical, pharmacy and attendance records to see if a care management program actually lowered medical costs and illness absences.

Beware: Having a lot of data is not the same as having a measurable result. Knowing how many times a participant visited a health website, for instance, does not tell you about the program's impact.

[SHRM members-only how-to guide: How to Establish and Design a Wellness Program]

3. Doing the Math
Question: How is that data put together to show the program's return on invesment?

Tip: There is a map—called technical specifications—that leads from data to a measurable health finding. If your program vendor has no map, you have no results.

A final step is organizing data on program results such that you can compare it with groups similar to your employees. This is not as simple as, for example, adding up the number of hospital stays or emergency department visits.

There are published health specifications from national organizations, and the program vendor should be able to cite one of these published measures when reporting how employees in its program improved compared to the other populations.

For example, the Healthcare Effectiveness Data and Information Set (HEDIS) publishes health measure specs. If the vendor tells the employer "We use HEDIS's measure for 30-day hospital readmissions," then the employer knows that the measure was done correctly and can be compared to other employee populations whose health was gauged using the same HEDIS measure.

Employers should easily be able to get the details about how the measure was constructed, either from a national measure steward or from the vendor. If, however, the vendor claims its health measures use a "secret sauce," rest assured that it does not know how to measure results. There are no secrets in compiling valid measures.

Don't Stand for Excuses

Posing these three questions and refusing to accept "yeah, but" excuses from vendors will help you adopt high-value, high-impact programs. You may find your inbox a little lighter, too, when word gets out that vendors have to prove their mettle to earn your business.


Linda K. Riddell is a population health scientist for the Validation Institute, which reviews vendors' outcomes and validates them.


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