|
|||
|
|
|
||||||
|
Many Wellness Programs Not Cost Effective
It may be true that an ounce of prevention is worth a pound of cure, but medical-prevention initiatives don't always translate into cost savings. In fact, according to a recent article published in the health policy journal Health Affairs, preventive intervention against some chronic diseases actually costs more than treatment. The article, entitled "Preventing Chronic Disease: An Important Investment, But Don't Count on Cost Savings," studied the cost-effectiveness of such diseases as hypertension, heart disease and diabetes. It concluded that in most cases, traditional treatment is more cost effective than preventive intervention. The author, Dr. Louise B. Russell, focuses strictly on medical costs associated with treatment compared to prevention and excludes factors such as workforce productivity as a measurement of cost benefits. According to Russell, cost-effectiveness analysis began to emerge in health and medicine in the 1970s. She cites a 1976 study on hypertension, which found that accumulated costs for treating high-blood pressure are greater than the savings, because not everyone who must take medication for the rest of their lives is at the greatest risk of heart disease or stroke to begin with. The distinction between cost-effectiveness and cost savings is important, says Russell, a research professor in the Institute for Health and a professor in the Department of Economics at Rutgers University in New Brunswick, N.J. "Cost-effectiveness used to mean cost-saving," she says. "It doesn't anymore. Now, we say, 'cost-saving' when it reduces cost, and 'cost-effective' when we decide that what we get is what we pay for." Russell says employers that pursue wellness initiatives should be more selective about creating programs that will actually save money for the company. "I think employers need to realize that they can't just say, 'Oh yes, if it's prevention, then by all means, go ahead and do it,' " she says. Smoking-cessation programs, she says, are very cost-effective, while other initiatives, such as annual Pap smears, are not cost-effective because they could be performed once every two to three years. While she doesn't dispute Russell's findings, Dr. Nina Taggart, corporate medical director and vice president of clinical programs for Wilkes-Barre, Pa.-based AllOne Health, which offers employee-assistance programs, says she hopes employers won't misinterpret Russell's findings to mean that wellness programs don't work. "The Health Affairs article measures cost-effectiveness purely by looking at medical-care costs," says Taggart. "Value is found not just through reductions in direct medical costs, but also in increased safety and productivity and decreased absenteeism." Russell, who has studied cost-effectiveness in medical prevention programs for more than 20 years, says that, while some prevention provides value, others are "enormously expensive." Employers need to choose wisely when they consider prevention programs for their workforce, she says. Prevention should be tightly focused on potential diseases and individuals at greatest risk, rather than covering broad sectors. Taggart agrees that HR should use wellness programs to carefully target groups as well as weigh the costs of initiatives against the value the employer expects to receive. "I think the employer needs to look at the population and say, am I doing the best things for the population to create a healthy environment, and am I taking every advantage of opportunities to create these low-cost interventions," she says. But Taggart adds a perspective that she says is also absent from Russell's findings: the potential costs associated with avoiding wellness initiatives for employees, particularly in an aging workforce. "Wellness and disease-management efforts help employers achieve more value for their total benefits package," she says.
July 23, 2009 Copyright 2009© LRP Publications |
||||||
Print
Email
Write to the Editor
Reprints
|
||||
|
||||
|
||||
|
© Copyright 2010 LRP Publications. All rights reserved.
|
||||