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Paul Carroll, CEO

Editor's Note by Paul Carroll

I got what I wanted for Christmas — and I’m not even talking about the Mean Joe Greene jersey that my daughters bought this Pittsburgh native. What I got was a response from a prominent proponent of workplace wellness programs, something that regular readers of this column know I’ve been requesting for quite a long time.

The column, from Ron Goetzel of Truven Health Analytics and the Johns Hopkins University Bloomberg School of Public Health, carefully lays out the areas where he agrees with and disagrees with the sorts of criticisms that Al Lewis, Vik Khanna and Shana Montrose laid out in an ITL article, “Workplace Wellness Produces No Savings.” 

At the risk of inserting myself too much into the debate, I think there is an emerging area of common ground that includes three important points:

  1. Claims of return on investment (ROI) for corporate wellness programs should not be the focus. Goetzel says that ROI can be generated in well-designed and -executed programs but that focusing on ROI misses the broader point, which should be helping employees improve their health. Lewis, Khanna and Montrose argue that claims of ROI are a sham. In either case, both proponents and opponents now say ROI (and, by extension, claims of increased productivity) should not be the focus for buyers and should not be the major selling point for vendors.
  2. Wellness programs can lead to overdiagnosis and overtreatment that can increase costs while doing workers no good. Again, the two sides only go so far in their agreement. Goetzel says the problems can be avoided in well-designed programs, while Lewis and Khanna at least imply in numerous pieces on ITL that the problems are present in almost all wellness programs and harm workers.
  3. Some types of  incentives now being used simply don’t work. People resent being punished for not participating in wellness programs, and personal motivation matters far more when it comes to health than do any incentives that employers can offer.  Again, Goetzel seems to believe that the problem with incentives is marginal and can be avoided, while Lewis and Khanna believe that the problem is fundamental to wellness programs. Both sides agree that those with chronic diseases — who are highly motivated to improve their health — can be helped significantly through approaches that come from the discipline of disease management.

This area of agreement, if widely accepted among wellness vendors and understood by buyers, would create important change. But lots of areas of disagreement remain. So I hope the debate will continue.

This is exactly the sort of discussion we want to have at ITL: Someone puts an idea forward, has it challenged, responds, is challenged again and so on until a battle-hardened strategy emerges that helps take the insurance and risk management industry in important new directions.

I invite not only Goetzel, Lewis, Khanna and Montrose to continue the discussion but hope all of you will either contribute articles or will add your thoughts in the comments sections at the end of others’ pieces.

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Paul is the CEO and editor-in-chief of Insurance Thought Leadership. He is also co-author of The New Killer Apps: How Large Companies Can Out-Innovate Start-Ups and Billion Dollar Lessons: What You Can Learn From the Most Inexcusable Business Failures of the Last 25 Years and the author of Big Blues: The Unmaking of IBM, a major best-seller published in 1993. Paul spent 17 years at the Wall Street Journal as an editor and reporter.


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