Sources: The New York Times, January 18, 2016
A New York Times Op-Ed column authored by Harald Schmidt, PhD, discusses the practice of employers and health plans incentivizing women to get mammograms. Since the pros and cons of getting a mammogram can be complicated, depending on age and risk profiles, he suggests that employers and health plans should instead offer incentives that reward the use of online decision aids which are based on the best available scientific evidence. In short, he writes "Don’t pay women to get mammograms — pay them to use a tool to decide whether they should get mammograms."
Source: NPR KERA News, March 5, 2014
Harald Schmidt spoke with NPR Dallas about cost savings for workplace wellness programs. Even though a number of studies show little cost savings for prevention, employers are still searching for the right incentives. Harald notes that gamified corporate wellness programs that use rewards could be effective but he warns that we don't want to make people dependent on these financial winnings, rather, we want them to develop healthy habits that will be in their own and their employer's best interest.
In response to low participation rates in their wellness program, Penn State is switching from carrots to sticks. Starting January, they will charge a $100 monthly surcharge to employees that haven't filled out their health screening forms and gotten a physical exam. Harald Schmidt says that unfortunately, due to lacking reporting requirements, it is difficult to learn from the range of natural wellness incentive experiments that employers conduct.
Source: Reuters, August 10, 2013
In response to the rapidly growing employer wellness-based incentive program market, Weight Watchers is planning to commit more resources to it's workforce division. This division, called Health Solutions, partners with corporations to create incentive programs with Weight Watchers. Although the market appears to be growing, employers are not required to report participation in these programs, so it is hard to gather exact data, said Harald Schmidt.
The August Issue of Medical Ethics Advisor brings up the key ethical issue of whether responses to obesity should focus on societal level, individual level or both. Harald Schmidt spoke about how “we need action at both the social and individual level, but we must take care not to penalize people unduly.”
Source: Financial Times, June 20, 2013
The use of penalties for employee non-participation in wellness programs has more than doubled in the US from 2009 to 2011. Penalties to drive reductions in smoking or obesity raise ethical questions, says Harald Schmidt. “In principle there would be nothing wrong if it was equally easy for all to comply with conditions,” he says. “But because that’s questionable for smoking, just as for obesity, real fairness issues are raised.”
The New England Journal of Medicine featured two perspective essays about the smoker hiring ban by two groups of Penn researchers. David Asch, Kevin Volpp and Ralph Muller highlight the reasons an employer would want to implement a no-smoking policy for new hires in their article "Conflicts and Compromises in Not Hiring Smokers." The opposing article, written by Harald Schmidt, Kristin Voigt and Ezekiel Emanuel, points out the ethical issues behind the ban in their article "The Ethics of Not Hiring Smokers."
A new Commonwealth Fund issue brief examines a study by Harald Schmidt and colleagues evaluating a German wellness program. While German wellness programs show cost-saving potential, participation in the programs is less likely among those with low incomes or poor health. As the Affordable Care Act allows for incentive increases in employer wellness programs, these researchers caution that the programs should be monitored very carefully.
In a Cincinnati Business Courier report addressing company hiring decisions, Harald Schmidt comments that employers have a key role to play in helping their workers develop healthier behaviors, and abrogating responsibility by not hiring smokers and obese people is not sufficient.
In an interview regarding workplace wellness programs, Harald Schmidt offered that in order for a program to be truly effective, it needs to look at several factors including better health, cost savings and participation. He also commented that since programs are becoming more common, we ideally should expect to see health improvement and not just cost savings and improved productivity.
Harald Schmidt was interviewed about the empirical evidence behind employee heath care incentive programs. He stressed that finding out what works and what does not work is of major importance and he also describes some potential problems that could arise.
Harald Schmidt's article entitled "Wellness Incentives, Equity and the Five Groups Problem" describes how employees that are offered wellness incentives belong to one of five groups: "the lucky ones," the "yes-I-can" group, the "I'll-do-it tomorrow" group, "the unlucky ones," and the "leave me alone" group. He offers insight on how policymakers can respond to the inequalities that exist among the groups.
In an article describing the growing trend of employer-levied penalties for employees with health issues such as obesity, high cholesterol, or who smoke, Harald Schmidt noted that such programs place a higher burden on low-paid workers, who are typically poorer and have less access to exercise facilities and fresh produce.