Junkfood Science: Survey says....

April 20, 2007

Survey says....

A press release went out yesterday from Hewitt Associates, a provider of human resources outsourcing and consulting services,” resulting in countless media stories. That in itself isn’t news, of course, but what’s really at work might be.

Hewitt just released the results of its opinion survey of major U.S. employers covering more than 8 million employees, “The Road Ahead: Emerging Health Trends 2007.” They report it revealed that nearly two-thirds of employers surveyed plan to “take more aggressive, multiyear steps to help employees improve their health by increasing education efforts, implementing condition management programs, and using data analysis and other cutting-edge programs to improve health and productivity while holding participants accountable for their behaviors.”

Companies will be rewarding good behavior and compliance with their wellness and management programs, it says:

According to Hewitt’s survey, most companies are not confident that employees have the appropriate skills and knowledge to make educated health care decisions....

More than three-quarters (77 percent) of responding companies are profiling the chronic health conditions prevalent in their workforce in 2007... and between 65 percent and 79 percent of companies gave employees—or planned to give them in 2007—access to targeted condition management or wellness programs through health plans or focused programs. Almost half (48 percent) also offered or planned to offer incentives to employees who participate in wellness or other health-related initiatives....

Almost one-tenth (9 percent) of companies require or plan to require health plans to have pay-for-performance programs in place by the end of the year, and another 56 percent are considering it at a future date.

While these claims will concern any consumer who believes that they and their healthcare provider are better able to decide what’s best for them than an employer, there are indications we should be especially skeptical of this survey and stories like it. As should other employers.

We’ve looked at how opinion polls and surveys are one of the most common tactics used by public relations firms and advertisers to create the bandwagon effect — to sell an idea, shape opinions and create a demand for something by trying to convince us of its popularity. “Everyone else is doing it....” It works with kids and it works with businesses in persuading them they should get on board, too. But it is marketing.

There’s big money to be had in the fast-growing business of wellness, including employer wellness programs — $50 billion a year so far is being made taking advantage of American’s obsession with looking and feeling younger, according to the New York Times. And this figure was only looking at a small aspect, that of alternative modalities, underestimating the full potential of wellness and management programs. They're selling, too, because most consumers have come to believe that good health and longevity are the rewards for good behavior.

Insurers are first in line offering wellness and healthy lifestyle programs as part of the health benefit packages sold to employer groups, and one of the biggest lobbying organizations promoting them to employers is the National Business Group on Health (NBGH) and its Institute on the Costs and Health Effects of Obesity. It was launched in 2003 to, as we’ve learned, convince employers by intense marketing that these interventions mean healthier, more productive employees and, most importantly, will lower healthcare costs for their companies.

When the Institute was launched Helen Darling, president of the NBGH, said:

“The institute is structured specifically for a corporate audience.”... It will serve as a resource for large employers on the health and cost repercussions of obesity and related chronic conditions, and will identify effective strategies, including workplace health promotion efforts, to decrease the incidence of obesity among U.S. workers, she added. In addition, the group will develop and disseminate “clear messages that stress obesity’s preventable nature as well as its role in physical and mental health."”

“Research has shown that the overall impact of obesity on health and costs outweighs even that of smoking," she said. “As a result, no company in America can afford to ignore the problem of obese and overweight employees."

It’s core objectives appear right on schedule. We’re into its fourth year objectives to promote healthy weight and lifestyle programs; sell the benefits of bariatric surgery; and market the costliness and need for lifestyle and drug management of “risk factors,” diabetes and the “metabolic syndrome.”

Which brings us to an important piece of the puzzle. Hewitt Associates was listed as one of the Founding Board Companies of NBGH’s Institute on the Costs and Health Effects of Obesity [page 1 of its 2004 document is pictured] and continues to be an active member of the NBGH, along with nearly 300 large employers and special interests. So, this survey of large employers could be translated to mean it mostly surveyed its own membership, as it appears to reflect NBGH’s larger objectives.

As we know, survey questions can be written and interpreted to promote most anything a pollster desires. Something other than a neutral stance appears visible in the promotional language in the rest of their press release:

According to Hewitt’s survey, companies that plan to take a more active role in the health of their employees report being more focused on health care quality than other employers and are more likely to select plans based on accreditation by organizations such as the National Committee for Quality Assurance (NCQA)....

This enthusiasm also generated interest in a number of other initiatives driven by data and health IT. While almost three-quarters (72 percent) of companies do not anticipate investing time or resources in implementing health IT programs this year, most plan to consider adopting programs such as computerized order entry and computerized clinical decision support tools in the future. In addition, 43 percent believe health plans should provide employees and dependents with portable electronic health records as part of their standard services.

Remember, when we hear in the news “survey says....” it’s usually a commercial.

© 2007 Sandy Szwarc

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