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When a Harvard professor recants her research on ROI, you know wellness programs are doomed
Professor Katherine Baicker is a rising star in the health services research firmament. Only 42, she is already a full professor at the Harvard School of Public Health. She recently enhanced her reputation immeasurably by analyzing what happens to clinical outcomes when a state provides Medicaid to the uninsured, a study that became popular upon publication.
Much to the detriment of the wellness industry, Baicker is also honest. A comment she made on the July 24 Marketplace broadcast torpedoed the field’s credibility. She said, “It’s too early to tell” whether workplace wellness programs save money, joining a chorus of others-including the RAND Corporation-reaching similar conclusions about this 30-year-old industry.
But here’s why her comment matters: it essentially recanted her own findings in the most important academic paper ever published in support of the wellness industry, “Workplace Wellness Programs Can Generate Savings,” published in Health Affairs in January 2010.
That meta-analysis concluded that workplace wellness provided a 3.27-to-1 return-on-investment, a number both precise enough to imply definitiveness and high enough to provide cover for those who wanted wellness provisions (meaning the ability to penalize unhealthy workers and hence reduce employer-paid health insurance costs) included in the Patient Protection and Affordable Care Act (PPACA).
The 3.27 ROI became a well-cited figure, appearing in scholarly articles 187 times since it was published in 2010.
Why is the industry continuing almost exclusive emphasis on this single number in this single article? Because in the intervening three or so years nothing else of great significance happened. No article in any respected journal has ever confirmed Baicker’s 2010 findings. Quite the contrary, many negative articles have cast doubt upon the value of wellness, including questions that large employer Safeway had made up its iconic wellness savings figure.
Baicker, no doubt with her legacy in mind, wisely distanced herself from the debate generated by her own research in the first place. “It’s not my area of research,” she tells me.
So where does that leave the wellness industry advocates? Having lost their only independent financial justification with nothing to fall back on other than case studies of Johnson and Johnson, they have also lost control of the dialog: Reuters, the Wall Street Journal, Bloomberg, Forbes and now even Health Affairs have joined RAND in finding no savings. As cited in Health Affairs, it turns out savings from intrusive workplace biometric screens are mathematically impossible to achieve.
Perhaps it’s time for the entire industry to recant and recast themselves in a more legitimate and supportable incarnation. Until then, if you think you saved money, you didn’t: Re-check your own numbers and make a mid-course correction. If Baicker can do it, so can you.
Al Lewis, a population health program validation and procurement consultant, is author of the award-winning bookWhy Nobody Believes the Numbers and co-author with Tom Emerick of Cracking Health Costs: How to Cut Your Company’s Health Costs and Provide Employees Better Care