Prevention Matters

The Wall Street Journal reports that recently issued federal guidelines may throw a monkey wrench into the plans of employers who have or are planning to establish wellness rewards programs. The guidelines, aimed at protecting genetic information, prohibit health plans and employers from offering any financial rewards to any worker for participating in a health risk assessment that requests information about their family medical history.

Employers whose health plans aren't in compliance can face fines of up to $500,000. The rules apply to group health insurance with plan years beginning on or after Dec. 7. Employers and insurers have until Jan. 5 to submit comments, which means they could yet be revised.

The Wall Street Journal's Anna Wilde Mathews profiles an initiative by AmeriGas Propane, which requires all employees would to get physical exams preventive screenings. Workers and covered spouses have a year to complete the tests, which are covered 100%, or lose their insurance.

"AmeriGas, based in Valley Forge, Pa., is one of just a handful of companies that have mandated health testing, but benefits consultants say it is at the cutting edge of a growing trend," Mathews writes. "In a February survey by consulting firm Towers, Perrin, Forster & Crosby Inc. 45% of companies said they planned to, or were considering, adding penalties for employees who didn’t participate in wellness activities."

Wellness requirements pose legal questions and raise objections from labor officials. But Mathews notes that, prior to its mandatory program, AmeriGas was facing annual health-expense increases of 10% or more, while its workers had high rates of diabetes and heart disease and only 6% of the enrollees in their health plan had gotten recommended cholesterol checks in the previous 18 months and just 20% had their blood sugar tested.

I know that an untreated chlamydia infection can result in infertility, but many young women do not know. In today's Wall Street Journal, consumer health writer, Melinda Beck, addresses the facts about chlamydia infections and the challenges to getting young women screened routinely. In developing the article Melinda interviewed several members of the National Chlamydia Coalition (www.prevent.org/NCC) which is convened and operated by Partnership for Prevention, in conjunction with the Centers for Disease Control and Prevention.

Susan Maloney
Senior Program Manager
Partnership for Prevention




URL to link to

Has anybody seen the Wall Street Journal column praising the benefits of prevention? Neither have we, and we're starting to suspect such a column doesn't exist. But we sure have seen their columns that take the opposite tack. In the last dozen or so days, in fact, the WSJ has published two columns and two blog postings dismissing prevention as part of health reform.

Was it something we said?

First, there was a June 12 print piece by Janet Adamy entitled "Prevention Efforts Provide No Panacea on Health Costs." On the same date, WSJ printed a blog post by Shirley S. Wang entitled "Does Preventing Disease Really Save Money?" (Her answer: probably not, and it may not even improve health); and a blog post by Peter Landers entitled "Disease Prevention in Germany Is Mostly Good for Doctors." Then there was Abraham Verghese's June 20 column on entitled "The Myth of Prevention."

C'mon, folks, how do you really feel?

The logic employed in these pieces is simplistic - preventive services aren't worth investing in because not all of them save money. But that's concentrating on the hole, not the doughnut.

The fact is that some preventive services DO save money. We reviewed 25 procedures approved by the US Preventive Services Task Force and found that six of them actually saved money while 12 of them were highly cost-effective. We also found five preventive clinical servces that are currently underused that could save an additional 100,000 lives a year if they were broadly utilized. Three of those services save money, while the other two are highly cost-effective.

Which raises another problem with the logic in the WSJ columns. A preventive service doesn't have to save money to provide value to the health care system. Many of the procedures that don't save money still deliver significant health benefits for the dollars spent.

Using logic like that employed in the WSJ columns, the owners of Major League Baseball teams wouldn't invest in hitters, because even the best of them get a hit less than a third of the time they go to the plate. In reality, of course, those owners look not at the hits the players don't get, but at the hits they DO get - how many homers they hit, how many runs they drive in, how many put people in scoring position - and they invest in the players that give them the most bang for the buck.

Perhaps there's a lesson there for health care... and for the WSJ.

Safeway CEO Stephen Burd says well-designed health-care reform, utilizing market-based solutions, "can ultimately reduce our nation's health-care bill by 40%."

In an op-ed in today's Wall Street Journal, Burd says Safeway implemented such a plan for its workers in 2005. Since then, he says "we have kept our per capita health-care costs flat (that includes both the employee and the employer portion), while most American companies' costs have increased 38% over the same four years."

"The key to achieving these savings is health-care plans that reward healthy behavior," he says. Burd is a member of Partnership for Prevention's "Leading by Example" initiative.

The Wall Street Journal's Anna Wilde Mathews reports that coding errors on health care provider bills are increasingly providing an unwelcome surprise to patients who try to take advantage of preventive screening that is covered by their employers' health plans.

Pharmaceutical company Johnson & Johnson has decided to drop plans to start a separate wellness and disease-prevention unit, the company's chief financial officer told the Wall Street Journal in an interview.