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  • ACOEM Urges Congressional Budget Office to Focus on Workplace Wellness Programs

    June 22, 2009

    Honorable Kent Conrad
    Chairman, Committee on the Budget
    United States Senate
    Washington, DC 20510

    Dear Mr. Chairman: 

    On behalf of the American College of Occupational and Environmental Medicine (ACOEM), I am writing with respect to the recent analysis of health reform proposals by the Congressional Budget Office (letter from CBO to Sen. Conrad, June 16). The CBO analysis focuses on prevention and wellness programs for the general population but does not consider the impact of such programs in the workplace.

    As the medical society devoted to promoting the health of workers, we believe strongly in the efficacy of workplace wellness and prevention programs in reducing healthcare costs and improving worker productivity and we support them as a fundamental component of health reform. Accordingly, we wish to take this opportunity to suggest areas where the CBO analysis may be refined, and as a result, more fully inform the current debate over health care reform.

    In particular, we believe that the CBO analysis overlooks several key factors:

    • The analysis focuses on prevention and wellness programs for the general population, but does not discuss the impact of these programs in the workplace. This, we believe, is a persistent void in the current health care reform debate, which has failed to recognize the potential power of workforce health in addressing the nation’s long-term health care and economic problems. Enlightened employers are proving that wellness and prevention programs can be structured in a way that brings measurable results – including clear-cut economic benefit beyond personal health. Numerous studies of the financial impact of health and wellness programs in the workplace show strong return on investment. An article reviewing the literature and published in May, 2009, by the American Journal of Health Promotion, for example, found an average ROI of $3 for every $1 invested in employer health-promotion programs and $2 for every $1 invested in employer disease-management programs. Furthermore, those average ROIs across multiple studies were only related to the savings in medical and pharmacy costs and did not account for the savings generated from health-related productivity improvement inthe workforce by reducing absenteeism and increasing worker performance. Please see the attached list of a sampling of these studies, for your information.
    • The CBO analysis does not sufficiently consider how critical a healthy workforce will be to the long-term viability of our Social Security and Medicare systems. Our workforce is aging and increasingly beset by chronic disease – across all age groups. Without a pipeline of healthy, available workers, our social entitlement programs will fail. Therefore, it is essential that we take proactive steps to maintain the health of our national workforce, with programs targeted specifically through the workplace. By doing so, we will keep older workers – and those of any age dealing with chronic disease – working, and out of the Social Security/Medicare system. This is a commonsense policy position that we should begin to apply as quickly as possible. Again, we must not underestimate the power of the workforce as an engine that can help us address the nation’s long-term health care and economic problems.
    • The CBO analysis seems focused on secondary prevention, thus minimizing the cost-effective benefits of primary and tertiary prevention as a part of an overall prevention strategy. Secondary prevention, which consists of detecting and identifying disease in early stages through diagnostic screening tests, biometric testing, and other interventions, is just one part of the prevention and wellness formula. Primary prevention – which focuses on staying healthy and includes health risk reduction, health promotion, health education, immunizations  and other measures aimed at significantly lowering the individual’s likelihood of developing disease -- is very cost effective and is becoming an integral part of successful workplace-centered wellness and prevention programming. Tertiary prevention, which is aimed at limiting complications and restoring function, and includes evidence-based disease management and disability management as well as vocational rehabilitation programs and other workplace measures designed to improve health, enhance performance and keep people gainfully employed, has significant cost-ratio benefits. Again, ACOEM can provide compelling data to illustrate these impacts. Realistic assessments of prevention must include the impact of primary, secondary and tertiary prevention – which, when applied properly in the workplace, yields measurable return on investment.

    ACOEM has distributed to Congress a seven-point action plan for achieving a healthier workforce as a part of our “Healthy Workforce Now” initiative, which I am including with this letter. I urge you to make it a part of your advocacy for health care reform.

    As the health care debate intensifies over the next several months, Congress should consider the distinction between general prevention programs and those targeted at workforce health. There is compelling evidence to prove that targeted, measurable prevention programs in the workplace will yield important benefits to the nation that go far beyond the health of individuals.

    If you would like to discuss the studies referenced in this letter, please contact Patrick O’Connor, ACOEM’s Director of Government Affairs. He can be reached at 202-223-6222 or by e-mail at patoconnor@kentoconnor.com.

    Eisenberg - new.png(4) 
    Barry S. Eisenberg, CAE
    Executive Director, ACOEM


    cc:       Honorable Edward M. Kennedy
                Honorable Michael B. Enzi
                Honorable Max Baucus
                Honorable Charles E. Grassley

    Identical letter sent to the Honorable Judd Gregg