One of the big questions arising from national health care reform is how wellness programs and disease prevention initiatives will be affected.
The comprehensive health care reform legislation includes a robust array of provisions promoting wellness and prevention. Sally Stephens, president of Spectrum Health Systems, says the bill creates a new emphasis on fitness, physical activity, good nutrition and disease prevention — all designed to keep people out of the hospital.
“One of the fundamental challenges facing health care reform is taking a system that has focused on sick care and shifting it to one focused on wellness and prevention,” Stephens says. “By reforming our system to focus on fighting and preventing chronic disease, we have a huge opportunity. We can save hundreds of billions of dollars and dramatically improve the health of Americans.”
Smart Business spoke with Stephens about how health care reform will affect wellness.
How will the new health care reform affect wellness and prevention initiatives?
There are several provisions in the new health care reform that affect wellness:
- The new reform will provide grants for up to five years to small employers that establish wellness programs beginning in 2011.
- It will provide technical assistance and other resources to evaluate employer-based wellness programs, as well as conduct a national survey of worksite health policies and programs to assess employer-based policies and programs within two years of enactment.
- The new reform will permit employers to offer employees rewards in the form of premium discounts, waivers of cost-sharing requirements or benefits that would otherwise not be provided of up to 30 percent of the cost of coverage for participating in a wellness program and meeting certain health-related standards. Employers must also offer an alternative standard for individuals for whom it is unreasonably difficult or inadvisable to meet the standard. The reward limit may increase to 50 percent of the cost of coverage if deemed appropriate effective 2014.
- Last, the new reform will establish 10-state pilot programs by July 2014 to permit participating states to apply similar rewards for participating in wellness programs in the individual market and expand demonstrations in 2017 if effective.
In addition, the law requires chain restaurants and food sold from vending machines to disclose the nutritional content of each item within one year of enactment.
