Comment by cc438 | Hacker News Reader

Comment by cc438 | Hacker News Reader

I've always been told that wellness programs existed to obtain discounts from the insurance providers, akin to "honor roll" discounts with car insurance. As long as you have the bare minimum to qualify, you get a nice chunk of $$$ chopped off your rate.

I get that plenty of rate modifiers have strong links to driving safety like age and marriage status. However, in my limited opinion, there's no way "honor roll" has anything but the weakest link to safe driving as the barrier to achievement varies drastically on a school-to-school basis. Insurance companies are data driven but data (especially healthcare data) lags so long that I wouldn't be surprised if discounts for running a wellness program were founded purely in speculation. This article seems to back that assumption with hard proof as well.

Large employers are generally self-funded, meaning that they pay their healthcare claims dollar-for-dollar. Blue Cross (or whomever) serves as a claims administrator and takes a premium for the service, but may not provide any actual "insurance" with respect to the company (some have maximum per-year and maximum per-employee caps to the company but they aren't usually triggered by the sorts of things that wellness programs address).

Big companies hope that wellness programs really will decrease healthcare spend and increase morale --- chronic conditions like diabetes and smoking do have a disproportionate impact on the healthcare bottom line. That said, once-off specialty conditions (cancer, heart surgery, etc.) have an even bigger impact and aren't addressed by this.

The big items are also probabilistic events likely related to a lot of underlying health circumstances. If cancer or heart surgery can be merely delayed a year through the wellness program, then that may just be the year the employee retires or switches jobs and goes onto a different health insurer.

These things are so incredibly expensive that even a small shift in them could be worth a considerable amount of dollars per worker. And that's not even considering productivity benefits (which are in turn so hard to quantify we'll almost always be talking about gut feelings on this issue.)

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