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Penn Staters protest wellness program's steep fines

By Sharon Begley

NEW YORK (Reuters) - Matthew Woessner, associate professor of political science at Pennsylvania State University, doesn't smoke, spends an hour every day on the elliptical trainer and eats (mostly) healthy food. But he draws the line at new "wellness" steps required by his employer, such as filling out a form that asks whether he examines his testicles every month - and paying a $1,200 penalty if he doesn't comply.

An open letter Woessner wrote protesting the university's 2014 wellness requirements has sparked a protest by more than 2,000 faculty and staff employees at Penn State who argue that it is coercive and unethical and ask that it be stopped.

Studies show the $1,200 annual penalty is one of the most severe to be imposed by a U.S. employer, only 2 percent of which use fines alone, rather than rewards, to push staff to undergo medical testing, provide data on their health and otherwise participate in wellness programs.

Most of the opposition to the program focuses on what Woessner calls "the ethical ramifications of coercing employees to turn over private health information" to companies running the wellness program. But he and other faculty members have recently been contacted by experts in workplace wellness, pointing to studies showing that such programs, on average, save employers little, if anything, in healthcare costs and may even increase spending by forcing workers to undergo extra testing and schedule additional doctor visits.

"That gives me the sense that the administration hasn't weighed the program's costs, especially in employee morale and threats to privacy, against its benefits, which might be very small," said Woessner.

"The university is desperately trying to come up with money to cover the worst scandal in higher education (the conviction of coach Jerry Sandusky of sexually molesting children and the resulting $60 million fine and other sanctions). We have to wonder if the $1,200 penalty is a Sandusky tax."

University spokeswoman Annemarie Mountz said the wellness program is "totally unrelated" to the Sandusky sanctions, which are being paid out of a separate budget from the one that covers healthcare, and that the university's 2009 strategic plan included reining in healthcare costs.

Those costs are projected to top $217 million this academic year, $17.7 million more than last year, in a total budget of $4.4 billion. That works out to $5,425 per insured individual, compared with a U.S. average of $9,000. The university, which covers about 40,000 employees at campuses across the state, did not offer an explanation of why its costs are lower. It is self-insured, meaning it pays medical claims out of its own pocket.

'TAKE CARE OF YOUR HEALTH'

Penn State gave its covered employees and spouses until October to comply with two key requirements of the new "Take Care of Your Health" wellness program: complete an online wellness profile from WebMD and undergo a preventive physical, including tests of cholesterol and glucose levels, and measurements of height, weight, and waist circumference.

Employees who fail to do both will have $100 per month deducted from their paycheck.

Penn State is hardly alone in turning to workplace wellness programs to reduce its healthcare spending; 51 percent of employers with more than 50 employees offer one. But results have been disappointing.

In a report requested by Congress and released in May, researchers at the RAND Corp., an independent think tank, found that the programs have only a modest effect on health. Employees who participate in workplace wellness programs lose, on average, one pound a year for three years, for instance, and participation "was not associated with significant reductions" in cholesterol level.

A key determinant in whether a wellness program will yield net savings is how much an employer spends on illnesses - such as smoking-related emphysema - that can be reduced by counseling, preventive care and other elements of wellness.

Averaged across all employees, those "wellness-sensitive events" cost employers $300 per person per year, said Al Lewis, president of the Disease Management Purchasing Consortium International, which helps employers reduce healthcare costs. Because wellness programs are not magic wands - they don't make every smoker quit or every obese person slim - they make only a small dent in that spending, which RAND estimated at $29 per person per year in the first year and $133 in the fourth, "both nonsignificant changes."

Highmark projected that the wellness program would keep cost increases to two percentage points above the rate of medical inflation which is 2.7 percent so far this year.

'INCREASED UTILIZATION'

For Penn Staters, the WebMD survey includes questions that may lead to more healthcare spending. The 12-page form, reviewed by Reuters, asks for data on glucose, cholesterol, weight, about feeling sadness or guilt, experiencing problems with friends or supervisors or finances, and a long list of screenings, all of which can trigger more doctors' visits, invasive tests and surgery that may not improve health.

"You're looking at increased utilization," said Vik Khanna, a healthcare consultant in St. Louis and editor of The Health Care Blog. "There can only be more claims if people fill these out."

More problematic, he said, the questionnaire includes items whose relevance to preventing disease has been dismissed by scientific studies. Women, for instance, are asked if they conduct regular breast exams. Men are asked if they perform regular testicular exams and when they last had a PSA test, which is supposed to detect prostate cancer.

The U.S. Preventative Services Task Force recommends against all three measures. WebMD spokeswoman Kate Hahn said medical groups disagree about the value of various cancer screenings and that WebMD reviews its questionnaire annually, adding or deleting questions "to reflect changes in national standards."

As part of his campaign of "civil disobedience" against Penn State, Woessner is suggesting that employees refuse to have their physical at the mobile vans the university has hired and instead go to their own physician. For his last full physical in 2012, Penn State was billed $421, including $144 for blood work.

If the 2,000 staff (and their families) who signed a Change.org petition protesting the program took Woessner's advice, the university would be hit with more than $1.5 million in additional costs as a result of the wellness mandate.

(Reporting by Sharon Begley; Editing by Michele Gershberg and Douglas Royalty)

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