Wellness programs move center stage in healthcare reform efforts

As the healthcare reform debate presses on, a number of new policies and compliance requirements approved as part of the Affordable Care Act (ACA) — and as addendums to existing HIPAA regulations – are already being implemented, or will become effective January 1, 2014.  It is important to be aware of recently adopted federal regulations about wellness programs and how the new regulations may affect your existing wellness program as well as what they mean for those interested in starting a wellness program, says Jennifer Herz, assistant counsel, CBIA.

“Part of federal healthcare legislation is shifting health coverage attention to targeting prevention and promoting healthy behavioral changes,” Herz explains. “Some employers already use wellness programs to support such healthy behaviors and other employers may take advantage of the increased attention to help promote and reward employees for participation in healthy lifestyle programs, goal setting, health screenings and proactive wellness efforts that benefit them and their families.”                            

“Free” preventive care is one of the positive changes already in place. Changes of special interest to small employers address participation in wellness programs, educational outreach, and efforts to increase self-management behaviors.

The bottom line, Herz stresses, is that the new regulations are a good opportunity to remind employers about the benefits of wellness programming to support a healthier workforce, which increases productivity, while also working to reduce premium costs.

What is changing

Wellness programs come in all shapes and sizes, and these programs attempt to address body, mind, and pocketbook, helping employers reduce benefit costs and lost work time, while increasing employee productivity and satisfaction. For example, a wellness program might create incentives to encourage employees to adhere to a particular course of treatment or to otherwise better manage their health.

The Departments of Labor, Treasury, and Health & Human Services have issued final regulations and modifications which, among other things, reflect changes made by the ACA to wellness programs subject to the HIPAA nondiscrimination rules. As a result, companies currently offering wellness programs will need to determine if any design changes are necessary. The regulations are effective for plan years beginning on or after January 1, 2014. Read the final regulation here.             

Click here for an expanded version of this article with additional details on the ACA’s wellness program provisions.

CBIA will continue examining healthcare legislation changes that affect your policies, and will offer periodic ACA updates and explanations of program changes and opportunities. This information will be available through CBIA’s Health Connections Resource Center, cbia.com/healthcare2014.

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