3 employee benefits to ditch

Most opinions expressed in this and other publications these days are about adding benefits. As a result, many large corporations have accumulated a plethora of plans and point solutions. But more isn't necessarily better, especially in the absence of value. 

Many programs are actually a waste of time. So let's consider a few staples that easily could be put on the chopping block: 

Annual check-up incentives
They are already free for employees. Many plan sponsors give employees incentives to get one as well. The problem is that probably two-thirds of your employees — largely the ones most likely to schedule checkups whether they're incentivized or not or not — will get no benefit from them. A few employees may even be harmed by a doctor over-diagnosing or overtreating a "finding" that doesn't exist. 

This is not one person's opinion. Five separate studies show no net benefit and possible harm, versus zero studies demonstrating a benefit. The conclusions were not reached until after the Affordable Care Act made checkups free under the same assumption we all had: that everyone should get preventative annual checkups. Having been codified into an entitlement, free checkups are politically impossible to walk back, regardless of the evidence.

Read more: 'Prevent consent' form eliminates surprise bills from ER visits

Some benefits managers know that checkups don't improve health, but want employees to develop a relationship with their PCPs. An elegant way to do that without a useless checkup is to offer the same financial incentive for obtaining a note from a PCP saying an employee is healthy enough not to need one. Only healthy employees who already enjoy an excellent PCP relationship could get those notes. The rest will have to develop that relationship first, and now they'll have one more reason to do so.

Nor will this be a HIPAA issue. As opposed to disclosing an illness, employees will be very happy to "disclose" how healthy they are. Personal example: My PCP says that, barring any observable change in my health status, I don't need another checkup until 2025. That's called bragging, not "disclosing." 

Precertification for scans
You read that right. Traditional precertification costs a fair amount of money and annoys employees. For all that cost and angst, only about 1% of proposed interventions get denied, always to the consternation of the employee and his or her provider.

At least for certain procedures, why not drop old-fashioned precertification and let employees pre-certify themselves instead? Self-precertification would take the form of ensuring that employees know the downsides of tests and procedures, since they already think they know the benefits.

Read more: Time to bring dental benefits into the 21st century

Scans would be one example. Americans are "addicted to scans," and get far more than any other developed country with no better outcomes. Self-precertification can discourage overuse simply by educating employees on the downsides.

For example, do employees know that CT scans emit 100 to 1,000 times the radiation of an x-ray? That a dye may be injected into their veins that may cause kidney damage? That back MRIs are wrong a very large percentage of the time? That the "contrast media" used in MRIs gets lodged in their brains?

At Quizzify, we offer "self-precertification" quizzes to educate employees in a more entertaining way (and can check to see if they've actually gotten the answers). Employees who complete the quiz might get their copays halved. 

One way or the other, you'll avoid way more scans by having your workforce realize that maybe certain scans are not good ideas. As a result, your employees will be grateful instead of angry.

Annual biometric screenings
A good clinical idea can take 17 years before it is put into practice. Biometric workplace screenings are the example that suggests it may also take the same amount of time for a bad clinical idea to get out of practice. 

Apparently there is a reason that of the 50-plus companies approved by the esteemed Validation Institute, only one is a wellness vendor (U.S. Preventive Medicine) – and even they don't claim an ROI, just a validly measured risk reduction. It's because screening vendors don't save money and (excluding this company) don't even "move the needle" on risk factors. 

Technically, USPM hasn't been the only wellness or screening vendor to produce results. Two others did so as well, albeit in the wrong direction. Wellsteps made risk factors increase. Another wellness vendor decided to "do wellness" on its own employees. The result? They gained weight and eating habits got worse.

Read more:In benefits and healthcare, the cost of inaction is unaffordable

The authors of the so-called "Harvard study" with the oft-quoted 3.27-to-1 ROI reversed course when (as opposed to the first study, which just summarized findings that wellness vendors had claimed) they did their own extensive study that found zero risk reduction. The National Bureau of Economic Research reached exactly the same conclusion. One would expect that the wellness industry would rebut those findings. Yet instead, the industry's own study found the same thing: gross savings were only $0.99 a month. 

So maybe, given mountains of proof, it's time to ditch those screening programs in 2023 instead of waiting until 2040? Employees will love you for it. 

And you've probably noticed that's the theme here: less intrusiveness doesn't just mean less spending. In these cases, it also means making employees very happy.