Sixteen months ago, Inspector General Joe Ferguson raised “serious questions” about whether Mayor Rahm Emanuel’s highly touted wellness program was “achieving any demonstrable benefits or whether it will ever do so.”
Now Emanuel has granted a one-year extension to Healthways SC LLC at a $5.8 million price tag, nearly double the annual cost of the expiring agreement, with a few tweaks in hopes of getting more bang for the city’s buck.
All participating employees will be required to participate in a biometric screening, well-being assessment and health adviser call.
But only those identified as high risk will be required to get health coaching, attend on-site classes, read about health-related topics, participate in disease care and management programs or use the wellness portal to track health activities.
“This is a change . . . to foster improvements and success for the most at-risk employees. The disease or care management program focuses resources only on high-risk participants,” Mary Kay Accurso, a spokesperson for the city’s Office of Budget and Management, wrote in an email to the Chicago Sun-Times.
Emanuel campaigned on a promise to save $20 million in 2012 — and $240 million over four years — by riding herd over costly but controllable problems like diabetes, high blood pressure, heart disease and asthma. Obesity is also a contributor. So is heavy smoking.
At the time, Chicago taxpayers were spending $500 million a year to provide health care for city employees, nearly 10 percent of the city’s annual budget. Four percent of the city’s workforce was driving 60 percent of the annual expense.
The mayor’s incentive-laden health and wellness plan called for the city to raise monthly health insurance premiums by $50 for employees who fail to participate in a program to manage chronic health problems.
The program offers city employees and their dependents an enhanced screening to establish benchmarks and long-term goals, including weight loss, medication, exercise and kicking the smoking habit.
Participants get wellness training. Coaches are supposed to check in on a bimonthly basis to make certain participants are following their prescribed nutritional, medical and physical fitness regimens.
Those who refuse to participate pay higher premiums. They do not have to succeed; they simply have to try.
The carrot-and-stick approach was enough to persuade an overwhelming majority of eligible city employees and their spouses to sign on.
But in his August 2015 advisory, Ferguson accused Emanuel of dropping the ball and being long on rhetoric and short on follow-through.
The company then known as American Healthways Services LLC was being paid $3 million a year — and $10.5 million over a three-year period — but the city had failed to measure whether the program had improved employees’ health or reduced the city’s skyrocketing health care costs, Ferguson said then.
“Chicago Lives Healthy is an admirable first attempt by the city to promote improvements in employee health. However, there are serious questions as to whether the program is achieving any demonstrable benefits and if it will ever do so,” Ferguson wrote.
“The uncertainty surrounding the effectiveness of this and other employee wellness programs makes it critical that the city use the data and lessons gleaned from the first two years of the program either to set and track explicit goals tailored to measurable, targeted policy objectives or allow the current multi-million dollar contract to sunset . . . until such time as the city can identify measurable expectations and outcomes. In light of the current fiscal challenges, the city — however well-intentioned — simply cannot afford to invest in programs that have no discernible impact.”
If the program was renewed, Ferguson advised the city to establish a “performance measurement framework” to ensure the contractor is delivering results. Without it, the city can’t make “evidence-based, cost-benefit decisions about the future” of the program. The inspector general noted then that the city had “declined to make any changes to the way it measures the program.”
Eleven companies answered the original request for proposals to manage the wellness program.
Respondents were asked to provide eight levels of cost-per-participant with a “declining price scale” based on the number of eligible employees and spouses. The highest level was 45,000 participants.
By adding 10,000 employees at the Chicago Public Schools, Chicago Housing Authority, Park District and City Colleges and the Emanuel-chaired Public Building Commission, the participant pool topped the 45,000-employee benchmark needed to guarantee the lowest price.
The mayor’s office hoped that reaching the 45,000-employee benchmark would turn up the heat on rank-and-file police officers. But it did not work with the Fraternal Order of Police.
The FOP fought long and hard for its own wellness program — one without penalties or incentives — and was determined to keep it.
