Inspector General Joe Ferguson on Tuesday raised “serious questions” about whether Mayor Rahm Emanuel’s highly-touted wellness program “is achieving any demonstrable benefits or whether it will ever do so.”
Ferguson noted that cash-strapped Chicago is paying American Healthways Services LLC $3 million-a-year–and $10.5 million through Dec. 31–to administer the program.
But City Hall does nothing to “track or measure” whether the program has either improved employee health or reduced the city’s skyrocketing health care costs, according to the advisory.
The city’s workforce declined by 19 percent — to 33,354 full-time equivalent employees in the decade ending in December 2013. Despite that drop, health care costs rose by 43 percent during the same period.
The threat of a $50 surcharge in monthly health insurance premiums was enough to persuade nearly 85 percent of eligible city employees and their dependents to sign up for the wellness program. The city has so far collected $1.9 million in “non-participation” fees, Ferguson’s report said.
But in the advisory issued Tuesday, Ferguson accused the Emanuel administration of dropping the ball and being long on rhetoric and short on follow-through.
“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 at the end of fiscal year 2015 until such time as the city can identify measurable expectations and outcomes.”
Emanuel spent his first two years at odds with Ferguson, but the two men have since developed a close working relationship–so much so that the mayor appointed the inspector general to another four-year term and expanded his power to include the Public Building Commission.
That’s apparently why the mayor reacted to Tuesday’s advisory by agreeing with Ferguson that more needs to be done to monitor wellness results. That’s a far cry from the inspector general’s claim that the city has “declined to make any changes” in the way it measures the program.
“If you want to see both improved health care and further reduction in long-term health care costs, you not only have to have participation. But, you have to be able to measure progress, which is what” Ferguson appears to be saying, the mayor said.
“I originally said that. There was some resistance to making progress on, if you have a blood pressure issue or if you have a smoking issue. But, the first step was getting participation. I ultimately would like to see, now that it’s not such a threat, that we measure peoples’ progress if they have one of the six chronic illnesses. But, that’s aspirational. We’ve got to get our partners in labor to agree to that.”
Emanuel noted that roughly six percent of the city’s workforce drives 60 percent of health care costs around the chronic, but controllable illnesses, such as obesity, high blood pressure, heart disease, asthma, diabetes and smoking.
Anecdotally, the mayor said said there is no question that city employees are in better health. He pointed to the case of an operating engineer who stopped the mayor at City Hall to report that he had a heart condition that was only discovered because he had “checked in” with a wellness coach.
Chicago taxpayers spend $500 million a year to provide health care for city employees, nearly 10 percent of the city’s annual budget.
Emanuel campaigned on a promise to save $20 million in 2012 — and $240 million over four years — by implementing an incentive-laden health and wellness plan mirrored after the one pioneered by such private sector companies as Safeway and Johnson & Johnson.
To qualify for continued participation, employees must complete three steps: a bio-metric screening, an online health assessment questionnaire and a “check-in call” with a health adviser from Healthways.
Participants are further required to earn twelve “participation points” each quarter by completing wellness activities that include on-site programming and web-based activities.
Up to 30 percent of wellness participants qualify by getting coaching by telephone, with two calls-per-quarter to discuss goals related to diet, exercise, smoking and emotional health.
Ferguson’s advisory is particularly timely given the fact that Emanuel directed his budget director to meet with the inspector general last week to get his ideas on ways to raise revenue and cut costs.Chicago desperately needs every dollar it can get to erase a $754 million shortfall and solve a combined $30 billion pension crisis at the city and public schools that has dropped both the city’s and the Chicago Public School system’s bond rating to junk status.“In light of the city’s ongoing financial challenges, the city cannot afford to invest in programs of undetermined impact,” Ferguson wrote.