CCA Supports National Employee Wellness Month

 CCA joins forces with many organizations to promote the value of an engaged and healthy workforce, during the fifth annual National Employee Wellness Month. This month-long initiative helps business leaders learn from best practices how to successfully engage employees in healthy lifestyles.

“We are particularly proud of the work and programs many of our members provide to encourage the real engagement of employees in wellness programs offered to companies of all types and sizes,” said Fred Goldstein, CCA interim Executive Director. “As part of our participation in this month´s activities, we are going to feature some of the most relevant programs. It is also very exciting to see the strong involvement of some of our partners and fellow advocates, such as the STOP Obesity Alliance and the Partnership to Fight Chronic Disease.”NEWM_2013_Supporter_Logo_f

National Employee Wellness Month is sponsored by Virgin HealthMiles, in partnership with the Strategies to Overcome and Prevent (STOP) Obesity Alliance, the Partnership to Fight Chronic Disease and WorldatWork.

A healthy, engaged workforce is critical for business success. Now more than ever employers must find effective strategies to improve employee health and productivity, and create healthy cultures that help to attract and retain the best employees. National Employee Wellness Month highlights the powerful role the workplace can play in assisting employees to make healthy lifestyle changes. Forward-looking organizations understand that promoting engaged and healthy employees can significantly improve productivity and reduce health risks.

Over the years, CCA has conducted research on and advocated for worksite wellness related issues on behalf of its members and the industry as a whole. CCA has done considerable research, in partnership with members, regarding the use of incentives in employer based wellness programs. Last October, it released a comprehensive report, Participant Engagement and the Use of Incentives, and in late January sent formal comments to the Department of Health and Human Services on the proposed rule discussing Incentives for Nondiscriminatory Wellness Programs in Group Health Plans.”

Wellness programs have been in the news lately, and CCA has been in the forefront of the conversation. In June, CCA members and staff will be visiting Capitol Hill to discuss wellness programs and their impact with members of the U.S. Congress.

Find more information and resources about workplace wellness, and suggested ideas to celebrate National Employee Wellness Month at


Just Released: Final Rule on Incentives for Nondiscriminatory Wellness Programs in Group Health Plans

After a long wait, on May 29, the agencies released the final rule on Incentives for Nondiscriminatory Wellness Programs in Group Health Plans is a must read and essential for all population health and wellness industry stakeholders.

The rule was issued by the Internal Revenue Service, Department of the Treasury; Employee Benefits Security Administration, Department of Labor; Centers for Medicare & Medicaid Services, Department of Health and Human Services.

Victoria Shapiro, Care Continuum Alliance Government Affairs Director wanted to share our initial impression review of the rule´s impact for CCA members and the industry as a whole.

In its formal comments on the proposed version of this rule, CCA asked HHS to:

  • Maintain flexibility in the core features of a “reasonably designed” wellness program.
  • Allow for program innovation to create new evidence on wellness strategies for specific populations.

The final rule expressly used this language and granted both of these requests. CCA is also cited in the language of the final rule:

“Currently, insufficient broad-based evidence makes it difficult to definitively assess the impact of workplace wellness on health outcomes and cost; however, available evidence suggests that wellness programs may have some effect on improving health outcomes. The RAND Corporation’s analysis of the Care Continuum Alliance (CCA) database found statistically significant and clinically meaningful improvements in exercise frequency, smoking behavior, and weight control between wellness program participants and non-participants.”

The Departments anticipate that future sub-regulatory guidance may be needed to further clarify portions of this final rule, and will issue such guidance as necessary.

Some Key Points about the Final Rule

  • Clarifies the scope of HIPAA and the Affordable Care Act rules governing wellness programs.
  • Outlines criteria for “an affirmative defense that can be used by plans and issuers” in a claim regarding compliance with HIPAA provisions.
  • Offers detailed steps a plan or issuer can take to ensure wellness programs are reasonably designed and also what constitutes a “reasonable alternative standard”.

Last Thought

The language of the rule reads:

“These final regulations continue to provide plans and issuers flexibility and encourage innovation.”

Final rule on Incentives for Nondiscriminatory Wellness Programs in Group Health Plans

Considering a Graduate Certificate? Why Not One in Population Health?

The paradigm has shifted.  The current health system is broken. We are moving to a new model that stresses population health. Jefferson’s Graduate Certificate in Population Health from the Jefferson School of Population Health is intended for current and emerging leaders who want to thrive under Health Reform and implement real world solutions.

  • 5 online courses (15 credits)
  • 21 months to complete
  • $725 per credit

The Certificate will enable you to:

  1. Define the population health paradigm and its relationship to the chronic care model.
  2. Describe ways in which a population health perspective reorders existing healthcare priorities and establishes new priorities in areas such as prevention, evidence-based practice, comparative effectiveness, public health and health policy.
  3. Identify and address key determinants of population health outcomes.  
  4. Identify and characterize key stakeholders, including governmental and private sector institutions, and analyze how their complex relationships influence population health outcomes. 
  5. Analyze the impact of health care and health services on population health outcomes and identify strategies for improving healthcare quality and safety.
  6. Analyze the relationship of population health outcomes to health economics and to value in health care. 


  • Population Health and Its Management
  • U.S. Healthcare Organization and Delivery
  • Intro to Healthcare Quality and Safety
  • Chronic Disease Prevention and Chronic Care Management
  • Intro to Health Economics and Outcomes Research

Admissions Considerations

  • Bachelor’s degree with GPA of 3.0
  • GRE or other graduate entrance exam or graduate degree or 9 graduate credits

For more information: or 215-503-0174


Guest Blog Post Disclaimer

CCA invites guest bloggers to post on Voice on Population Health Blog as a benefit for our members and the industry and to allow for exchange of ideas and information regarding population health.

The views, opinions and positions expressed within these guest posts are those of the author alone and/or of the company the author represents and do not represent those of the Care Continuum Alliance (CCA), its members, or the industry as a whole. CCA is not responsible for the accuracy, completeness and validity of any statements made within this guest post article. We accept no liability for any errors, omissions or representations. The copyright of this content belongs to the author(s) and any liability with regards to infringement of intellectual property rights remains with them.

CALL FOR ACTION: Showcase The Value of Workplace Wellness Incentives

CCA has reviewed the March 2013 Health Affairs article discussing the use of incentives in wellness programs. The authors’ conclusions are not reflective of the evidence and experience of CCA members in implementing health contingent wellness programs. In addition, the title of the article seems to be unduly inflammatory, and not fully supported by the analysis.

We are concerned that the timing of this publication could adversely affect the nature of the forthcoming regulations on non-discriminatory wellness programs.  Therefore, the Care Continuum Alliance is:

  1. Alerting our members and the industry to the potential impact of this negative-toned article in the current regulatory and policy environment;
  2. Conducting a comprehensive literature review including CCA’s recent research on Participant Engagement and the Use of Incentives;
  3. Issuing a Call for Case Studies from the CCA membership to address the points made in the Health Affairs article;
  4. Calling our members to a concerted action in response to the assertions made in this article:
    1. Respond to CCA’s Call for Case Studies.
    2. Read Care Continuum Alliance Evidence Statements: The Use of Incentives in Employer-Sponsored Wellness Programs.
    3. Attend CCA Capitol Caucus, on April 11, where discussions on incentives and other regulatory issues will be center stage. Learn more and register today.
    4. Highlight your organization’s research and outcomes on incentives for wellness programs through media and public outreach.

Article’s Key Points

The article Wellness Incentives In The Workplace: Cost Savings Through Cost Shifting To Unhealthy, published in the peer-reviewed journal Health Affairs, offers a conceptual framework for assessing whether health-contingent wellness programs are effective in achieving cost-savings through health improvement. The authors determine that the relationship between high-risk health conditions/ behaviors and increased healthcare costs is not definitive; conclude that the current evidence on the effectiveness of incentives in behavior change science is ambiguous; and posit that demonstrated cost-savings from wellness programs may result from cost-shifting and placing an undue burden on those of lower socioeconomic status.

Our Response

CCA is developing a more detailed, comprehensive, and evidence-based response, which will incorporate our members’ research.

Please submit your case studies, experience and evidence illustrating the following points:

  • CCA members engage in rigorous program evaluations and scientific assessments with ample data to ensure wellness programs are appropriately designed and tailored to improved health outcomes.
  • Significant evidence suggests a clear relationship between high-risk health conditions/ behaviors and increased healthcare costs.
  • Years of epidemiological data clearly show that a healthy lifestyle reduces the likelihood of disease.
  • CCA acknowledges that current evidence yields mixed outcomes on the effectiveness of incentives in behavior change science. Though, as program innovation continues, a growing body of research positively indicates that incentives can, in some cases, facilitate behavior change to increase patient engagement in wellness programs.
  • Appropriate incentive and wellness program design can produce cost savings for employers without any cost shifting to less healthy employees.
  • The value of wellness programs extends beyond direct healthcare cost-savings. As one component of an organizational culture of health, wellness programs can produce additional positive outcomes such as workforce productivity, aside from short-term Return On Investment.

The final rules on Incentives for Nondiscriminatory Wellness Programs in Group Health Plans from the Department of Health and Human Services (HHS), the Department of the Treasury, and the Department of Labor are under development and expected in the coming months. In addition, there is concern about the possibility of lawsuits. Read CCA Letter to HHS Secretary Sebelius on Incentives for Wellness Programs.

CCA’s Actions

Your Actions

Prevention is Not Expendable

A core component of the Affordable Care Act is the most comprehensive recognition to date of the value of prevention and health promotion. Numerous provisions in the ACA support wellness and prevention efforts in the workplace and in Medicare and Medicaid. CCA has repeatedly applauded these provisions and actively and aggressively supports their rapid implementation.

Yet, we continually face efforts by Congress and even the administration to target the ACA’s landmark Prevention and Public Health Fund as an extraneous cost – particularly now, in discussions on the fiscal 2013 federal budget. But the Prevention Fund is anything but extraneous or expendable. Rather, it provides a critical catalyst for the surge nationally in health care system innovation and care delivery improvements.

CCA strongly supports allocating monies dedicated to the Prevention Fund to fulfill its intended purpose and to power health care transformation. The Department of Health and Human Services must seize the opportunities made possible by the Prevention Fund through community collaborations and partnerships with health care industry leaders. Congress, rather than looking to the fund for easy cuts, should instead encourage its constructive use legislatively, such as through Sen. Ron Wyden’s “Medicare Better Health Rewards Program,” which would apply Prevention Fund monies toward initiatives that build on programs already established through reform.

States have a stake in the Prevention Fund’s viability, as well. The Fund materially impacts and advances individual state health care initiatives, such as behavioral health screenings, data infrastructures and wellness services. It has contributed more than $121 million toward state projects in Ohio, California, Nevada and Kentucky alone. provides a full public accounting of individual state contributions and program descriptions.

The Prevention Fund already has sustained a 10-year, 33 percent cut through February’s Middle Class Tax Relief and Jobs Creation Act. Additional cuts would derail federal and state progress toward prevention and health promotion, stifle health care transformation and undermine significant industry investments in innovation.

Stakeholders are working continuously and at an unprecedented pace to drive the health system toward better care, better health and lower costs. The Prevention Fund must remain available to achieve this important goal.

Love Letter to TEDMED

Wow. That’s all I can say after three unbelievable days attending the inaugural TEDMED DC event. My head is swelling with ideas and inspiration and innovative opportunities for population health. It was unlike any “event” I’ve ever attended and it sets a new standard for education and networking.

What’s it all about? TED stands for “technology,” “entertainment,” “design.” There were performance artist poetry slams about thinking outside the box that literally took my breath away. There were personal vignettes about surviving breast cancer by the President and CEO of the Red Cross. There were discussions about the technology of food, of fitness, of wellness, of illness. So much of this conference had a population health theme that is perfectly aligned with CCA’s goals and the work of our industry leaders. It was all just presented in a way that makes you think harder and better and more collaboratively.

A common thread through nearly every presentation, I found, was the importance of personal wellbeing and responsibility. Obesity was a key theme and presented from various perspectives. A huge takeaway for me: Obesity is directly linked to one-third of all cancers. Encouraging healthful behaviors at a community and social network level was another key issue and was the top choice of TEDMED delegates in the Great Challenges of health and medicine. Kudos to Challenge Advocate Rajiv Kumar, Founder and Chief Medical Officer, ShapeUp, for promoting the “Inventing Wellness Programs that Work” Challenge. Rest assured, you got several of my votes!

Finally, let me state emphatically: TEDMED, don’t change a thing for next year in DC. I ran into a few of my DC colleagues who work in other health industry organizations this week and, in the words of one, they just “didn’t get it.” Yes, it’s different. Yes, it’s all “West Coast-y.” It is NOT your same old, same old conference with a bunch of boring policy wonks and PowerPoints. Not all of the speakers were equally enthralling (although most of the ones I saw were) but there was certainly a nugget or grain of an idea in every single one that spurred a conversation and possibly another innovation down the road. This conference is about IDEAS and PEOPLE and NEW WAYS OF THINKING. It was also a great equalizer in that the vast cross section of delegates attended to meet and explore. There was no hierarchy, just idea sharing. It was, simply, awesome.

—Tracey Moorhead, President & CEO

Incentive-Based Wellness Initiatives for All: Good practices = Good Outcomes

CCA has long supported the use of incentive-based workplace wellness programs. We’ve issued recommendations on core components and the role of incentives, and certainly agree that programs should not “inappropriately punish workers in poor health, [be] overly coercive, or create perverse financial incentives that result in poorer health outcomes.” We further believe that existing federal and state safeguards should be applied to programs that violate existing HIPAA requirements for reasonable design, annual requalification, alternative standards and other benchmarks. In short, there’s a growing body of research that clearly demonstrates the value of wellness programs, including those employing incentives for participation and outcomes, for improving health and reducing preventable health care costs (see here, here, here and here).

Congress, too, recognizes the value of wellness programs for all populations. The Affordable Care Act provided landmark recognition of workplace and community-based wellness and prevention programs. Particularly important, the statute in 2014 will increase from 20 percent to 30 percent of total premiums the allowable value of incentives employers may offer employees to participate in workplace wellness programs. We applaud Sen. Tom Harkin, D-Iowa, for his continued support for workplace wellness initiatives.

Now, another leading Senate Democrat is poised this week to unveil legislation that would offer incentive-based wellness programs to Medicare beneficiaries. This legislation recognizes the importance of wellness initiatives, including smoking cessation and weight management, and the success of incentive-driven wellness initiatives for our nation’s seniors.

I’m delighted to report on these developments and the sustained march toward greater awareness of the value of wellness programs for all populations. These developments stand in direct contrast to the thinly veiled conjecture and anecdotes propagated by policy organizations and advocacy groups that repeatedly ignore the preponderance of evidence on the benefits of workplace wellness programs.

Clearly, there is significant evidence of the positive impact of incentive-based wellness. CCA looks forward to supporting this important new Senate legislation and to promoting the real truth about wellness programs, using evidence and research rather than speculation and fear tactics.

—Tracey Moorhead, President & CEO

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