A Very New Year: It's Time to Track

As we enter 2017, we find "affordable care" is not so affordable for many individuals. They are discovering what employers learned long ago: Health care is expensive – and keeps getting more expensive. Every year, most employers plan for a minimum 6 percent increase in the cost of maintaining their employees' health; sometimes, the increase is in the double digits.

For nearly 20 years, employers have been looking at the possibility of reducing health care costs through "wellness" programs. The early programs were designed to reduce smoking, assist in weight loss and promote a healthier lifestyle.

About 10 years ago, health insurers began offering wellness components to their policies. These provided reimbursement for gym membership / attendance, as well as other incentives for healthier living.

The past few years have seen the popularity of wearable devices that can track steps, heart rate and sleep duration, and allow the entry of information regarding food consumption. A 2014 study notes that 44 percent of white-collar American workers would be interested in their employers providing "an activity/fitness tracker."¹

Almost 80 million wearable devices were sold in 2015, half of which were fitness trackers. There was a year-over-year 67 percent increase in sales in the first quarter of 2016. And while they began as a novelty for well-to-do under-35-year-olds, they are beginning to show their value. A paper published in early 2015 in the Journal of the American Medical Association speculates on how wearable devices might facilitate health behavior change. The authors note:

"Some of these devices aim at individuals already motivated to change their health behaviors. Others are being considered by health care organizations, employers, insurers and clinicians who see promise in using these devices to better engage less motivated individuals. Some of these devices may justify that promise, but less because of their technology and more because of the behavioral change strategies that can be designed around them."²

A study conducted at the University of Pittsburgh and also published in JAMA (October 2016) gained media attention when researchers discovered that people who used a wearable fitness tracking device actually lost less weight (7.7 pounds) than those who didn't wear one (13 pounds). The participants also had been placed on low-calorie diets and prescribed increased physical activity.³

But a third study⁴ released by health analytics company Springbuk looked at the impact of wearable fitness devices from the perspective of health care costs. After two years of studying employees at an unnamed, 22,000-plus-employee, self-insured company, the authors found that people who wore the devices:

• Enjoyed a 46 percent ($1,292) reduction in total health care costs after two years of use
• Experienced a reduction in the cost of prescription drugs used
• Of note, users classified as "less active" at the start of the study realized a 59 percent ($3,543) reduction in total health care costs over the two-year period.

The authors of the Springbuk study believe wearable fitness devices will provide employers with important data on their employee population health and help guide these companies in their strategic planning.

According to a 2016 survey of employers on "The State of Wearables in the Workplace," sales of wearable devices are expected to expand to 245 million by 2019, with half of those being fitness tracking devices. More than 35 percent of employer wellness programs already include wearable tracking devices. Most employers who offer wearable tracking devices use incentives to encourage their use, including discounts on insurance premiums and gym memberships.⁵

Based on postings across the web, many tracking device users are looking to share their device data with their health care providers. Some devices facilitate the sharing of such data, while others make it more difficult, but not impossible.

Driven by popular demand and employer investment, tracking devices will soon become a normal part of many people's daily routine. They may even play a role in determining the cost of individual health insurance rates in the future.

If your patients haven't requested it already, at least some will want you to have access to their tracking device data and be able to tailor their care / consultations accordingly. They will be looking for you to be similarly engaged in their wellness and fitness, providing your knowledge and expertise to their efforts to lead healthier lives.

This may be a good time to make the investment yourself in preparation for the conversations to come. Who knows: It's not unrealistic to believe these tracking devices could one day (sooner than you think) remind patients when they need to make their next appointment with you.

Editor's Note: The American College of Sports Medicine lists wearable technology as the top trend for 2017. See some of the other trends and how they relate to your practice in Dr. Jeff Tucker's article in this issue.

References

1. "Wearable Technology in the Workplace Survey." Modis, 2014.
2. Patel MS, Asch DA, Volpp KG. Wearable devices as facilitators, not drivers, of health behavior change. JAMA, 2015;313(5):459-460.
3. Jakicic JM, Davis KK, Rogers RJ, et al. Effect of wearable technology combined with a lifestyle intervention on long-term weight loss. JAMA, 2016;316(11):1161-1171.
4. "Wearable Technology: Unlocking ROI of Workplace Wellness. An Employer Case Study in Health Care Cost Management." Spingbuk, 2016. https://www.springbuk.com/wearable-study/
5. "The State of Wearables in the Workplace." Corporate Health & Wellness Association, June 1, 2016. https://www.youtube.com/watch?v=4Op3J72GURQ

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