Amy McDonough, Vice President and General Manager at Fitbit Wellness, testified before a congressional hearing last week in a session entitled “Innovations in Health Care: Exploring Free-Market Solutions for a Healthy Workforce”.

The hearing itself was somewhat scattered in terms of its focus, as the representatives took every opportunity to defend or take potshots at the Affordable Care Act, while the witnesses tackled topics including employee privacy, Equal Employment Opportunity Commission guidelines on employee wellness, and the effectiveness of employee wellness programs.

“We have a specific vision of wellness, one that addresses the diverse needs of both organizations and the people that power them,” McDonough said in her opening remarks. “The fundamental goal of any wellness program should be to provide opportunities for individuals to improve their health and wellness. The need for wellness programs has never been greater, and employers are uniquely positioned to improve population health by starting right in the workplace. Wellness should always be inclusive, voluntary, and should protect the privacy of the people it is aimed to serve.”

When asked whether the program has a concrete ROI when it comes to healthcare costs, McDonough said that in some cases it has — she shared a number of case studies in her written testimony — but in other cases, that’s not yet what employers are looking for. 

“There’s a value on investment, termed VOI, which includes productivity and absenteeism and things like that,” she said. “Employers are looking holistically across that. But there’s not always an expectation for most employees that there’s going to be a direct healthcare savings cost in the next year.”

There was some discussion about what constitutes voluntary participation when premiums or payments are tied to an employee’s decision to participate in a program. Sabrina Corlette, Senior Research Professor at Georgetown University’s Center on Health Insurance Reforms, argued that not only are those programs coercive, there’s little evidence that they’re effective. 

“Wellness programs that are tied to some premium-based financial incentive have really not been shown by themselves to change behavior,” she said. “What does seem to work are targeted disease management programs that really target people with diabetes or heart disease with direct, personal interventions. Also, frankly, changing the environment. Google is a great example of a company that has experimented with different wellness things, but one of the most effective things was, in their cafeteria, moving the healthy foods up front, reducing the sizes of plates and bowls.”

Rather than incentivize participation monetarily, McDonough said that when Fitbit works with employers, the focus is on getting that voluntary opt-in by really working with employees.

“Communication and transparency upfront is what leads to great participation rates,” she said. “A shared commitment to health, a culture of wellness, and really understanding what data’s being shared, how it’s being used, and how that’s going to impact the culture within the organization.”

Furthermore, Fitbit benefits from being a household consumer name that puts employees at ease.

“The adoption rate can sometimes be a barrier, but what’s great about consumer technology is you’re able to capitalize on a movement that’s already happening in the marketplace and being able to increase those participation rates,” she said. “Being in a corporate marketplace, we’re able to push back a lot of those objections.”

Finally, McDonough emphasized that getting employees to participate in a wellness program also meant assuring them of the privacy and safety of their data and securing employees’ trust.

“The privacy of our user data and the trust of our customers is paramount at Fitbit,” she said. “So we have a clear easy to read, friendly, privacy policy. It’s written in plain English so that they can understand it. When we work with an employer on an employer wellness program, they have to opt in and give explicit consent to share data with an employer and it’s a subset of the data that’s collected by Fitbit overall.”