Insurers offer discounts for stepped-up participation in wellness programs

    Employers get a payoff for nudging their workers toward wellness

    For years companies have set up wellness programs to help employees shed unhealthy habits. In most cases, businesses have had to take it on faith that those investments might some day translate into lower health costs. But now insurance premium rates are rising so quickly, some companies are asking for, and getting, those savings in advance. (Photo: Flickr/yuan2003)

    Listen: [audio:090602teinsure.mp3]

    The Delaware Valley Healthcare Coalition gets a 2 percent break on its annual premium increase from Independence Blue Cross. In return, coalition officials coaxed more members into signing up for the insurance company’s disease prevention programs.

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    Kearney: There’s a percentage of our people who have to fill out a personal health profile. There’s a percentage of people that we have to get to join the smoking cessation program, to join the fitness reimbursement program.

    Matthew Kearney is president of the coalition. It’s a group of labor unions that have banded together to negotiate better rates. Coalition officials spoke at union meetings and sent out letters to increase participation in the wellness programs.

    Kearney:
    It was quite a bit of work but for the most part our members did buy into it.

    When a worker signs up for the wellness program, it gives the health insurance company permission to review the employee’s health information and then contact the worker with tailored health suggestions.

    One painters union local will save $7 million during the five-year deal with Independence Blue Cross. And that’s not counting potential back-end savings from a healthier workforce and fewer medical claims.

    Lawrence Kissner is a vice president of sales and marketing for Independence Blue Cross.

    Kissner: Our goal is to sort of bend the trend. If normal health care trends were rising at, let’s say, 10 or 12 percent, if we can bend that 2 or 3 percentage points, that would be a significant win for an employer.

    Dr. Robert Muscalus works for Highmark Blue Shield. He says the evidence shows that simply having employees fill out an online form describing their health habits can lead to good results, like fewer hospital admissions over time.

    Muscalus: While I can’t prove it, I believe that it’s because many individuals get a wake up call when they complete a health risk appraisal, resulting in either identifying that they have a condition or resulting in better treatment for a known condition so that they don’t have acute problems like heart attacks or strokes.

    Insurance firms consider the health of an entire company when they calculate group insurance premiums. So Gateway Ticketing in Berks County uses both carrots and sticks to nudge workers toward better health.

    Gateway employees who sign up for the wellness program pay about half as much for a family health plan as workers who don’t. Nina Bohn is human resource director for the software firm.

    Bohn: Our feeling is that they want to be an active participant in saving money for the company therefore we give them an upfront discount.

    Experts say wellness programs likely cut health-care costs over a person’s lifetime, but it’s still unclear whether those programs save money in the short term, or for individual firms. That’s particularly true for businesses with high employee turnover – like restaurants.

    Kevin Volpp is a health economist with The Wharton School. He says it may take many years for a weight management class to pay off in lower medical costs. By that time, the employee likely will have moved on.

    Volpp: It would never make sense for me to do a program like this because the economic benefits of getting people to change their behavior would accrue to other employers and not to me.

    But Volpp says short-term savings shouldn’t be the only way to measure the value of wellness programs. The health-care system readily pays for plenty of costly treatments when someone becomes ill. Volpp says the health system often hesitates, though, to pay for steps that might actually keep people well.

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