Ready to Fine Employees for Poor Health Screening Scores?

Think I'm crazy?  Unfortunately, it's just a matter of time.

Consumerism is slow to develop bottom-line results.  The employees most likely to use your fitness benefit are the ones who are already healthy.   Your medical costs keep multiplying...

Oh yeah, and this little tidbit - employers can now charge employees who are are unhealthy more for benefits under the final rules the federal government issued in December 2006 to ensure that wellness programs comply with the nondiscrimination provisions of the Health Insurance Portability and Accountability Act of 1996.  The rules became effective July 1, 2007.

Workforce recently reported that Indiana-based Clarian Health will begin charging employees more for their health insurance in 2009 if they allow health risks such as tobacco use, obesity or high cholesterol to go unchecked.  From the Workforce article:

"Clarian’s decision to impose fees came after several years of operating a comprehensive wellness program, according to Steven Wantz, senior vice president for administration and human resources at Clarian, which has 13,000 employees working at five hospitals in the Indianapolis metropolitan area.

"We didn’t just decide this. We have five years of wellness program history that included health risk appraisals, health coaching and other resources to help people reduce their risk factors," he says.

But even with the wellness initiatives, Clarian’s annual health benefit costs continued to climb, growing 12.9 percent in 2006 and 15.7 percent in 2007.

So when the U.S. departments of Labor, Health and Human Services and Treasury released final rules to ensure that wellness programs comply with HIPAA, "it was our window of opportunity," Wantz says.

"We believe that by using this premium charge approach, where it shows up in employees’ paychecks every two weeks, it will keep [costs] in front of the person, and we think it will be more effective at creating behavior change," he says. "It seems that a charge gets people’s attention more readily than an incentive."

The program will assess $5 per-paycheck fees on employees who do not meet minimum standards for body mass index, cholesterol, blood glucose, blood pressure and nonuse of tobacco. Although it will not be fully implemented until 2009, the effort was announced this year to give employees plenty of warning, Wantz says."

And that, my friends, is the cold hard reality.  Minus more significant results from consumerism and happy wellness programs, the stick will slowly begin to replace the carrot.  The only question is the pace of change. 

If you have ever read about recruiters doing negative recruiting among college sports programs, wait until you have to spin and rationalize this type of program in the marketplace as you try and recruit and retain the employees you have...

Comments

[Wally Bock]

This had to happen, even if it only attacks one part of the healthcare problem. My worry with decisions like this is that they're often the camel's nose in the tent.

First we penalize those who are taking no action to improve their health. Next it might be logical to charge more to people who are taking action but not getting "results" as the plan defines them. After that we charge more to workers with genetic markers or family history of serious diseases. We can follow the example of the auto insurance industry and penalize those with poor credit reports or who live in the wrong zip code.

[Steve Roesler]

As I started to write, I realized that Wally had already laid out my reaction in a very straight and articulate manner.

This smacks of yet another way to appear "rational" by giving a "scientific" reason for hiking costs.

The reality is that whether overt , covert, or a combination of the two, insurance companies, medical providers, and employers are colluding--with the help of the government--to pick the pockets of working people.

I'm all for increased fitness and decreased smoking. However, those are not guarantees of "satisfactory" scores on measurements of factors that are outside of an individual's control (as Wally mentioned).

My health insurance carrier sends me spiffy, expensive newsletters each month highlighting spiffy low-fat recipes and sample exercise programs. I exercise heavily 5x/week at a fitness club. But I can't get a discount on the premium or shared fitness center costs as a result of working hard to stay in excellent shape.

I'll be looking for a help wanted ad from Clarian seeking qualified candidates to join the Pituitary Police.

[Kris]

Steve -

Thanks for the comment. Couple of thoughts as I read it --

Companies like mine will definately move to subsidize the positive things you are doing - for example, we pay all or part of the fitness cost for our employees. The hope is that drives lifestyle changes that result in lower utilization of the heathcare plan.

It's a good point to highlight that some people work hard and don't get the results. That happens, but the much bigger problem is the folks who don't do anything to improve their metrics in the areas in question.

I think what you are looking at in the future is credit for the folks who are working to improve, and based on the trends I cited, penalties to those doing nothing.

I undestand why you say it, but as the agent of the employer, I can guarentee you we aren't colluding to pick the pockets of our employees. We (the employer) are attempting to find ways to keep healthcare affordable for our employees without cutting benefit levels.

KD

[Steve Roesler]

Kris,

Kudos!

That's refreshing to hear. I hope that approach is taken by more and more employers.

Those of us who have small firms or are self-employed still have to deal with the kind of insurance company mindset that I mentioned in the previous comment.

Keep up the good work...

[Em]

A company really has to look on what their employees health status is because the companies future depends on it