What is the most motivating factor in changing unhealthy lifestyle behaviors? One might think that death or the threat of death would be enough to get people to make healthier choices. Not so! It is a well-known fact that in follow-up two years after coronary-artery bypass grafting, 90 percent of the 600,000 people in the United States who undergo the procedure each year have not changed their lifestyles, resulting in reoccurrence of cardiovascular disease.
If a return to chest pain, repeat surgery and possible death won’t motivate people to switch to healthier lifestyles, what will?
Local companies are using a variety of strategies that give employees and their families incentives to make cost-effective health care decisions, as well as providing assistance with lifestyle choices that will minimize their risk for illness and disease.
One such strategy includes linking participation in healthy lifestyle programs to the cost of the employee-funded portion of the health benefit. It’s immediate, it’s financially motivating and it has results. For many, seeing $60 or so per month less in a paycheck adds up.
Some companies have gone as far as requiring employees to participate in health programs such as an annual health risk assessment to be eligible for the company-sponsored health insurance plan.
Mike Benben Inc., a Sturtevant- based grower and distributor of fresh produce, established a wellness plan for its 33three employees and linked it to the 2005 health benefit plan year. Driving the decision to get employees involved in a wellness program were the company’s increasing costs of health benefits and its interest in maintaining a healthy and productive workforce.
To be eligible for benefits under the health plan, employees are required to participate in a company-sponsored health risk assessment, including completion of a health questionnaire, a screening for specific blood and body measurements and a follow up counseling session with a registered nurse.
Dan Zenner, company controller, reported 100 percent employee participation in the health risk assessment and attributed the success largely to the health benefit-based incentive. As an additional part of their wellness efforts, company management encouraged employees to become more physically active by giving their six-member office staff an additional 20 minutes of paid lunchtime to walk outside on the plant grounds.
"It is interesting what motives people," Zenner said. "This part of the program has not been as successful. Only one employee took advantage of the paid time to walk."
The walking program was not tied to the health benefit; it was simply paid time to exercise.
How are employees responding to these changes? Employers report the initial reaction is often anxiety and resentment. But once employees go through the process and see their actual health measurements, such as cholesterol, blood sugar and body fat percent, they become engaged in making changes. Although often small and gradual, change is happening.
Local insurance brokerage firms estimate that between 10 and 20 percent of their clients are engaged in some type of consumer-driven health care or health promotion activity. Experience is showing that those who offer lower monthly health premium contributions or require participation in health promotion activities for plan eligibility are having the greatest success in getting employees to participate.
Another effective
strategy
Dave Kliber, owner of S-F Analytical Laboratories, a West Allis based environmental products testing laboratory, switched to a health reimbursement arrangement (HRA) with higher deductibles to get employees to accept more of the responsibility for their health.
Fifteen of the 31 S-F employees are enrolled in the company-sponsored health plan. Through what Kliber calls a "semi self-insured dice roll," the company is subsidizing the "back end" of the employees’ higher deductible.
"An individual enrolled in a single plan has a $2,000 deductible. The employee pays the first $1,700, and we pick up the $300 beyond that. We also added office co-pays and a prescription drug card, which we didn’t have with our original plan – benefits which employees value greatly," Kliber says.
The S-F plan, provided through United Health Care, also gives employees access to on-line health information. The big risk for S-F is with family coverage, which went from a $3,400 deductible to $6,000.
"The back end, for which we are responsible, is $2,600. Basically, if employees are efficient on utilization and keep their deductibles down, we don’t have to reimburse, but if they don’t, we are out there. It is a bit of a risk, but so far a good one," Kliber says. "It has helped keep cost increases down, because of the higher deductibles. We only had a 4.5 percent increase this year. I guess I’m supposed to be grateful for that, but it sure beats the double-digit increases we got every year for a long time. My insurance costs went from 1.25 percent of sales in the mid-1980s to a peak of just over 4 percent."
Jo Steinberg, president of Midland Health Testing, whose company provides health risk appraisals, estimates that about 50 percent of the firm’s clients use health benefit-based wellness incentives.
Brookfield-based Wisconsin Lift Truck Corp., a Midland client, has used a combination of benefit-based wellness incentives and a restructured health plan to impact employee participation in their health.
"The combination of the two has resulted in significant savings," says Sharon Cerny, vice president of human resources for Wisconsin Lift Truck.
High-deductible health plans and tying participation in healthy lifestyle activities to the health benefit are fairly new concepts. It’s too early to tell whether companies that are using these practices will save money in the long term, but most believe they will.
Connie Roethel, RN, MSH, is president of Complementary Health & Healing Partners (CHHP), a corporate wellness and health promotion services company with offices in Mequon. She can be reached at 262-241-9947.
June 10, 2005, Small Business Times, Milwaukee, WI
