Julie Appleby of Kaiser Health News reports, “Employers Tie Financial Rewards, Penalties To Health Tests, Lifestyle Choices.” Excerpt:
Gone are the days of just signing up for health insurance and hoping you don’t have to use it. Now, more employees are being asked to roll up their sleeves for medical tests — and to exercise, participate in disease management programs and quit smoking to qualify for hundreds, even thousands of dollars’ worth of premium or deductible discounts.
Proponents say such plans offer people a financial incentive to make healthier choices and manage chronic conditions such as obesity, high blood pressure and diabetes, which are driving up healthcare costs in the USA. Even so, studies of the effect of such policies on lifestyle changes are inconclusive. And advocates for people with chronic health conditions, such as heart disease and diabetes, fear that tying premium costs directly to test results could lead to discrimination.
Employee reaction has also been mixed. “It’s an invasion of privacy,” says Bradley Seff, 54, a court reporter who filed a lawsuit against his employer, Broward County, in August, 2010, for introducing such a plan.
Nonetheless, such plans could be the wave of the future. Faced with crippling healthcare costs, the number of employers embracing such programs shot up from 49 percent in 2010 to 54 percent last year — and more say they expect to do so soon, according to a survey by consultants Aon Hewitt. Big-name participants include insurer UnitedHealthcare, car rental firm Hertz, postage meter maker Pitney Bowes and media owner Gannett, owner of USA TODAY.
And more employers are expected to adopt them starting in 2014, when the health law allows them to offer larger incentives or penalties than they can now.
While supporting wellness programs in general, several patient advocacy groups warned the Obama administration last March that additional consumer protections are needed. Tying medical test results to financial incentives or penalties in premiums or deductibles could discriminate against some workers, especially those who already have health problems, the groups said.
“When you start increasing premiums or pumping up the deductibles, you’re making it more expensive and harder for people to access insurance,” says the Cancer Society’s Woodruff, who adds that offering gift cards or bonuses are a better way to reward people for participation.
Employers, however, argue that since they’re on the hook for the bills, they can ask workers to take more responsibility.
“House money, house rules,” says Ken Sperling, global healthcare practice leader at Aon Hewitt.