oncerned that not enough employees would use wellness and preventive services
when Bacou-Dalloz USA Inc. introduced its consumer-driven health plan last year,
the Smithfield, Rhode Island-based manufacturer promoted the benefits as "free stuff,"
says Michael Vittoria, director of human resources.
"We used the language of consumerism and listed the wellness
items that are covered at 100 percent and told them what things were ‘free,’ " Vittoria
says. "Everyone likes free stuff. So we promoted wellness as being free stuff. That
really got people’s attention."
Well-child visits, routine checkups and gynecological visits,
including related laboratory work, were promoted as "free" by the manufacturer of
head, body and fall protection equipment.
Bacou-Dalloz also never used the term high-deductible health
plan, Vittoria says. "Our employees don’t know they have a high-deductible health
plan. We call it an upfront deductible. We found people understand that a whole
lot better. It also has a better connotation," he says.
Although the manufacturer does not yet have claims data for
this year from its plan administrator to know if the promotion has been effective,
"anecdotally, we’ve heard a lot of positive feedback from employees," Vittoria says.
To ensure that more CDHP members use wellness and preventive
care services, a growing number of employers are turning to stepped-up communications
and financial incentives.
Aside from 100 percent coverage of preventive care, typical
incentives include reductions in employees’ monthly premiums, contributions to employees’
health reimbursement arrangements or health savings accounts, gift certificates
and more. One health plan—Chicago-based Destiny Health—even offers discounted vacation
packages to those who achieve a certain level of participation in its Vitality wellness
program.
The incentives, which can be taxable income to employees if
they are not directly tied to the health plan, are generally given to employees
for enrolling in care management programs or for completing health risk assessments,
although employers are increasingly making health risk assessments a required part
of enrolling in health benefits, benefit experts say.
Stephanie Pronk, chief health officer at RedBrick Health,
a CDHP education firm based in Minneapolis, says she is noticing a trend of using
phased incentives, where payments are made to plan members at the beginning, middle
and end of a care management program to ensure they follow through.
Experts say it takes several years for an employer to realize
a return on its investment in health and wellness programs. Vendors say that return
can be as much as $3 in health care savings for every $1 spent on preventive services.
While many employers are using incentives with CDHPs, some
are adopting a more punitive approach, such as imposing penalties on plan members
based on poor health habits.
Indianapolis-based Clarian Health, for example, is charging
employees $5 per pay period more per factor if they smoke, are obese, have high
cholesterol, uncontrolled hypertension or uncontrolled diabetes. That maximum additional
employee charge is $25 per paycheck.
Minnetonka, Minnesota-based UnitedHealth Group Inc. also recently
unveiled a CDHP that provides deductible discounts for plan members who meet one
of four biometrics that include not smoking.
"I think we’re seeing employers testing the waters now," says
Steven Noeldner, principal and senior consultant in the health and productivity
management specialty practice of Mercer Health & Benefits based in Newport Beach,
California.
However, Noeldner and other consultants advise their employer
clients to choose the carrot approach over the stick.
"We encourage incentives over the penalties," he says. "However,
one person’s incentive is another person’s penalty."
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