Getting Healthy, With a Little Help From the Boss

By LESLEY ALDERMAN

Get ready to get well. Boss’s orders.

Once upon a time, corporations offered generous health benefits as a way to woo employees into their ranks. Now, most companies have turned from amorous suitors into stern parents — shifting more costs, and more responsibilities, to their employees.

According to a January survey by the benefits consulting firm Hewitt Associates, nearly two-thirds of large employers planned to transfer more costs to employees. At the same time, one-third planned to put greater emphasis on wellness plans — programs that encourage employees to adopt healthier lifestyles. (So long, Big Macs).

Congress is climbing onto the wellness bandwagon, too. Senator Tom Harkin, the Iowa Democrat who is a leader of the Congressional health reform movement, recently proposed giving tax incentives to companies that offer comprehensive wellness programs to their employees.

The focus on healthier lifestyles makes sense. Unhealthy employees use significantly more medical services than healthy ones and cost employers more money.

“If you are an employer who wants to keep providing health care coverage, you have to target employees’ exercise, diet and nutrition habits,” says Dr. Kenneth E. Thorpe, chairman of the health policy and management department at the Rollins School of Public Health at Emory University.

Three-quarters of the money the nation spends on health care is for chronic conditions, Dr. Thorpe pointed out. If companies can get workers to make behavioral changes to control problems like high blood pressure or diabetes, the businesses’ costs typically go down.

But though the logic seems sound — employees get healthier and employers reduce their overall costs — not all wellness plans are alike.

At paternalistic companies like General Mills, employees have a host of generous options. Workers at the company’s headquarters just outside Minneapolis can exercise at the on-site gym, get eye exams at the medical office and see a physical therapist for random aches and pains — all free of charge.

But some aspects of wellness plans may feel more meddlesome. About 80 percent of big employers offer health risk surveys, which are aimed at identifying health problems or potential health problems. And 60 percent of employers give financial incentives to employees who fill them out, according to a joint survey by the benefits consulting firm Watson Wyatt and the National Business Group on Health, an association of more than 300 large employers.

After a worker takes such a survey — the results are off limits to the employer — a coach or nurse from the outside contractor running the program will call the person and suggest medical interventions or lifestyle changes. Those changes may involve exercising more, eating less meat or losing weight.

“It’s one thing for an employer to offer insurance that protects you from illness,” says Ronald C. Kessler, a professor of health care policy at Harvard Medical School. “It’s another when they start suggesting that you shouldn’t eat a P.B.&J. sandwich for lunch. That can feel intrusive.”

But whether you love them or hate them, wellness programs are probably here to stay. Here’s how you can make them work for you.

UNDERSTAND THE TOOLS More and more companies are using health questionnaires as a way of to create personalized health improvement plans for their workers. These surveys ask about your body mass index, how much you exercise and whether you smoke, and are typically administered by a third party.

According to privacy laws, the information you provide to the plan administrators cannot be used by your employer for any purpose related to your employment status. In addition, an employer cannot deny health insurance to an employee for failure to complete a health risk questionnaire, says Martin J. Moderson, vice chairman of employee benefits and executive compensation at Sonnenschein Nath & Rosenthal.

While many employers offer incentives for filling out health surveys, there is some debate over whether it is legal for them to do so. Under the federal health privacy law known by its acronym, Hipaa (pronounced HIP-ah), your employer can provide an incentive for filling out a risk survey, as long as the reward does not exceed 20 percent of the cost of coverage under the plan, and certain other requirements are satisfied, Mr. Moderson said.

The Equal Employment Opportunity Commission, however, has questioned whether such incentives would violate the American with Disabilities Act. If you feel coerced into filling out a questionnaire, or annoyed that some employees get compensated for doing so, speak to the human resources department.

MAKE IT WORK FOR YOU If you’re already using your company’s wellness plan, great. But if you’ve been reluctant, find out what your company has to offer.

“The guy who is not taking advantage of the company wellness plan is underwriting the one who is,” Mr. Kessler said. “You’re basically leaving money on the table.”

Call up your human resource department and find out what you might be entitled to. Or go on your company’s intranet site and look for a health portal where the information is housed. Common perks are ones that even the change-averse are likely to appreciate: discounts on gym memberships and free flu shots, blood pressure tests and mammograms.

MAKE SUGGESTIONS If your company doesn’t offer wellness benefits, and you wish they did, talk to your supervisor or human resources department.

“There’s been a dramatic shift in attitudes toward health at all sized companies,” said Shelly Wolff, national health and productivity leader at Watson Wyatt. “Start by asking for simple things that don’t cost much money.”

Can the company arrange for a corporate discount at a local Y or gym? Will they sponsor a baseball or basketball team? Could they arrange to have a yoga class once a week in an empty conference room? If they snarl, remind them that studies show wellness programs result in less absenteeism and lower costs.

What boss can argue with that?
Source: New York Times
http://www.nytimes.com/2009/05/23/health/23patient.html?_r=1&ref=health

Congress Plans Incentives for Healthy Habits

In its effort to overhaul health care, Congress is planning to give employers sweeping new authority to reward employees for healthy behavior, including better diet, more exercise, weight loss and smoking cessation.

Congress is seriously considering proposals to provide tax credits or other subsidies to employers who offer wellness programs that meet federal criteria. In addition, lawmakers said they would make it easier for employers to use financial rewards or penalties to promote healthy behavior among employees.

Two Democratic senators working on comprehensive health legislation, Max Baucus of Montana, the chairman of the Finance Committee, and Tom Harkin of Iowa, have taken the lead in devising such incentives.

"Prevention and wellness should be a centerpiece of health care reform," said Mr. Harkin, who regularly climbs the stairs to his seventh-floor office on Capitol Hill.

The White House agrees. One of President Obama's eight principles for health legislation is that it must "invest in prevention and wellness," a goal espoused in almost identical words by Republican senators like John Cornyn of Texas and Orrin G. Hatch of Utah.

Frank B. McArdle, a health policy expert at Hewitt Associates, a benefits consulting firm, said, "Wellness and prevention programs have become a mainstream part of the benefits offered by large employers, and it's virtually certain that Congress will include incentives for such programs" in its bill. The goals of such programs are to help people control blood pressure, fight obesity and manage diabetes and other chronic conditions.

Under Mr. Harkin's proposal, employers could obtain tax credits for programs that offer periodic screenings for health problems and counseling to help employees adopt healthier lifestyles. Programs could focus on tobacco use, obesity, physical fitness, nutrition and depression, he said.

If, for example, an employer pays the cost of gym membership for employees as part of a wellness program, the payment is often counted as taxable income to employees.

Helen Darling, president of the National Business Group on Health, which represents 300 large employers, said, "We would like Congress to change the law so it would not be taxable income if an employer provides a benefit to help employees stay healthy."

Employers who reward healthy behavior may also run afoul of a 1996 law intended to prevent group health plans from discriminating against people because of their health status or medical history.

If an employer offers financial incentives to employees for lowering cholesterol, losing weight or stopping smoking, the amount of such rewards generally may not exceed 20 percent of the cost of coverage.

Many employers would like to offer larger incentives, and many in Congress want to let them do so.
Source: IHRSA