Workplace Wellness Programs: Good For Health Costs?

Some companies offer discounts to healthy employees, but patient advocates fear such wellness programs could be unfair.

NPR's Renee Montagne interviews Safeway Inc. CEO Steve Burd, who "says employees receive a discount on their health insurance if their body mass index is below 30, the number over which people are considered obese." If someone's BMI is above 30, they pay $318 more, he explains, "[b]ut the beauty of our plan is that if you make a reduction of, let's say 10 percent of your body mass index, we write you a check at the end of the year for making that progress. …On a per capita basis, Burd says, Safeway has kept its costs flat for the past five years. He argues that if similar programs were implemented across the nation, health care spending would be drastically reduced."

NPR notes that "[c]ritics of Burd's data say Safeway's health care savings have not been independently verified. In a Kaiser Health News report, a spokeswoman for Safeway acknowledged that there has been no independent analysis, but said, 'We were able to see savings clearly and immediately the first year we implemented the program.'" And some organizations, including the American Heart Association and the American Cancer Society say "that a program that lets the healthy pay less for health care discriminates against those who may be less healthy for a variety of reasons, including pre-existing conditions or socioeconomic status" (Morning Edition, 10/7).

Meanwhile, "[o]n Capitol Hill, lawmakers seem eager to encourage employers to create and expand programs that tie a portion of workers' health insurance premiums to their willingness to change unhealthy behaviors," NPR reports in a separate story. "But there's growing concern that some of those programs represent a new way to discriminate against those in less than perfect health." The Senate Finance Committee recently approved an amendment "that would expand existing rules that let workplace 'wellness' programs pay bonuses in the way of reduced premiums to workers to lose weight, quit smoking, control their blood pressure or practice other healthy behaviors. Current rules allow premiums to vary by up to 20 percent of a worker's total health insurance premium. Under the amendment adopted by the committee, that could rise to as much as 50 percent."

But Dick Woodruff, senior director of federal relations at the American Cancer Society-Cancer Action Network says such programs allow "insurers and employers to cherry pick.'" Georgetown professor Karen Pollitz, "who studies the insurance industry, says some existing wellness programs already clearly separate the sick from the healthy" (Rovner, 10/7).

Charlotte Observer: "Raleigh North Carolina is poised to become only the second state to penalize state employees by placing them in a more expensive health insurance plan if they're obese. Smokers will feel the drag of higher costs, too, as North Carolina and South Carolina state employees who use tobacco are slated to pay more for health insurance next year. ... State workers who don't cut out the Marlboros and Big Macs will end up paying more for health insurance. Tobacco users get placed in a more expensive insurance plan starting in July and, for those who qualify as obese, in July 2011" (Johnson, 10/7).

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