Moving Towards Outcome-based Wellness Incentives
Stumbled across a thought-provoking article in the Employee Benefit News earlier today regarding how to get the best bang for one’s buck utilizing employee wellness incentives. Here are a few excerpts from the article:
…the wellness industry is moving toward an outcomes-based incentive model that measures health outcomes such as tobacco use, BMI, cholesterol, blood pressure or blood glucose levels. Penalizing smoking is most popular among wellness programs, with many employers applying a premium surcharge against smokers. But employers can reward or apply a penalty for each metric. According to Frank Hone, managing director of Healthcentric Partners, Inc., many employers are considering structuring incentives as a tiered health plan, similar to the auto insurance market.
In terms of implementation, Hone suggests determining how a wellness incentive structure fits in with the employer’s overall human capital approach and company culture. Another factor is whether the employer is more paternalistic or leans toward a model of accountability based on the insurance plan selected. A value-based plan or consumer-driven health plan would have accountability built into the overall structure. For example, employees could earn additional contributions into their health savings accounts by participating in a health coaching series or achieving a health goal.
The article also provides some quality general guidance on staying in compliance with HIPAA and ACA rules and regulations:
Downs recommends employers implement wellness incentives as part of a group health plan to avoid litigation under discrimination of employment laws. She adds that employers should pay attention to state laws because some states allow for smokers’ rights.
The number one red flag she sees is prohibiting individuals from enrolling into a health plan until they lower their BMI or achieve another health outcome, which could violate HIPAA’s discrimination rule.
To avoid penalties, she suggests that “the more aggressive the wellness program, the more cautious the employer should be before implementing it and getting legal counsel before applying incentives.”
And eventually self-reported data will need to be supplemented by more hard data to confirm outcomes more objectively:
Cigna’s Herbek believes the next stage in incentive programs will be making metric reporting easier to monitor. Instead of self-reporting data or measuring health status in a lab, self-monitoring devices that are objective will measure the individual’s health.
Go read the whole article here today.