Wednesday, February 21, 2007

A nationwide increase in illness preventive programs shows that employers understand healthy lifestyles can reduce crippling health care costs.

But state governments aren’t always as supportive. In Maryland, for instance, there is no provision for companies to offer preventive programs to quit smoking or lose weight.

So CareFirst BlueCross BlueShield, the Mid-Atlantic’s top health insurer, is making a push in the state legislature to pass a bill that would allow insurers and companies to offer workers incentives, such as cash, to participate in preventive care programs.



“Without incentives there is very little participation in wellness programs,” said Bill Casey, vice president of government affairs at CareFirst. “And that’s expected when there isn’t a carrot.”

Mr. Casey said the Maryland Insurance Administration under former Gov. Robert L. Ehrlich Jr. supported the bill, which is sponsored by Delegate Dan Morhaim, Baltimore Democrat.

The legislation was passed by the House Health and Government Operations Committee this month, although incoming Gov. Martin O’Malley’s administration has not taken a position on the bill.

Businesses in Maryland that self-pay health insurance costs — versus firms that pay an insurance company to administer medical claims — cannot offer an employee incentives worth more than $10 to join a wellness program. The current law is designed to stop employers or health insurers from enticing workers into buying bad policies.

But Mr. Casey said there is no cost to an employee to join a wellness program. The company takes on any additional costs, he said. Mr. Morhaim’s bill does not place a dollar amount on incentives but would allow anything “reasonable.”

Preventive care initiatives or “wellness programs” range from smoking cessation plans to prenatal care programs to annual health screenings and are taking off across the country, a new survey found.

Nationally, more than three-fourths of American workers participate in health screenings, over a 10 percent increase from last year, according to the Principal Financial Group, a national health care provider in Iowa.

Jerry Ripperger, director of consumer health at Principal said large employers — 500 or more employees — still offer wellness programs more often than smaller companies but the gap is closing.

“This used to be something that large employers were only able to do but more and more companies that pay for their own insurance recognize the cost savings that can be achieved,” he said.

“The more employers that offer wellness programs, the more employees will participate. We’ve already begun to see the financial impact.”

The most common type of inducement into a wellness program is cash, according to a February 2007 by Mercer Health and Benefits, a global human resources consulting company in New York. Other incentives are more specific. For instance, CareFirst offers pregnant women gift baskets with diapers and infant care seats, which normally don’t exceed $100 in total value.

“The unhealthy behavior we engage in is expensive and places a burden on the individual, employers and our state [Maryland],” said Richard Safeer, medical director at CareFirst. “Those with good exercise habits have medical costs $400 to $500 less than those with poor exercise habits. Smokers incur an additional $1,600 in medical costs per year when compared to non-smokers.”

The Black & Decker Corp. in Towson is a self-insured company, meaning it pays its own health care costs and is not restrained by state law from offering incentives to its workers. Six years ago the company decided to use preventative care programs to lower health care costs. The result is a zero increase in health care costs, according to Raymond Brusca, vice president of benefits.

“We cannot be there when an employee decides to buy a double quarter-pounder from McDonald’s,” he said. “But we can educate our employees to the effect of poor health decisions and offer ways to get healthy. We’ve seen our health care costs level off since taking this approach.”

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