By Patricia Anstett, Detroit Free Press |
The 50-year-old UAW benefits coordinator attends occasional Zumba, yoga and weight-loss classes at work and has access to a free personal trainer in the company's state-of-the-art fitness center. The company even has a pharmacy and
With so many opportunities to shape up, Shipp has lost 18 pounds and gotten her cholesterol to healthy levels without medicine.
"It's the healthiest I've ever been," she said.
And by agreeing to take an annual online health assessment and working on goals identified in it, Shipp gets a break on her Blue Cross Blue Shield of
"This has been a real plus for me," Shipp said of her workplace health benefits. "I'm thrilled. I have no plans to leave here."
Employers all over the country, from big companies to city governments, increasingly are offering health insurance policies that reward or penalize employees for progress on personal health goals.
Typical goals -- identified in yearly online health tests that employees voluntarily take -- include smoking cessation, weight loss and management of high-blood pressure and cholesterol. Coaching, either by telephone or through a Web-based program, usually is available to help people through tough spots.
Twenty-seven percent of 536 midsize
The average worker got a
It's a trend that is expected to grow by 2014 because of a provision in the federal Affordable Care Act that will allow insurance plans to increase penalties for habits such as smoking.
The charges could be as much as 50% of a smoker's monthly premium. The government still needs to issue rules on how the penalities would work.
Interest is high
Insurance penalties continue to be controversial. Major companies, including
"The evidence is not clear it does drive change," said
Dow offers two state-of-the-art fitness centers, outdoor walking trails and complete reimbursement for some classes involving diabetes education and weight reduction. It has used health risk assessments for 50 years to encourage workers to shape up but doesn't tie progress on goals to penalities.
The wellness programs alone "absolutely helped" save money on health bills -- an estimated
Among health insurance experts, as well as leading organizations of people with chronic diseases, there are concerns that penalizing employees will hurt the people who need to see doctors the most because they won't be able to afford their share of the bill. There also is no good evidence the plans save money and improve health in the long run, they said.
But with costs rising, both for employers and workers, interest in the plans is high.
Employers spend
At Pat Milliken Ford in
"Everyone wants their premiums to be in check," office manager
Those who refuse to get a health assessment and report on their progress on personal goals have a
"I'd say it's working well," said VanDoornik, citing both savings and health improvements in his workplace.
"We've had cases where people have stopped smoking. Even some spouses stopped. The other piece of it is, you see people taking better care of themselves."
LaFrance, 45, mows lawns, trims trees and plows snow for the
A former high school and college softball and volleyball player, she began to exercise seriously on
She lost 40 pounds through an online weight-loss program that sent her e-mails with eating and nutrition tips. She also stopped smoking and started a daily power walk. She gave up red meat and switched to whole grains.
"You need to take time for yourself, concentrate on goals," LaFrance said. "It's more a personal thing. I didn't do this for
She said she hopes the city stays with its current plan, rather than move to one that charges higher monthly rates or monthly surcharges on smokers and others.
"I think that's going too far," she said. "If you are trying to do the best you can," that should be enough, she said.
Experts urge caution
Until now, health insurers have tried to encourage good health habits with cash prizes, free pedometers, gift cards and other freebies. But without broader support and year-round programs, the efforts too often amount to "wellness-lite," said
Edington said companies are "going to jump on the bandwagon, and they will end up disappointed." Improving health is more complicated than setting up programs to reward the right behaviors, he said.
"People can be paid to lose weight ... but then they go back into the same environment" where they fail without the help and resources they need, he said.
Last month, a coalition of leading heart, cancer, diabetes and other groups issued guidelines to help employers and insurance companies write policies that encourage participation in wellness plans without discriminating against people with chronic diseases.
"The goal of a wellness program should be to empower and enable the individual to improve their health and well-being," said Dr.
The group's primary suggestion is that companies need to develop a corporate culture of wellness that encourages healthy habits year-round. Loeppke pointed to Dow as a model.
Dr.
"I'm not afraid to use sticks, but it's important first to use carrots," Fendrick added.
Chrysler, GM and the
"It's a transformation," said
The company hopes to convey the importance of good health through year-round activities and programs.
'"Improving health is an organizational priority," Neal said. "It's been easy for employers, in the past, to have treated health care as an expense. We feel it's time to change that and look at health care as an investment, not a cost center."
GM's
"The goal is to keep raising the bar to get people more engaged in their health," Manning said.
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