How's this for an incentive? You get to keep your health insurance
Feb 02, 2009
by By Karrie Andes
Why is he so disgruntled? Because while many employers offer cash incentives, reduced premiums, t-shirts, gift cards and other carrots for completing health risk assessments, we make them mandatory. I worked through all the legal details with our local Employee Benefits Security Administration and our carrier. New enrollees must complete the assessment within 45 days; and annually thereafter.
Consequence for noncompliance? We drop your coverage.
For some, this approach is tough to swallow. But for me, it's necessary for our workforce. We are heavy industry, primarily male, with an average age of 43. During a claims review meeting, I saw that a good portion of our members never filed any claims. For most that sounds good, but claims are the primary source of triggering our disease management programs. Generally, it's not employees that are using insurance that I worry about, but rather the "ticking time bombs" that never have any claims then show up at the emergency room with a major event. Unfortunately, heart attacks seem to be a general theme.
Over 60% of our folks are drivers, covered under Department of Transportation regulations. DOT requires a physical every two years, to be completed at an occupational clinic. This information, unfortunately, is not coordinated through our health plan, so I needed something else to trigger disease management programs. Health risk assessments have been the answer.
We started the questionnaires in the fall of 2007. So far, the assessments have triggered 12% of our members into our nurse-assisted programs. But I do have to say, this process has been painful. We had 1,700 assessments that needed to be completed, and of course, we pushed them toward the online version. Regardless, more than half of our assessments were completed on paper; we were surrounded by "War and Peace"-thick stacks at every turn.
Then came the real nightmare, as we faced charges from the carrier to enter the data or do the work ourselves. I'm all about savings, but I didn't anticipate all the input problems we'd have with logins, passwords and the carrier trying to hide behind HIPAA.They claimed they needed to protect confidentiality, but we argued that we were the plan sponsor and were entitled to all data on the plan. Besides, we can look up anything we need to in the claims system anyway. What's the difference? Long story short, we finally got them all in, but the experience was similar to a root canal.
Is it making a difference? You bet. If a nurse can help keep a diabetic on track, that's less expense for us down the road and greater protection for our self-insured plan.
Not too long ago, I attended a wellness seminar. The speaker asked the audience if anyone offered health risk assessments. My mouth literally fell open when one attendee reported that they offered each employee a $750 refund on their premiums. What do we offer? Awesome benefits, low premiums and decreased plan expenses over the past two years. "Mr. Grumpy" certainly doesn't like it, but he'd be even grumpier if we took more from his paycheck or slashed his benefits. Then again, he'd probably still be cranky.
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