by Bruce Shutan
It’s easy for employees to fall short when it comes to achieving fitness, weight loss or smoking cessation goals if they become complacent about maintaining behavior change. This complacency can stem from their employer falling into the same trap by not adequately promoting their wellness program with fresh communications, relying solely on an incentive to create an impact.
Incentives can be effective in improving participation and behavior change, but are not sufficient to improve long-term outcomes on their own. To have the greatest impact, a well-designed health and wellness program should have an effective communications strategy and an emphasis on creating a culture of health in the workplace.
An effective communications campaign can shape an employee’s view of the incentive program and has the potential to impact the size of incentive necessary to generate the desired outcomes. A recent article on incentives by Healthways’ Center for Health Research cited evidence that employers that advertised their wellness programs more frequently and through multiple mediums could use much lower incentives to achieve the same results compared with employers that were less committed to promotion.
Employers also can improve outcomes by creating a culture of health in the workplace through stocking the corporate cafeteria or vending machines with healthier selections, sponsoring employee walking clubs and yoga classes, providing gym membership discounts or declaring a smoke-free workplace.
“If the culture is in place, then people feel more inclined to develop healthy behaviors,” explains Elizabeth Rula, Ph.D., manager of clinical research at Healthways Inc. “A lot of the research shows that employer commitment to the program is really a huge driver of success.”
Reward and punishment
One of the first things an organization must do is to carefully consider whether to adopt a “carrot or stick” approach to incentives, based on their objectives, comfort level and tolerance for controversial measures when determining the most effective means of achieving results.
Incentives are used to reward individuals for taking certain actions or for achieving desired results such as enrolling in a program, changing health behaviors or making measurable improvements to their health. Alternatively, disincentives penalize those who do not take an action or have a successful outcome.
A combination disincentive/incentive approach is often employed by increasing the cost of health insurance coverage for all employees, then providing a discount for program involvement. This strategy, if communicated properly, may avoid the stigma of a disincentive yet minimize the costs associated with incentivizing a program.
The key to success is how resources are deployed. Rula noted the success of the incentive program used in the SilverSneakers Fitness Program for seniors, even though the program is limited to using incentives that align with Centers of Medicare and Medicaid Services guidelines and generally involve small gifts, such as t-shirts.
Despite the fact that small tangible gifts are not typically effective at driving healthy behaviors, these gifts were promoted with great fanfare and rewards were given for discreet, time-limited actions such as visiting a fitness center a certain amount of times. Gifts also were emblazoned with the SilverSneakers logo, which helped create a powerful brand and fostered a sense of community among participants who greatly valued the program. Also, the demographic group targeted may have an impact.
Realistic goals
One challenge is to ensure that each incentive or disincentive reflects the perceived difficulty of the required action. Rula says some companies use focus groups to pin down these details and also need to be mindful that goals must be achievable. This may require the establishment of incremental rewards for ongoing participation or progress toward a goal.
In discussing how organizations monetize incentives, Rula cited a study by Great-West Healthcare that examined the minimum dollar amount that would encourage the adoption of healthy behaviors. The decision on where to spend those dollars ultimately hinges on the behaviors that are driving up health care costs within any given employee population.
“It’s not very difficult for someone to take an HRA or floss their teeth everyday, but to implement an exercise program, lose weight, eat healthier or stop smoking are big changes in one’s lifestyle that require larger dollar amounts,” she notes.
Healthways has found that in a health coaching program, people are more likely to take calls at off-peak times when it’s not so convenient if there’s a greater incentive involved.
“Incentives help to overcome perceived barriers to participation. The success of almost any program can be further enhanced through the appropriate use of incentives,” Rula says.
About the author
Bruce Shutan, former managing editor of Employee Benefit News, is a freelance writer based in Los Angeles.
Wednesday, September 9, 2009
Friday, August 21, 2009
Health Reform Is Useless Without Behavior Change
Les Masterson, for HealthLeaders Media, August 19, 2009
I have come to a sobering conclusion. All of this talk about reducing healthcare costs through reform is a waste of time unless the American population takes responsibility for their own health. And I don't see much evidence of personal responsibility built into any of the reform plans.
This change will take more than health insurers and employers passing more costs to the individual through higher copays and deductibles—or conversely lowering costs for proper testing, counseling, and immunization. It will also take more than doctors telling patients to get active and eat better or payers reforming payments so that physicians are properly reimbursed for providing that guidance. It will even require more than the government spending millions on wellness and prevention programs that are part of healthcare reform proposals.
All of these ideas are steps in the right direction, but they won't be effective without more Americans taking responsibility for their health.
In an article I wrote for the August 2009 issue of HealthLeaders magazine, I explored the idea that prevention can reduce health costs. During my interviews, one of the most depressing—and truthful—lines about health came from Michael D. Parkinson, MD, MPH, FACPM, principal at P3 Health LLC, which promotes personal and organization prevention, performance, and productivity improvements. Parkinson told me “there is no such thing as a healthy American any more.”
Parkinson, who is also past president of the American College of Preventive Medicine, and former executive vice president and chief health and medical officer at Lumenos, a pioneer consumer-driven health plan, pointed to the recent National Health and Nutrition Examination Survey that found only 8% of the population eats five fruits and vegetables a day, doesn't smoke, spends 30 minutes on physical activity a day, and is within 5 pounds of their ideal body weight.
You might consider that too high of a threshold, but how many people even meet two of those healthy living ideals? Stop by your local breakfast joint and you'll see what I mean.
Chronic disease is costing healthcare and the American economy billions of dollars through direct health costs and reduced productivity costs. David Knowlton, president and CEO of the New Jersey Health Care Quality Institute and board member of the HealthWell Foundation in Gaithersburg, MD, told me preventable chronic disease costs $7.5 billion in New Jersey annually. Meanwhile, state health reforms would cost the state $1.1 billion. By simply reducing the numbers of people with chronic diseases, healthier Garden Staters could help cut healthcare costs without having to open their wallets.
This is not to bash Americans as gluttonous. Heaven knows I could drop a few pounds and devote more time to physical activity. But what's it going to take for Americans like me to actually become more active and care about our health? Sure, a diabetes or heart disease diagnosis would spark action, but by that point prevention is out the window and then it is all about changing gears to stop the progress of the disease.
The last major physical fitness craze was in the early-1980s when Olivia Newton-John and Jane Fonda hopped into their spandex and got Americans into the gym and into bad aerobics outfits. I hope we don't need a celebrity to spark a new fitness craze, but one thing is clear: Unless we get more of the population interested in their health, the trillions of dollars that will go to health reform won't stop the spiraling health costs.
--------------------------------------------------------------------------------
Note: You can sign up to receive Health Plan Insider, a free weekly e-newsletter designed to bring breaking news and analysis of important developments at health plans and other managed care organizations to your inbox.
--------------------------------------------------------------------------------
Les Masterson is senior editor of Health Plan Insider. He can be reached at lmasterson@healthleadersmedia.com.
I have come to a sobering conclusion. All of this talk about reducing healthcare costs through reform is a waste of time unless the American population takes responsibility for their own health. And I don't see much evidence of personal responsibility built into any of the reform plans.
This change will take more than health insurers and employers passing more costs to the individual through higher copays and deductibles—or conversely lowering costs for proper testing, counseling, and immunization. It will also take more than doctors telling patients to get active and eat better or payers reforming payments so that physicians are properly reimbursed for providing that guidance. It will even require more than the government spending millions on wellness and prevention programs that are part of healthcare reform proposals.
All of these ideas are steps in the right direction, but they won't be effective without more Americans taking responsibility for their health.
In an article I wrote for the August 2009 issue of HealthLeaders magazine, I explored the idea that prevention can reduce health costs. During my interviews, one of the most depressing—and truthful—lines about health came from Michael D. Parkinson, MD, MPH, FACPM, principal at P3 Health LLC, which promotes personal and organization prevention, performance, and productivity improvements. Parkinson told me “there is no such thing as a healthy American any more.”
Parkinson, who is also past president of the American College of Preventive Medicine, and former executive vice president and chief health and medical officer at Lumenos, a pioneer consumer-driven health plan, pointed to the recent National Health and Nutrition Examination Survey that found only 8% of the population eats five fruits and vegetables a day, doesn't smoke, spends 30 minutes on physical activity a day, and is within 5 pounds of their ideal body weight.
You might consider that too high of a threshold, but how many people even meet two of those healthy living ideals? Stop by your local breakfast joint and you'll see what I mean.
Chronic disease is costing healthcare and the American economy billions of dollars through direct health costs and reduced productivity costs. David Knowlton, president and CEO of the New Jersey Health Care Quality Institute and board member of the HealthWell Foundation in Gaithersburg, MD, told me preventable chronic disease costs $7.5 billion in New Jersey annually. Meanwhile, state health reforms would cost the state $1.1 billion. By simply reducing the numbers of people with chronic diseases, healthier Garden Staters could help cut healthcare costs without having to open their wallets.
This is not to bash Americans as gluttonous. Heaven knows I could drop a few pounds and devote more time to physical activity. But what's it going to take for Americans like me to actually become more active and care about our health? Sure, a diabetes or heart disease diagnosis would spark action, but by that point prevention is out the window and then it is all about changing gears to stop the progress of the disease.
The last major physical fitness craze was in the early-1980s when Olivia Newton-John and Jane Fonda hopped into their spandex and got Americans into the gym and into bad aerobics outfits. I hope we don't need a celebrity to spark a new fitness craze, but one thing is clear: Unless we get more of the population interested in their health, the trillions of dollars that will go to health reform won't stop the spiraling health costs.
--------------------------------------------------------------------------------
Note: You can sign up to receive Health Plan Insider, a free weekly e-newsletter designed to bring breaking news and analysis of important developments at health plans and other managed care organizations to your inbox.
--------------------------------------------------------------------------------
Les Masterson is senior editor of Health Plan Insider. He can be reached at lmasterson@healthleadersmedia.com.
Tuesday, July 14, 2009
Healthcare Costs for Overweight and Obese Patients Grow
Cheryl Clark, for HealthLeaders Media, July 13, 2009
Healthcare payers spent a lot more per person to treat those who were obese and overweight in 2006 than they paid in 2001.
That's the message from a new federal report that ranked spending on adult patients categorized by body mass index. The increased spending per person is attributed to greater expense of managing chronic conditions, such as diabetes or high blood pressure.
Those who are obese and overweight tend to have one or more such diagnoses, and also tend to have more of them than they did in 2001.
Spending increased 82% for people who were obese in that period, from $167 billion to $303 billion. For people who were classified as overweight but not obese, healthcare spending increased 36% from $202 billion to $275 billion. For people of normal BMI, treatment costs increased 25%, from $208 billion to $260 billion.
On an average spending per person basis, spending went from $3,458 to $5,148 for those classified as obese. For those who were overweight, the cost rose from $2,792 to $3,636. For each person of normal weight, the average costs rose from $2,607 to $3,315.
Additionally, the percentage of people classified as obese went from 23.6% of the population in 2001 to 27.2% in 2006, or 58.9 million. The number classified as normal or under weight stayed about the same. The percentage of people classified as overweight decreased slightly, from 35.4% to 34.9%, or 75.6 million. The percentage of people classified as normal weight dropped slightly from 39% to 36.1%, or 78.3 million.
The report said variables influencing higher costs included asthma, ischemic heart disease, angina, heart attack stroke, emphysema, and arthritis. Estimates for each year are in that year's dollars. Spending included the cost of doctor, hospital outpatient and emergency room visits, hospitalizations, home healthcare services, dental visits, other medical expenses and prescription drugs.
The report was prepared as part of a series of briefs issued from data from the Medical Expenditure Panel Survey and was written by Marie Stagnitti of the Agency for Health Research and Quality.
The report was among four released in the last week pointing to the growing impact of obesity on the health status of Americans.
The first, issued by Trust for America's Health and the Robert Wood Johnson Foundation, showed that obesity in adults rose in 23 states in the past year and didn't decline in any of them. The state with the most obesity was Mississippi, followed by Alabama, West Virginia and Tennessee.
The second report came from the Centers for Disease Control and Prevention, which said 26% of the population is now fully obese with two thirds of America either obese or overweight.
The third report last week was published in the journal Health Affairs, which said that while the prevalence of obesity in children and adolescents had not increased, hospitalizations and the cost of care for those patients nearly doubled.
The four reports prompted the president of the Massachusetts Medical Society to warn that failure to fight the problem more aggressively could thwart meaningful efforts at health reform. "The impact of obesity on personal health is damaging enough, which such chronic diseases as diabetes, heart disease, and arthritis," said Mario Motta, MD, a cardiologist. "But the public health implications are enormous and the associated costs to treat obesity and its complications could hinder health care reform."
--------------------------------------------------------------------------------
Cheryl Clark is a senior editor and California correspondent for HealthLeaders Media Online. She can be reached at cclark@healthleadersmedia.com.
Healthcare payers spent a lot more per person to treat those who were obese and overweight in 2006 than they paid in 2001.
That's the message from a new federal report that ranked spending on adult patients categorized by body mass index. The increased spending per person is attributed to greater expense of managing chronic conditions, such as diabetes or high blood pressure.
Those who are obese and overweight tend to have one or more such diagnoses, and also tend to have more of them than they did in 2001.
Spending increased 82% for people who were obese in that period, from $167 billion to $303 billion. For people who were classified as overweight but not obese, healthcare spending increased 36% from $202 billion to $275 billion. For people of normal BMI, treatment costs increased 25%, from $208 billion to $260 billion.
On an average spending per person basis, spending went from $3,458 to $5,148 for those classified as obese. For those who were overweight, the cost rose from $2,792 to $3,636. For each person of normal weight, the average costs rose from $2,607 to $3,315.
Additionally, the percentage of people classified as obese went from 23.6% of the population in 2001 to 27.2% in 2006, or 58.9 million. The number classified as normal or under weight stayed about the same. The percentage of people classified as overweight decreased slightly, from 35.4% to 34.9%, or 75.6 million. The percentage of people classified as normal weight dropped slightly from 39% to 36.1%, or 78.3 million.
The report said variables influencing higher costs included asthma, ischemic heart disease, angina, heart attack stroke, emphysema, and arthritis. Estimates for each year are in that year's dollars. Spending included the cost of doctor, hospital outpatient and emergency room visits, hospitalizations, home healthcare services, dental visits, other medical expenses and prescription drugs.
The report was prepared as part of a series of briefs issued from data from the Medical Expenditure Panel Survey and was written by Marie Stagnitti of the Agency for Health Research and Quality.
The report was among four released in the last week pointing to the growing impact of obesity on the health status of Americans.
The first, issued by Trust for America's Health and the Robert Wood Johnson Foundation, showed that obesity in adults rose in 23 states in the past year and didn't decline in any of them. The state with the most obesity was Mississippi, followed by Alabama, West Virginia and Tennessee.
The second report came from the Centers for Disease Control and Prevention, which said 26% of the population is now fully obese with two thirds of America either obese or overweight.
The third report last week was published in the journal Health Affairs, which said that while the prevalence of obesity in children and adolescents had not increased, hospitalizations and the cost of care for those patients nearly doubled.
The four reports prompted the president of the Massachusetts Medical Society to warn that failure to fight the problem more aggressively could thwart meaningful efforts at health reform. "The impact of obesity on personal health is damaging enough, which such chronic diseases as diabetes, heart disease, and arthritis," said Mario Motta, MD, a cardiologist. "But the public health implications are enormous and the associated costs to treat obesity and its complications could hinder health care reform."
--------------------------------------------------------------------------------
Cheryl Clark is a senior editor and California correspondent for HealthLeaders Media Online. She can be reached at cclark@healthleadersmedia.com.
Wednesday, July 8, 2009
New Web site helps employers combat the obesity epidemic
By Joelle Atkinson
July 7, 2009
Responding to requests from the employer community, the Centers for Disease Control and Prevention recently launched a new Web site titled LEANWorks!, which offers metrics and advice on weight-loss programs in the workplace.
Advertisement
The CDC’s Web site is free and helps employers to calculate how much the obesity epidemic is costing them. For instance, online visitors can access an obesity cost-calculator that estimates obesity-related health costs based on workforce demographics.
Additionally, the online program comes equipped with a portal that assists employers in personalizing weight-loss programs, such as fitness classes, lunchtime health and education sessions and other wellness activities.
The CDC hopes the Web site will facilitate employers’ efforts to plan and execute interventions to stop obesity before it starts. “CDC has identified science-based interventions that work to prevent and control obesity. [The online program] provides the tools that employers need to take action,” says Dr. William Deitz, director of CDC’s division of nutrition, physical activity, and obesity.
Obesity can be a large risk factor for high blood pressure, type 2 diabetes and cardiovascular diseases. The government reports that obese individuals tend to spend an average of 77% more on medications needed to combat their chronic diseases.
“Obesity affects more than just health care costs. It also has a significant impact on worker productivity because the more chronic diseases employees have, the more likely they are to be absent from work, or less productive if they come to work sick,” says Dr. Janet Collins, director of CDC’s National Center for Chronic Disease Prevention and Health Promotion.
Many employers tend not to publish outcomes and results on their wellness and diseases programs in scientific journals. Consequently, researchers at the CDC personally visited businesses that had promising obesity prevention and control practices. Employers' testimonials on their weight-loss programs are also posted on the new Web site.
Related coverage:
Health Workforce Act may help, but employers, advisers must continue to promote
Well-being indices next on stock ticker?
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No part of the content contained herein may be transmitted, redistributed, copied, stored, downloaded, abstracted, disseminated, circulated or included as part of any other service or product. For all permissions, please contact Godfrey R. Livermore at 212-803-8351, godfrey.livermore@sourcemedia.com.
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July 7, 2009
Responding to requests from the employer community, the Centers for Disease Control and Prevention recently launched a new Web site titled LEANWorks!, which offers metrics and advice on weight-loss programs in the workplace.
Advertisement
The CDC’s Web site is free and helps employers to calculate how much the obesity epidemic is costing them. For instance, online visitors can access an obesity cost-calculator that estimates obesity-related health costs based on workforce demographics.
Additionally, the online program comes equipped with a portal that assists employers in personalizing weight-loss programs, such as fitness classes, lunchtime health and education sessions and other wellness activities.
The CDC hopes the Web site will facilitate employers’ efforts to plan and execute interventions to stop obesity before it starts. “CDC has identified science-based interventions that work to prevent and control obesity. [The online program] provides the tools that employers need to take action,” says Dr. William Deitz, director of CDC’s division of nutrition, physical activity, and obesity.
Obesity can be a large risk factor for high blood pressure, type 2 diabetes and cardiovascular diseases. The government reports that obese individuals tend to spend an average of 77% more on medications needed to combat their chronic diseases.
“Obesity affects more than just health care costs. It also has a significant impact on worker productivity because the more chronic diseases employees have, the more likely they are to be absent from work, or less productive if they come to work sick,” says Dr. Janet Collins, director of CDC’s National Center for Chronic Disease Prevention and Health Promotion.
Many employers tend not to publish outcomes and results on their wellness and diseases programs in scientific journals. Consequently, researchers at the CDC personally visited businesses that had promising obesity prevention and control practices. Employers' testimonials on their weight-loss programs are also posted on the new Web site.
Related coverage:
Health Workforce Act may help, but employers, advisers must continue to promote
Well-being indices next on stock ticker?
Reprints
No part of the content contained herein may be transmitted, redistributed, copied, stored, downloaded, abstracted, disseminated, circulated or included as part of any other service or product. For all permissions, please contact Godfrey R. Livermore at 212-803-8351, godfrey.livermore@sourcemedia.com.
Reprints
Related Articles
Remote diabetes testing could curb medical, drug costs
Minority report
Mental Health Parity and Addiction Equity Act signed into law
Paid sick days are highly valued
Chronic conditions afflict more than half of Americans
Most Popular
New Web site helps employers combat the obesity epidemic
‘Pay or play’ not as painful as originally thought
Tips for IPS Refining your 401(k) IPS and other fiduciary compliance tips
Most Forwarded
Employers, workers clash over social networks
House panel approves 401(k) transparency bill
Could your employees be corporate thieves?
Advertisement
Sponsored Links
Click here to advertise in this space
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