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Insurers ride new wave of wellness-based plans

Controlling costs has become the top health and welfare benefits objective of most employers, according to the eighth annual Employee Benefits Trends Study from New York City-based MetLife. However, while 69 percent of employers believe that health and wellness programs can reduce medical costs and 48 percent believe they also can increase employee productivity, the growth of wellness programs prior to the passage of the health reform law can only be described as steady. According to MetLife's data, 37 percent of employers currently offer a wellness program, up from 33 percent in 2008 and 27 percent in 2005. Wellness programs are more prevalent among large employers with 500 or more employees: 61 percent now offer a wellness program compared to 57 percent in 2008 and 46 percent in 2005. The wellness programs offered by employers run the gamut. Ten percent of employers who provide wellness programs institute financial penalties for employees who don't follow wellness guidelines, and 39 percent offer employee assistance programs.

There is a definite disconnect between employer beliefs about the benefits of wellness programs and their actions. Roughly 60 percent of the employers that cite cost savings and employee productivity as important benefits objectives don't offer wellness programs. Further, almost nine out of 10 employers who didn't offer health and wellness programs last year report they are unlikely to offer such programs within the next 12 months, according to MetLife.

But the health reform law could provide new "opportunities of convergence" as employers seek out the best bang for their buck and the nation's healthcare system takes on a newly preventive slant. Heath insurers definitely are making a concerted push to create innovative wellness programs. Here are some new programs announced just this month:

  • UnitedHealth Group in Minneapolis made the biggest splash with the debut of the Diabetes Prevention and Control Alliance. The health insurance giant is partnering with the YMCA-USA and retail pharmacies (Walgreens is the first) to create networks of life coaches and pharmacists who will be paid to help people prevent or control diabetes. UnitedHealth also is partnering with "Sesame Street" parent Sesame Workshop to create a bilingual outreach education program to help low-income families address nutrition and obesity issues.
  • This September Aetna Inc., in Hartford, Conn., will launch the Healthy Lifestyle Coaching program, which is designed to address multiple health issues, including weight management, tobacco cessation, stress management, nutrition, physical activity and preventive health. The program offers one-on-one motivational coaching sessions, as well as online self-directed programs, to engage members in wellness efforts.
  • Independent Health Association in Buffalo, N.Y. has created the Empower plan, which it bills as "the first product of its kind in New York state that rewards individuals who choose a healthier lifestyle with lower out-of-pocket costs." This plan, which will be available Sept. 1 to groups of more than 50 employees, has two options: enhanced and standard. The two options offer the same benefits, but the enhanced option has lower copayments and deductibles based on whether members follow plan requirements related to tobacco use, body mass index and blood pressure.

If health insurers are able to create targeted wellness programs that address the needs of both employers and employees, we may soon enter a new age where the image of the health insurer as a mere pencil pusher is but a distant memory. - Caralyn

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