Byline: MICHAEL BRADFORD
MIAMI-Employers can encourage workers to stay healthy by using financial incentives and penalties to promote lifestyle changes, a disease management executive says.
Such actions help employers change workers' perception of health care, and such a mindset change can aid companies' efforts to reduce their health care costs, he said.
Most workers consider health care an entitlement and give little thought to what impact having a healthy lifestyle could have on the cost of health care, said Richard Hodsdon, director of marketing and business development for HHS Health Options, a provider of health management services in Grand Rapids, Mich.
'When you get into an entitlement mentality...people believe that they deserve it, regardless of whatever contributing factors that they may have to the condition that they are experiencing,'' Mr. Hodsdon said during an educational session at the Self-Insurance Institute of America Inc.'s recent annual conference in Miami.
Such a mentality is encouraged by a system where health care premiums are the same, for example, for someone who stays fit and runs marathons and another individual who 'eats two or three pizzas a week and drinks a six-pack a night,'' Mr. Hodsdon said.
'Both are paying the exact same amount for access to health care,'' Mr. Hodsdon said.
Employers can help reduce their costs by implementing changes in their health plans that encourage employees to instead view health care as a commodity, Mr. Hodsdon said.
Plans can be developed that identify workers who are likely to incur significant health care costs because of existing health conditions, unhealthy lifestyles or both, Mr. Hodsdon said. The aim of such plan designs is to make changes in managing a health condition and lifestyle before a condition develops that will 'trigger traditional case management,'' he said.
'So what we're trying to do is bring intervention earlier into the process than what we do right now,'' Mr. Hodsdon said, by identifying workers who need health care management services before they become claimants. 'Creating a care plan around whatever their needs are-that's going to give us an advantage in containing costs.''
Mr. Hodsdon stressed that the aim is not to create a methodology to ensure that all workers are of the perfect height and weight and are disease-free. Rather, 'if you have a condition that we know is directly attributable to lifestyle, you now have an obligation to participate in a care-planning process to ensure that you are doing everything possible to control that disease condition. That doesn't mean you're suddenly going to lose 50 pounds or mean that you are...magically not diabetic,'' he said.
However, such plans would impose a responsibility on workers to avoid lifestyles that would exacerbate their conditions, Mr. Hodsdon said.
'If you are diabetic, you're going to have your hemoglobin tested, you're going to go to your primary care physician at the dates and times indicated, you're going to be on a walking program, you're going to monitor your blood sugar. There's a level of compliance that you are bringing to the table, that you are expected to provide, that you didn't have to historically,'' he said.
If workers do not take on accountability under such programs, 'there is a premium that you're going to have to pay for that,'' Mr. Hodsdon said.
For example, a plan might be designed that imposes a 10% copayment on members that participate in the enhanced case management and a 40% copay on those that do not, he said.
Employers who implement such programs generally see health care spending fall by around 3% in the second year and around 9% in the third year, Mr. Hodsdon noted.
Despite any company savings, he warned, not all employees are going to be enthusiastic about such a big cultural change, and a backlash likely will be felt. 'This is not going to be well received, by and large,'' he said.
