What can an employer do to get employees to have regular medical checkups and tests to spot problems before they mushroom into very-expensive-to-treat complications?
The School District of Palm Beach County, based in West Palm Beach, Florida, has an answer: Give employees an immediate and financial incentive by providing a significant reduction in their health insurance premiums.
Launched in 2011, the school district's Wellness Rewards program offers employees a $50 reduction in the monthly premium they pay for health care coverage. To obtain that premium reduction, employees have to earn 300 points during the plan year, or if their spouses are covered, the employee and spouse each must earn 300 points.
Those points are earned through participation in a variety of health-related activities. For example, 100 points are earned for completing an online health risk assessment, and another 100 points can be earned by having a blood test to measure cholesterol and glucose levels.
The final 100 points can be earned by having a wellness physical, a colonoscopy, a screening mammogram, cervical cancer screening or participating in and completing an online or telephonic coaching program. Subjects in that program include weight loss, nutrition and stress management.
The results, says Dianne L. Howard, the school district's director of risk management and benefits in West Palm Beach, have been “phenomenal.”
For example, 85% of employees now get annual physicals, an increase of more than 50% since the launch of the program. Similarly, 16,000 employees now complete an online health assessment each year, compared with just 25 employees in 2008, she said.
In addition, over the past three years, breast cancer screenings rose 12%, colon cancer screenings climbed 13% and cervical cancer screenings increased 7%.
Already, the wellness rewards program is having a positive effect on the school's district's health care costs, due in part to decreases in hospital admission rates and a drop in outpatient surgeries, Ms. Howard said. The hospital admissions rate per 1,000 covered lives was 69.8 in 2011, but it dropped to 61.1 per 1,000 covered lives in 2013. The overall monthly medical spend per member dropped to $288.87 from $309.45 during this same time period.
And the impact of a wellness program for health plan enrollees with diabetes has been especially strong, she said.
Under that program, launched in 2010, diabetics are required to comply with a checklist of seven evidence-based medicine health actions, such as seeing their doctor twice a year, as well as having their cholesterol and blood sugar levels tested. In return, they receive a 50% reduction in copayments for office visits and for medications and supplies.
Over the past two years, the hospital admission rates for diabetic employees dropped 33% in 2011 and 2012 and another 2% in 2013. In addition, in 2013, health care spending for those enrolled in the program fell 31% per enrollee per month.
“People are taking better care of themselves,” leading to a reduction in hospitalizations and ultimately lower costs, Ms. Howard said.
In all, over the past three years, the diabetes program has saved the school district approximately $6.5 million, Ms. Howard said.
Additionally, about one-third of health plan participants with diabetes have complications, and participants in that subcategory saw a 39% decrease in medical spending, which Ms. Howard attributed to more consistent care and follow-up.