Group Health Cooperative
While a key ambition of Group Health’s Total Health program for employees was to reduce costs, the cooperative soon learned it had to start by spending more.
In 2010, Group Health revised its wellness program by shifting to a “value-based insurance design” that promotes effective use of services rather than broad-based disincentives. By reducing or waiving co-pays for preventive care and management of chronic conditions, for example, the company hopes to prevent or control illness over the long term. It says it is already losing fewer days to sick leave.
Employees can take advantage of up to two free office visits to manage certain chronic illnesses; home monitoring devices are fully covered. Services for mental health, tobacco cessation, chemical dependency and weight management are free or offered at a reduced cost.
Although employees of a medical cooperative are typically more knowledgeable than most about what makes good health, HR Manager Kathryn Bergmann admits, “They’re not necessarily living in a healthier manner.” They are subject to the same influences and stresses as everyone else, and find it just as hard to change their personal habits.
By participating in online health-risk assessments and by engaging in preventive care and approved physical activity, employees accrue points that can lead to lower health care premiums (up to $500 in 2012). Last year, 84 percent of eligible staff members met those requirements.
Preliminary results have been strong, with 90 percent of Group Health’s 9,000 employees participating. The cooperative is engaged in a four-year, federally funded study to measure the success of the program.
Group Health expects modest financial returns, with costs increasing one or two percentage points less than otherwise might be expected. The real payoff, says Bergmann, comes from a staff that simply feels better and has more productive days at work.
King County, Seattle
King County’s Health Reform Initiative seeks to empower patients with voluntary incentives to improve their health, thereby curbing demand for costly health care and also controlling costs through a collaboration aimed at improving health care quality throughout the region. The program, originally launched in 2005, won a Leaders in Health Care award in 2009 and continues to make headway, with 90 percent participation and 2,000 employees losing weight by more than 5 percent. Another benefit: a $26 million reduction in costs.