INSURANCE Companies want health to pay off

Incentives to quit smoking or lose weight can affect productivity, experts say.
ST. LOUIS POST-DISPATCH
ST. LOUIS -- Employers have built weight rooms, paid for smoking-cessation classes and stocked apples in vending machines. Health-conscious workers exercised and gave thanks.
But workers hard on the path to physical ruin -- the chronically stressed, the obese, the exercise-averse -- ignored the corporate call to wellness.
Now, spurred by health-care hyperinflation, some companies are speaking a language that gets everyone's attention: money.
They're giving discounts and rebates on health-insurance premiums as well as offering lower copays and richer benefits to employees who renounce their unhealthy ways. They're giving days off to winners of weight-loss contests and offering free sessions with personal trainers.
Key to productivity
The bottom line: A healthy employee is a productive employee.
Employers are concerned even more about protecting productivity than about reining in runaway health costs, said Jay Savan, the lead health-care consultant in the St. Louis office of Towers Perrin.
In promoting wellness, employers are acknowledging the high price of ignoring the bad habits of workers. Unchecked appetites can contribute to absenteeism in the short term and chronic disease in the long term.
Rodney Menzel, 40, a machine operator at Pohlman Inc. in Chesterfield, Mo., won cash and a day off this year in a workplace weight-loss contest. He has diabetes and hypertension, conditions related to the 420 pounds he once carried on a 6-foot-1 frame. He knew his weight was causing problems, but to motivate him, it took the friendly competition, the public weigh-ins and the company's decision to highlight health in posters and plant meetings.
"It makes a lot of sense to present this information in the workplace," Menzel said. "It kind of shows they are putting a little care into people. They want you to be healthy. I ... can tell you that walking around this plant all day after dropping 70 pounds, I don't go home nearly as tired."
Jim Sullivan, an executive vice president, said everyone wants to be healthier, but most people need a little push.
Avoiding discrimination
Benefits consultants report that a lot more companies are employing carrots than sticks to motivate behavioral change. Many are mindful of running afoul of discrimination prohibitions in the Americans With Disabilities Act. For example, prorating health-insurance rates based on body mass might be judged discriminatory against people with a genetic propensity toward obesity.
A few companies charge smokers more for health and life insurance. Benefits consultant Hewitt Associates has identified some that pay less toward medical bills if an employee or a dependent isn't wearing a seat belt when injured in a car crash.
Hewitt said 40 percent of the 960 large employers nationwide that participated in a recent survey used incentives or disincentives last year to promote healthier behaviors, up from 14 percent in 1993.
Experts estimate that 80 cents of every health-care dollar is spent providing care to the sickest 20 percent of patients.
Motivational coverage
Mercy Health Plans, a St. Louis-based insurer, is rolling out a product designed to motivate employees to take charge of their health and well-being.
William A. Bennett, head of marketing and communications, said it's the way of the future. The coverage is available only to employers that self-insure by assuming the financial risk for health-care claims.
Frequently, these companies hire insurers such as Mercy to administer their health insurance and to process bills for payment.
Pohlman was the first company to sign up for Mercy's plan. Pohlman spent a year preparing its 300 employees for the conversion March 1 from the traditional health-maintenance organization. First, it grounded them in using the Internet-based tools that support the insurance product and then taught them steps to become healthier.
Mary H. Althaus, a registered nurse and a health educator for Mercy, met with employees in groups and individually.
She chastised smokers for taking better care of their pickups than their bodies. She got one worker's attention by showing that he had spent nearly $23,000 on a pack-a-day habit.
Since the insurer entered Pohlman's automotive-components plant, 20 of the 45 smokers have completed cessation programs, and 16 stayed smoke-free.
Conditions of joining
Before employees can enroll in the My Choice program, people covered under the employee's policy must pledge to get age-appropriate preventive care as well as to abstain from smoking or to enroll in a smoking-cessation program. They must drive sober and wear seat belts. People with chronic illness must follow nationally recognized best medical practices.
Ultimately, employers decide whether workers who take the healthy-lifestyle pledge pay lower coinsurance or deductibles than those who opt for standard health-insurance plans.