Deductibles cut for healthy employees

PreferredOne offers employers a plan that lets workers pay less for health care if they are in good shape.

By Carolina Procter — Posted July 23, 2007

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A Minnesota health plan is adding another component to its high-deductible plans -- the use of blood pressure, body mass index, cholesterol levels and other wellness indicators to determine out-of-pocket payments.

PreferredOne, which in January 2004 became one of the first plans to offer health savings accounts, has begun marketing plans that offer clients the option of using "biomarkers" to reward healthier employees with lower deductibles.

Low blood pressure, target BMI and other positive indicators can slash deductibles by up to 20%, said Eugene Sako, PreferredOne's manager of product development.

"A lot of our clients have moved from a co-pay plan to a high-deductible plan. They had to give the employee something to bridge that leap from a $10 office co-pay to a $1,000 deductible. In the past it was a health reimbursement arrangement or a health savings account," Sako said. "This is allowing them to say, 'I'm not just going to give you the [money], I'm going to give it to you only if you're healthy.' Instead of just giving a kid an allowance, it's making him work for it."

Sako said 180,000 members will be eligible for incentives. The firm sells to mostly small- and medium-sized businesses. Experts say other plans have begun looking into biomarkers but that PreferredOne is among the first to use them widely in setting rates.

Emerson Smith, president of Metromark, a health care research company, said linking health and incentives makes sense. "Biomarkers have always been with us, with age, gender, race, ethnicity and country of origin being used to score the probability that someone would have a greater likelihood of a disease," he said. "It's the next step to use BMI, cholesterol levels and other measurable health indicators to predict usage of health care resources."

PreferredOne, owned by two health systems and a physician group, says it will ease its clients into the incentive-based plans by not requiring that biomarkers be used immediately, and by giving employers the freedom to implement incentives in their own ways.

"It's not a prepackaged situation," Sako said. "Somebody might give credit just for taking a health risk assessment or for getting blood glucose tested at a health fair. They can say, 'Just do it and I'll give you credit, and then next year I'll measure you.' "

Sako said this tactic can help reduce anxiety among employees who are sensitive to sharing personal health data. Also, PreferredOne says it will let employers see aggregate biomarker data on its employees but not individual data. Companies will know which employees received discounts but won't be told why.

"The knee-jerk reaction people have to this is, 'It's none of your business. You're going to qualify something you gave to me before?' " he said.

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Unhealthy living could cost health workers jobs, pay

Big hospital systems are among the employers joining ranks with companies who have decided a great way to have healthy employees is either not to hire people with unhealthy habits, or make people pay for them.

The Cleveland Clinic, which has 36,000 employees, announced that starting Sept. 1, it will not hire smokers. The Cleveland Clinic said it would screen all prospective employees for nicotine, and those with an unacceptable amount will be referred to a free stop-smoking program and will be allowed to reapply in 90 days. The ban does not extend to current employees. But employees who smoke will be directed toward free smoking-cessation classes.

Indianapolis-based hospital system Clarian Health Partners also is taking a harder line on unhealthy living. In 2008, its 14,000 employees will have to complete a health risk survey to enroll for benefits; those who say they smoke will pay $30 every two weeks. In 2009, Clarian employees who fall outside the healthy parameters of body mass index, blood pressure, cholesterol and blood glucose levels will have money deducted from their checks. To help employees stay healthy, the hospital system has started providing health coaches, on-site weight management and smoking-cessation classes, discounts to local fitness centers and more.

"Companies have historically cost-shifted in the form of higher premiums and higher deductibles. We feel that's not sustainable in the long run," said Steve Wantz, Clarian's senior vice president for administration and human resources.

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