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More employers penalizing workers who don't participate in wellness programs

Companies may ask physicians to conduct required health screenings or verify whether a patient takes part in such an incentive plan.

By Emily Berry — Posted Nov. 15, 2011

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Employers hoping to inspire healthier behavior by their workers have been relying on the proverbial carrot, but are turning in larger numbers to the stick as well. That means physicians are more likely to be asked to verify health status to their patients' employers.

The number of employers using penalties as part of wellness programs more than doubled from 8% in 2009 to 19% in 2010, according to a survey by human resources consulting firm Towers Watson. The survey respondents included human resources managers and benefits managers from 248 U.S. companies with at least 1,000 employees.

Asked what they had planned for 2012, 38% of employers said they will use penalties to get employees to participate in wellness and health management programs.

"Employers are really saying, 'We have got to have some help in health care. We need you to take responsibility for your health, and we're going to make it a little tougher on you to try to get your attention,' " said Shelly Wolff, health and productivity leader at Towers Watson.

Not long ago, employers offered lower premiums and other rewards to workers who exercised regularly and didn't use tobacco.

"In the early days there was a lot of trust," Wolff said. "There's been a definite shift in the last five years or so toward verifiability."

She said penalties typically included paying higher premiums for health insurance and forgoing some type of cash benefit. The rewards and penalties often are linked to whether an employee uses tobacco, exercises or completes a health risk assessment.

Physicians can help patients avoid penalties and take advantage of rewards available for healthy behavior, Wolff said.

Fairly often, physicians will be involved either in verifying a patient's participation in such a program or actually conducting required screenings, she said. In addition, she suggested that physicians could ask patients about available incentives, then help them earn those rewards -- or at least avoid penalties -- by working with them to meet their employer's requirements.

The Towers Watson survey touched on one driver behind the increased use of penalties: Employers believe workers should be responsible for their own health.

Of the surveyed employers, 80% believe "employees should be held accountable for maintaining and improving work force health and productivity." But only 10% said they actually held their workers accountable.

Given the answers about penalties coming into play in 2012, Wolff said she expects to see that second percentage rise the next time employers answer.

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