By Ronald E. Bachman, FSA, MSAA
President & CEO of Healthcare Visions, Inc.
Senior Fellow, Center for Health Transformation
Consumerism is about empowering individuals with information and a financial stake in their own health and healthcare. Unfortunately, ObamaCare move away from personal responsibility. ObamaCare is about limited choices, mandated coverages, regulated prices, and controlling individual decision-making. But, ObamaCare cannot shut out the forces of consumerism. Buried in the dark clouds of ObamaCare is the opening for consumerism to survive.
A key feature of healthcare consumerism is providing individuals with opportunities to be financially rewarded for doing the right activities that improve their health. Rewards can include activities such as, participation in a wellness assessment, attending a smoking cessation class, compliance with a condition management program (e.g. taking medications, diet, exercise, office visits), and maintenance of good health characteristics (e.g. blood pressure, cholesterol, nicotine use, body mass index).
ObamaCare allows both participation incentives and limited rewards based on specific health status outcomes. The new law increases the maximum for rewards based on health status from 20% to 30%. The act allows the Secretary of Health & Human Services to potentially increase the health status rewards to 50% of coverage costs. Financial rewards are critical to changing behaviors. If just being healthy was good enough, we would not have growing diabetes and an epidemic of obesity in this country. We are typically American. We want to be paid to do the right things. We want financial incentives and rewards. ObamaCare allows some current market initiatives to continue to include financial incentives and rewards.
Rewards and incentives can take on many forms. The chart below describes several options employers can use to engage employees in healthy choices. Both positive and negative rewards and incentives are possible. Existing rules should allow a combination of rewards and penalties to exist within the same structure as long as the difference between the best and worst financial impact is within the ObamaCare allowances.
Under Obamacare the major areas of differentiation in employment compensation packages will be provisions for rewards, incentives, and information to support healthy productive employees. Employers will always be concerned about their “human capital.” High functioning employees lower the costs of unscheduled sick days, absenteeism, disabilities, workers compensation claims, and improve productivity.. Here are typical options that employers can still use under ObamaCare:
Within these general areas, there are at least five ways to implement financial incentives:
Change the Premium - this allows both the employee and the employer to share any savings based upon the split in how each contributes to the overall cost of the plan.
Change the Employee Contribution Rate - this allows greater flexibility to award employees more or less that would occur by using the “change in premium” approach.
Change Deductible - increase or decrease the plan deductible based upon compliance standards set in the plan.
Change Cost-sharing - this would expand on the “change deductible” approach and impact any combination of deductible, coinsurance, maximum out of pocket costs, and copayments.
Change Personal Care Accounts - this would allow direct increases to health savings accounts (HSAs) or health reimbursement arrangements (HRAs). ObamaCare does limit some financial incentive options for individuals, small groups, and large group plans offered through the government exchanges if they directly impact premiums for employees. The law states:
“With respect to the premium rate charged by a health insurance issuer for health insurance coverage offered in the individual or small group market-
(A) such rate shall vary with respect to the particular plan or coverage involved only by-
(i) whether such plan or coverage covers an individual or family;
(ii) rating area,
(iii) age, except that such rate shall not vary by more than 3 to 1 for; and (iv) tobacco use, except that such rate shall not vary by more than 1.5 to 1; and
(B) such rate shall not vary with respect to the particular plan or coverage involved by any other factor not (above).”
Small employers are defined as groups with 100 or fewer employees, or 50 or fewer at the discretion of the states.
For those plans that can use the full capabilities of rewards and incentives, these areas of emphasis are likely to grow and expand as employers continue to seek ways of controlling health costs and improving productivity. A healthy employee is a more productive employee.
A survey of employers by Towers Watson showed that 22% of employers provide financial incentives using bio-metric screenings (e.g. blood pressure, cholesterol, body mass index) and wellness appraisals. An additional 19% of large employers are moving in that direction. While only 3-4% of employers currently provide financial incentives based on meeting bio-metric standards, results oriented incentives are considered the next generation of consumerism to motivate broad plan membership engagement in healthy choices.
There are many companies developing the technology and compliance standards to assist employers. One such company offering the technology to monitor and administer reward programs based on bio-metrics is Bravo Wellness. Forbes magazine highlighted Towlift, Inc., which selected Bravo Wellness’ incentive-based integrated wellness program. After four years of this strategy, Towlift has experienced a reduction of 26% in per capita claims cost and steady improvement in employee heath measures.
Employers can experience immediate cost savings by linking employee incentives to participation and results. There are obviously some rules to follow. When an incentive or penalty is contingent upon the satisfaction of a health standard, it must:
Be designed to promote health and wellness
Not exceed 20% (30% under PPACA) of the total cost of coverage offered
Be available to all “similarly situated individuals”
Offer an appeals process
Provide “reasonable alternatives” when appropriate
Offer re assessments at least once per year
Employers need to be cautious and flexible during these times of uncertainty. Do what is needed and what has been proven to work anyway. Consumerism with rewards and incentives has proven itself over the last eight years to lower costs and improve quality of care. The American Academy of Actuaries reports that healthcare consumerism lowers costs in the first year by 12-20% and reduces future trend increases by 3-5%.
Changes based on healthcare consumerism won’t have to be reversed even if ObamaCare is successfully challenged in court, a different Congress limits ObamaCare implementation, or a new Administration changes the regulatory rules. If it is consumerism versus ObamaCare, consumerism will win in the end. It’s an American health reform idea that will not be defeated.
CLEVELAND–(EON: Enhanced Online News)–Towlift, Inc., a leader in providing material handling solutions, has selected Stratum Benefit Solutions and Bravo Wellness to take it into its fourth year of incentive-based, integrated wellness. Towlift has benefited from several years of reduced claim costs in its self funded health care plan and has lead the way in its industry in addressing health care for employees as a risk management challenge and not a pricing issue. After four years of this strategy, Towlift has experienced a reduction of 26% in per capita claims cost and steady improvement in employee heath measures.
“The results-oriented culture at Towlift is a perfect fit for a Bravo Wellness program”
David Cannon, Towlift’s CEO and President, credits a strategy presented by Joe Ceccacci, Managing Partner, Stratum Benefit Solutions, Corporate Health IQ™ and Jim Pshock, President, Bravo Wellness. Dave Cannon notes, “… year after year we were extremely frustrated with the increasing cost of healthcare. So, we decided to be proactive and engage our employees in a plan to tackle this problem head-on. We had to start by educating our workforce on how lifestyle choices including diet, smoking and exercise, directly affect the cost of healthcare. Joe Ceccacci introduced Towlift to innovative risk management strategies that included yearly wellness screenings and a wellness educational campaign that includes smoking cessation programs, exercise incentives, and instructional videos and literature. With the support provided by our HR team, our employees have gained enthusiasm for the program with grassroots wellness committees forming in individual departments to help fellow employees with their fitness goals. The program has empowered employees to be part of the solution to more manageable health care costs.”
Working together, Towlift, Stratum Benefits and Bravo Wellness, continue to look for ways to improve their program and will be following recommendations from Stratum Benefit Solutions regarding outcomes from this year’s, Corporate Health IQ™, a 360-degree risk assessment tool. “The results-oriented culture at Towlift is a perfect fit for a Bravo Wellness program,” adds Jim Pshock. “In the Towlift model, employees can reduce their health plan deductible from $2,100 to as low as $100 by achieving goals tied to blood pressure, cholesterol, and obesity; and by not using tobacco or nicotine products.”
Towlift, Inc., is headquartered in Cleveland, OH and has other locations in Columbus, Mentor and Toledo. Ohio is a leader in material handling solutions. Contact David Bongorno for further information at Dbongorno@towlift.com.
Stratum Benefit Solutions is an innovator of integrated and incentive based insurance solutions for mid to large sized companies. Corporate Health IQ™ is a proprietary risk management model of Stratum Group, LLC, providing employers with precise information and insight into the unique risks driving their healthcare expenses. Stratum Benefit Solutions, LLC, is located in Independence, Ohio. For more information, visit www.stratumbenefits.com.
Bravo Wellness offers services to employers and business partners desiring results-based incentives for wellness. Customers experience immediate cost savings by linking employee incentives to participation and results. Bravo Wellness recognized the potential legal challenges of health insurance law, including HIPAA non-discrimination regulations, and has unique expertise in the practical application of wellness regulations for group health plans. Bravo Wellness is headquartered in Avon, Ohio. For more information visit www.bravowell.com.
More companies ask employees to meet programs’ targets By SHANNON MORTLAND
4:30 am, February 1, 2010
Wellness programs have been popular among employers for several years, but they’re coming with more strings attached as companies look for ways to trim their health care costs even more.
Many companies are looking for results — and, in some cases, rewarding employees for them — rather than giving employees incentives for just participating in initiatives such as walking 10,000 steps a day or completing a health risk assessment.
“You have to actually achieve a goal, not just take a test,” said Jim Pshock, president of Bravo Wellness LLC of Avon, which creates incentive-based wellness programs for 51 employers across the country.
Among those employers is Southwest General Medical Center, which signed up with Bravo Wellness this year and has given its employees one year to reach certain wellness goals or face higher health insurance premiums, said Judy Murphy, director of human resources at Southwest.
“The program focuses on employee health with regard to smoking, body mass index, cholesterol and blood pressure,” Ms. Murphy said. “Employees are being charged with being within a certain number within those health indicators.”
Southwest employees are participating in health screenings that will be followed by a detailed report of their current health condition so they will know how far they need to go to reach their goals, Ms. Murphy said.
Though the hospital already had a popular wellness plan in place, its health care expenses still were rising, she said.
“Certain health conditions which can be avoided or controlled by lifestyle changes are the most expensive to a health plan,” Ms. Murphy said.
Steve Millard, president and CEO of the Council of Smaller Enterprises advocacy group, said he’s seeing more small companies get involved in wellness and education initiatives, such as providing health screenings, exercise and diet programs, and lunch-and-learn sessions to teach employees how to live healthier.
Though annual increases in health insurance premiums have moderated to between 9% and 15%, after hitting 20% in previous years, Mr. Millard said the hikes are still high.
“It’s got everybody’s attention,” Mr. Millard said. “People are getting much more active because they can’t afford it anymore.”
Forget the television
Last year, COSE gave 70 wellness grants to local companies, Mr. Millard said. Under that program, COSE provides grants of up to $1,500 for wellness expenditures, such as repairing treadmills at the workplace. However, the use of the money does have limits.
“We’ve gotten a lot of requests for TVs in the workout room, but we haven’t approved those yet,” Mr. Millard said.
Pat Perry, president of the Employers Resource Council human resources group, said some midsize businesses responded irrationally to the economy last year by reducing benefits and increasing deductibles and co-pays for employees, both of which are only short-term fixes.
“They jumped off a really sound strategy and chased the dollar,” he said. “These cutbacks could have been made up elsewhere easily.”
However, not all midsize companies panicked, including Sawyer Technical Materials LLC in Willoughby.
The company continues to try to change the behaviors of its employees through incentives, said Kim Coleman, controller at Sawyer.
“People are getting skinny …’
The crystal quartz manufacturer has installed a walking track around the building and offers monthly incentives for participating in wellness programs, Ms. Coleman said. For example, the Fall Into Fitness eight-week program encouraged people to reach certain fitness benchmarks through cardiovascular workouts. Those who did more vigorous workouts received more points. The team with the highest point total got $25 gift cards to Subway restaurants, she said.
By participating in such wellness activities, employees can reduce their premiums by $50 each month, Ms. Coleman said. Smokers can reduce their monthly premiums by another $30 for not smoking. But, if they choose not to participate one month, their premiums rise by those same amounts, she said.
The incentives are working, as almost all of the company’s 35 employees participate in the wellness program.
“People are getting skinny, and they’re just trying to monitor their blood pressure,” Ms. Coleman said.
“I’m looking forward to spring to see how challenging I can make it.” PRINTED FROM: http://www.crainscleveland.com/apps/pbcs.dll/article?AID=/20100201/FREE/302019952&template=printart
Avon, OH, November 14, 2009 –(PR.com)– The producers of Inside Business are pleased to announce that Bravo Wellness, LLC will be featured in an upcoming episode on Wellness Solutions – Improving Clinical Outcomes and Reducing Healthcare Costs as part of the show’s Medical Minutes series.
In today’s economy, businesses are trying to reduce costs wherever they can. In many cases, that means cutting health insurance benefits or eliminating them completely. Business owners desiring to keep from taking such extreme measures are turning to results-based wellness programs offered by Ohio-headquartered Bravo Wellness, a niche provider of consulting and administrative services related to incentives for employee wellness.
“Results-based wellness programs are a ‘win-win’ for both the employee and the employer,” says Jim Pshock, President of Bravo Wellness. “Providing employees with a choice of benefit plan designs, based on their participation in wellness programs and their individual results helps them recognize a direct connection between their health and the cost of benefits.”
The CDC recently reported that 75 percent of all healthcare spending is spent treating conditions that are lifestyle related and largely preventable. Bravo Wellness believes that the reason for poor lifestyles is often not a lack of education, but rather a lack of motivation. By introducing a “live well, pay less” philosophy, employees are motivated to make healthier choices.
Bravo Wellness creates customized wellness programs to meet the specific needs of each business. Employers typically tie 15 or 20 percent of their total health insurance cost to the wellness program, and set moderate goals for things like blood pressure, cholesterol, body fat and tobacco use.
Filmed on location in West Virginia, the five-minute segment tells the success story of Bravo Wellness customer, Simonton Windows. Simonton Windows’ officials and employees, and Bravo Wellness President, Jim Pshock, share their thoughts with viewers on the benefits of results-based wellness programs.
###
Contact Information
Bravo Wellness, LLC
Jim Pshock
440-934-2090
jimpshock@bravowell.com
www.bravowell.com
Lovelace Health Plan thinks it has a way to keep New Mexicans healthy: Money, as in the form of lower health insurance premiums.
The Albuquerque insurer has rolled out a new premium-based wellness program that will offer members lower premiums if they meet certain healthy lifestyle goals.
Lovelace is partnering with the Ohio-based Bravo Wellness to offer the program, which will set wellness targets for cholesterol levels, blood pressure, body mass index, tobacco use and glucose levels.
People whose ratings fall within so-called healthy ranges for those areas will be given premium reductions.
Lovelace Health System, which owns the health insurance plan, is testing the program on its 3,600 employees in New Mexico. The way it’s designed, employees could be in line for premium reductions of up to $160 a month, said Marlene Baca, vice president and chief sales and service officer for Lovelace Health Plan.
The plan differs from current wellness programs in that it offers a direct financial incentive to people who maintain healthy lifestyles.
“This offers some accountability, and when we think about health care costs and reform, we feel strongly that this needs to be focused on,” Baca said.
The plan’s concept is simple. Lovelace will work with employer groups and Bravo Wellness to set target levels for the areas that have been selected for testing. Blood work will be done and the results will be sent to Bravo. That blood work is generally done at the beginning of an enrollment period. Based on the results, individual premiums can be raised or lowered. The blood work results are confidential and can’t be shared with the employer.
Employees who don’t qualify for those target rates can appeal the decision. Or they can work to get those levels in line with healthy guidelines by working with their physicians and using Lovelace Health Plan’s Healthy Steps program, which provides services ranging from nutritional counseling and smoking cessation to disease management. Employees can be retested every year or as often as their employer allows.
“As health care costs continue to rise, employers can realize tremendous return on investment by providing financial incentives for employees to take control of their own health,” said Lovelace Health Plan CEO Dennis Wilson. “We are committed to this program and believe in its effectiveness, which is why we are offering this benefit to all Lovelace Health System employees.”
The program, which can also penalize people in the form of higher premiums, was made possible by new federal regulations approved at the end of 2007 by the U.S. Department of Labor, said Bravo President Jim Pshock.
“Being able to penalize or reward people based on the results of wellness screening became illegal when Congress passed HIPAA (Health Insurance Portability and Accountability Act), and that was because of uniform coverage rules,” Pshock said.
The new rules take into account the reality of health care in the U.S., Pshock added.
“The Centers for Disease Control estimates that 75 percent of all health care coverage is lifestyle-related. We call this program the Good Driver Discount for Health Care. If you are doing a lot to stay healthy, then you are going to pay less than the person who is not managing those lifestyle risks.”
Bravo Wellness was founded in the fall of 2008 and has 27 employer groups in its programs, Pshock said. “They are spread throughout the nation and we’ve literally got hundreds in the pipeline.”
Pshock said more wellness incentive programs will hit the market in the coming years as employers look for ways to cut their health insurance costs and to keep offering their employees health insurance.
“We have found that with many companies, it is not enough to have wellness tools,” Pshock said. “With meaningful incentives, employees adopt lifestyles and behaviors to sustain good health.”
Ardent Health Services Partners with Bravo Wellness to Provide Employee Wellness and Incentive Program
Innovative Benefit Program Designed to Improve Employee Health and Reduce Costs
NASHVILLE, Tenn., Aug 31, 2009 (BUSINESS WIRE) — Ardent Health Services (www.ardenthealth.com) has selected Bravo Wellness to provide health assessment and wellness incentive services to its 6,500 employees. In addition to improving employee health and productivity, the partnership has the potential to reduce the company’s overall health care costs, including out-of-pocket expenses for employees.
As part of the three-year agreement, Ardent will supplement its current wellness efforts by offering employees the opportunity to participate in an online health risk assessment as well as blood pressure, glucose, cholesterol, tobacco and body mass index screenings. Participating employees will receive a discount on their monthly health insurance premium contribution while those who meet certain screening criteria will qualify for additional deductions.
“As a provider of both health care and health insurance services, we see tremendous value in engaging employees in the wellness process from the very beginning,” said Neil Hemphill, Ardent’s senior vice president of human resources. “Partnering with Bravo will allow us to better manage our overall health care costs while providing a meaningful benefit that can positively impact our employees’ health as well as their wallets.”
Bravo’s corporate wellness programs provide employers with an average annual savings of nearly 10 percent. While only three in 10 employees participate in traditional wellness programs, Bravo’s programs provide financial incentives that increase employee participation. Most Bravo clients experience an average of 92 percent participation.
“We are thrilled to work with a premier provider of health services such as Ardent,” said Jim Pshock, president of Bravo Wellness. “We have found that with many companies, it is not enough to have wellness tools. With meaningful incentives, employees adopt lifestyles and behaviors to sustain good health. We are pleased to supplement Ardent’s wellness tools with our results-based wellness incentive solutions to assist them in effectively managing rising health care costs.”
About Ardent Health Services
Based in Nashville, Tenn., Ardent subsidiaries own and operate acute care health systems located in growing urban and suburban areas. The network includes seven acute care hospitals, a rehabilitation hospital, a multi-specialty physician group, a 220,000 member health plan and a nationally-recognized medical laboratory. Through continued investment and a shared commitment to quality, Ardent is building stronger hospitals and stronger communities in each of the markets it serves. For more information about Ardent Health Services, visit www.ardenthealth.com.
About Bravo Wellness
Bravo Wellness offers services to employers and business partners desiring results-based incentives for wellness. Customers experience immediate cost savings by linking employee incentives to participation and results. Bravo Wellness recognized the potential legal challenges of health insurance law, including HIPAA non-discrimination regulations, and has unique expertise in the practical application of wellness regulations for group health plans. Bravo Wellness is headquartered in Avon, Ohio. For more information about Bravo Wellness, visit www.bravowell.com.
SOURCE: Bravo Wellness
Bravo Wellness
Jim Pshock, 440-934-2090
jimpshock@bravowell.com
or
Via Vera Group
Nikki DiFilippo, 216-780-0472
nikki@viaveragroup.com
Gearhart Insurance Helps Companies Further Gain Control of Health Insurance Costs by Incorporating Results-Based Wellness Incentives from Bravo Wellness
CLEVELAND–(BUSINESS WIRE)–Gearhart Insurance Agency, a leader in employee benefit solutions and results-based wellness programs, has been selected by Simonton Windows, a Fortune Brands Company, to assist in mitigating the escalating costs of health insurance with innovative benefit plans. Gearhart Insurance has been able to lower health insurance costs for its clients by partnering with Bravo Wellness to incorporate incentive-based wellness programs into its client’s plan designs.
Robert Jacobs, Vice President of Human Resources of Simonton Windows, states, “We are continually faced with increasing healthcare costs, and in working with our consultants at Gearhart Insurance to optimize our benefit plans, we selected Bravo Wellness to implement a results-based wellness program. With Bravo’s help, we quickly implemented our program with over 99% employee participation in this voluntary program. With proper design and incentives, we expect to fully recover our implementation costs and we now have hard data about the overall health and wellness of our employees and a clear path to remediation and future cost savings. We expect to realize measurable returns both from bottom line cost and employee satisfaction perspectives.”
“We recognize that over seventy-five percent of claims are directly related to lifestyle, and we have designed plans to incent healthy behaviors and give employees the option to lower costs for areas within their control,” says Joe Ceccacci, Partner of Gearhart Insurance. “One of our clients in the manufacturing business, similar to Simonton, now is in its fourth year of such a program, and they have seen measurable improvement in year over year claim costs. Over the last three years, their claims have decreased an average of 14% per year. For 2008, their per capita claim cost declined over 25% from 2007.”
“Results-based wellness programs are a win-win for both the employee and employer,” says Jim Pshock, President of Bravo Wellness. “Providing employees with a choice of benefit plan designs based on their participation in wellness programs and their individual results helps them recognize a direct connection between their health and the cost of benefits.”
About Gearhart Insurance Agency
Gearhart Insurance is a regional health insurance broker that began in 1991 as a health care claims administration company. In 1998 the administration company grew into a full service health and life insurance agency. Today, we have a national presence representing a diverse group of companies ranging from small privately held firms to some of the nation’s largest manufacturers. We are experienced and qualified to assist our clients with evaluating and purchasing the right health insurance program to meet the needs of their employees. For information, call (800) 806-4359 or visit www.gearhartinsuranceagency.com.
About Simonton Windows
Founded in 1946, Simonton’s hallmark has been to deliver its made-to-order products in seven days or less. Part of consumer products company Fortune Brands, Inc. (NYSE: FO), Simonton has manufacturing facilities in Pennsboro, Harrisville and Ellenboro, W.Va.; Paris, Ill.; McAlester, Okla.; and Vacaville, Calif. Simonton is a founding sponsor of The Weather Museum and a corporate partner of Homes for Our Troops. For information, call (800) SIMONTON or visit www.simonton.com.
About Bravo Wellness
Bravo Wellness offers services to employers and business partners desiring results-based incentives for wellness. Customers experience immediate cost savings by linking employee incentives to participation and results. Bravo Wellness recognized the potential legal challenges of health insurance law, including HIPAA non-discrimination regulations, and has unique expertise in the practical application of wellness regulations for group health plans. Bravo Wellness is headquartered in North Olmsted, Ohio. For more information, call (440) 716-0709 or visit www.bravowell.com.
Bravo Wellness helps employers reduce health insurance costs by an average of 10% within the first year.
Cleveland, Ohio — November 20, 2008 — Bravo Wellness launched to provide results-based, HIPAA compliant wellness programs for companies with 25 – 25,000 employees. Bravo gives employers a practical way to reduce insurance costs by an average of 10% in addition to rewarding employees who make healthy living choices. This is accomplished by linking a member’s cost of healthcare and/or their benefit plan design to their participation in wellness programs and their individual results in key areas like tobacco use, body mass and blood pressure.
Industry statistics state that over 75% of every dollar spent in healthcare is spent treating conditions that are lifestyle related and largely preventable. “Bravo Wellness helps employers navigate the non-discrimination laws associated with such plans as well as to coordinate the biometric screening process, the appeals process and the need for alternatives for individuals who have medical issues that prevent them from achieving a goal,” said Jim Pshock, President and founder of Bravo Wellness. “In my experience, over 92% of employees participate in plans that offer financial rewards for results, and many make meaningful changes for the better.”
Bravo Wellness solutions can work with employers’ existing carriers and brokers. Bravo Wellness offers a fully integrated set of services and resources to support HIPAA compliant wellness support including:
Expert consulting in wellness incentives
National screening partners for group and individual screenings
Results-based programs
Appeals and alternatives management
Bravo Wellness plans on hiring ten to fifteen sales and operations employees in 2009. Bravo Wellness currently occupies 2,300 square feet of office space with BeniComp, a partner offering a patent-pending wellness solution that utilizes a supplemental insurance policy.
About Bravo Wellness
Bravo Wellness offers services to employers and business partners desiring results-based incentives for wellness. Customers experience immediate cost savings by linking employee incentives to participation and results. Bravo Wellness recognized the potential legal challenges of health insurance law, including HIPAA non-discrimination regulations, and has unique expertise in the practical application of wellness regulations for group health plans. Bravo Wellness is headquartered in North Olmsted, Ohio. For more information about Bravo Wellness, visit http://www.bravowell.com.
