CLEVELAND – Bravo Wellness, an industry leader in results-based wellness incentive programs, was recently honored as a recipient of the 2012 Crain’s Leading EDGE Award for the second year in a row. In its fifth year, this prestigious award was created and developed by The Entrepreneurs EDGE to recognize value-creating, middle-market companies in the region.

“We are honored and excited to be among the leading Northeast Ohio winners to receive this prestigious award,” said Dave Campbell, president of Bravo Wellness. “It is a testament to the hard work of our employees and the results we have been able to produce for our clients.”

The results that Bravo’s clients are seeing, which include unparalleled employee participation averaging 95%, return on investment of $400 per employee per year and overall lifestyle improvement, have led to robust growth for the company. In just over three years, Bravo Wellness has grown from a startup to an industry leader in results-based wellness with over 225 employer groups and nearly 190,000 participants in all 50 states.

About Bravo Wellness
Bravo Wellness is a rapidly growing company that works with employers and business partners to design and administer wellness incentive plans that link participants, progress and results. Bravo possesses the expertise required to navigate the legal complexities 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.

About The Entrepreneurs EDGE
Founded in 2005, The Entrepreneurs EDGE is a 501(c)(3) non-profit organization that helps mid-market companies in northeast Ohio grow in value by creating programs, services, and events and by fostering economic development through education, innovation, and relationships.

http://www.corporatewellnessmagazine.com/article/wellness-personal-freedom.html

January 19, 2012

Several recent industry surveys confirm that employee wellness plan implementation is currently on the rise, particularly the use of “results-based” incentives or penalties. Results-based programs are tied to the actual achievement of a health standard rather than mere enrollment into a program that may or may not result in a desired outcome.

Leading a company that has been on the forefront of such initiatives since the very week that the regulations were published, I have been privileged to witness

the reactions and results of numerous plan designs among extremely diverse populations. What’s clear is that “one size does not fit all” and that “disruption of the status quo does not have to mean mass chaos.” After all, we’ve all heard that the definition of insanity is “doing the same thing over and over again and expecting different results.” Few could argue that our health care benefit system is anything but insane and that a drastic change is essential to changing the trend.

Every CEO, elected official and leader knows that consensus is ideal but typically unrealistic. As we enter an election year, we will choose a president and representatives who have to uphold the constitution and the “will of the people,” knowing that they could never possibly represent the “will of all people.” Just think about issues like abortion, immigration, and how to handle the deficit and you know that no matter what you do, at times half of the nation will have an opposing view or that you’ve failed. A leader must rise above the criticism and make the tough calls that are essential to the long-term success of their company and, at times, survival of their organization. Not a fun spot to be in, yet very rewarding when it results in sustained growth. After all, how many mission and vision statements contain the words “to provide our employees and their families with health insurance”? Businesses exist to fulfill a stated purpose, taking care of employees is part of every good business’s credo but if executives aren’t managing the bottom line, there soon won’t be any employees to take care of.

So what does this have to do with employee wellness? Everything! Our company, Bravo Wellness, now administers over 150 plan designs for over 200 employer groups. Some companies offer $10 gift cards for completing Health Risk Assessments (HRA’s) while some require a Body Mass Index (BMI) or Body Fat at the “ideal” level in order to earn up to $100 per month off of plan contributions. But most companies are somewhere in between the two or they use a hybrid model of maximum rewards for certain results or meaningful progress and partial rewards for certain activities. We see cases with 100% participation and stunning health improvement and others with tremendous good will and positive energy but virtually no results. The tug-of-war is always the same, employers want to incent results like weight loss and smoking cessation without offending anyone or causing them to feel like “big brother” is dictating their personal freedoms.

Effective and clear communications to employees is essential in making “personal accountability” part of an organization’s fabric. Significant change will inevitably create anxiety and strong opinions. I recently sat next to a man on an airplane who was sharing how he missed being able to smoke on an airplane. He was lamenting how certain states didn’t let him smoke in restaurants either. He shared that he wrote letters to Congress and to the airlines years ago but “nobody cared.” Really? Do you think nobody cared that they had an unhappy customer or an offended and upset voter? Or perhaps, they placed the greater good of the people and the organization above the strong (and loud) emotions and beliefs of an individual that didn’t share that perspective?

As a society, we’ve seen this play out with other issues like motorcycle helmet and seatbelt laws. I remember how angry my grandfather was when he was told to wear a seatbelt or pay a fine. Wasn’t that his choice? Even though the legislatures could prove the increased fatality rates and the massively higher costs to treat injuries, should they have the right to remove a person’s freedom to take an increased personal risk? The wellness rules are not about “punishing the sick” or retroactively underwriting risk. Those professing this either haven’t read or don’t really understand the rules.

In the workplace, we see mandatory hard-hats, steel-toed boots, safety goggles and so on. Is that employer micro-managing? The employer wants their employee to be safe. They also need to avoid the OSHA fines and penalties and the costly lawsuits that follow an employee who fails to adequately protect them. Large fines and lawsuits have caused organizations to close their doors forever.

Now, with the typical cost of employee health benefits hovering at $11,000 per employee per year and trending at 10% annually, doesn’t our government and corporate leaders have a similar obligation to introduce change that preserves the long-term viability of their organizations? Just as “toes were stepped upon” when cigarette smoke disappeared from airplanes, calmer heads and reason will prevail. The current rules protect those who legitimately cannot achieve a healthy goal due to a medical issue. Shouldn’t all others be expected to face consequences like higher premiums or deductibles if they don’t help their organization avoid the demise of their employee benefit plan by making progress toward healthy living?

In my opinion, this controversial drastic change will cause a season of discomfort, some hard questions and massive amounts of education and communication. Yet within a few short years, it will be accepted as “the norm” and become as common as the “good driver discount” is in the auto insurance industry. It is possible to adjust the portions of premium and levels of benefits that individuals pay in order to influence and motivate better choices without eroding the concept of insurance whereby the majority pay a little so that that the few who experience an event are able to afford the best possible care.

Do people realize that auto insurance is intended to cover “accidents” defined as: “sudden and unforeseen events, caused by external means”? You might have a $5,000 repair bill because you never changed your oil and you ruined your car’s engine. Your insurance company would not cover that claim because it was due to neglect and it was certainly not an unforeseen event. Every manual in the world can predict what will happen if you neglect to maintain your engine. The same is true of tobacco use and the impact of obesity on our heart and lungs, yet we have let the employer’s health plan bear the burden of the cost associated with neglect. I personally believe that if auto insurance paid for a new engine whenever you failed to change your oil, millions of people would stop changing their oil.

The Final Wellness Rules for Group Health Plans issued by the Department of Labor, and now adopted by the Patient Protection and Affordable Care Act (PPACA), provide a fantastic outline of how outcome-based wellness plans can be implemented without being overly aggressive, unreasonably harsh or truly unfair to those with medical issues that make the attempt to achieve a goal unreasonably difficult or medically inadvisable. I don’t understand the opposition coming from entities that claim to have a mission of health and wellness and the comments like, “next year they will penalize you if you are left-handed or if you wear glasses.” The authors of the regulations did their homework and were very careful to limit the categories, the financial impacts, the communication standards, and the appeal requirements required when outcome-based plans are implemented. Bravo Wellness now has dozens of cases that demonstrate the positive impact these plans can have on health improvement, trend reduction and on both the employer and the employee bottom line.

While I can clearly see short-term financial gain for the employer, due to the “cost-shifting,” that occurs as employees decline to participate and/or fail to achieve an outcome based goal we are also seeing that the “cost-shifting” dollars are also decreasing every year because more employees are passing the goals. Will the mere use of cash persuade everyone to quit smoking and lose weight? Of course not, but it can and does work for many of them. Others will need more intrinsic Page 3 of 3 *This article was reformatted from the previously published version in the January 2012 Corporate Wellness Magazine. motivation and significant support. The good news is that employers now have a way to pay for that support. The surplus premium contributions collected can be immediately reinvested into wellness coaching and outreach support.

When an employer has a budget (say $500 per employee per year) for program administration, health outreach and traditional incentives and communication, I think the ideal approach is to give the employees a year or two of support and coaching before considering an outcome-based approach. Unfortunately most companies don’t have this luxury. A company with 1,000 employees would need $500,000 for step one. Usually, the “wellness plan” fails right there or it gets morphed into a health fair with t-shirts, pedometers and balloons.

When the employees have more on the line, typically at least $50 per month of premium adjustment for wellness participation and results, you can expect over 90% participation and immediate readiness to change from a significant part of the population. And while many HR administrators are terrified of how their morbidly obese, three-pack-a-day smoker is going to react, they are typically pleasantly surprised by how many of the self-disciplined, health conscience employees go out of their way to applaud the fairness of the program. They are even more surprised by the number of obese smokers who have no problem with the concept, especially when they understand the exceptions that exist for those with legitimate medical issues.

Unlike most founders of “wellness” companies, I personally failed to earn my incentive for body mass index and cholesterol. I felt fine and many people even said I looked pretty good, at least compared to other guys my age. Without results-based rewards, I would not have pushed myself to eat better and exercise. The plan forced me to compare myself to “healthy” rather than to the people around me.

At Bravo Wellness, we can administer anything from “the Safeway Plan” to the ideal plan designs suggested by industry leaders such as Ron Bachman and Michael O’Donnell. Personally, I’d use a penalty for non-participation in an assessment, full rewards for achieving favorable results – or significant progress – relative to obesity, tobacco use, blood pressure, cholesterol and glucose and partial rewards for failing to manage these issues but willingness to accept help offered. Of course the full reward would still apply for those with documented medical issues that completed an alternative goal.

I do not favor the automatic receipt of full rewards for enrolling in a program unless the original goal was in fact medically inadvisable or unreasonably difficult due to a medical condition. Even in this, I would couple the program completion with an outcome-based alternative goal that an individual’s physician thinks would be reasonable for them to attain (i.e. if you are 150 pounds overweight, the goal might be to complete a course and lose 20 pounds).

An organization’s culture, budget and timeline will dictate whether they should use rewards or penalties, pass/fail goals or progress goals, or a preliminary year of coaching and education or intervention only for those who fail. The “one size fits all” approach is simply not practical given the diversity of businesses today but every organization can and should do something that is results-based. After all, history has proven that a non-disruptive approach will just produce insanity.

About Jim Pshock – Jim is the founder and CEO of Bravo Wellness and IncentiSoft Solutions. His career spans over 20 years in the health insurance industry. He has developed a comprehensive and unique expertise in the regulations related to governing wellness programs and the practical application of incentives to improve employee health.

*This article was reformatted from the previously published version in the January 2012 Corporate Wellness Magazine.

The executives promoted to Vice President, Business Development are Kevin Bodi, Joe Clark and David McGlennen. “Kevin, Joe and David each bring 25+ years of experience within the employee benefits industry,” stated Mike Mitchell, Bravo’s Senior Vice President, Business Development. “Their promotion is a result of their significant contribution to the company and the respect they’ve earned from their peers, clients and business partners. Each of these individuals will continue to play a critical role in the evaluation of target markets for business planning purposes and advancing Bravo Wellness as the leader in administering participation-based, progress-based, and outcomes-based wellness programs.”

Kevin Bodi – Having worked as an underwriter, executive and consultant, Bodi is an accomplished professional with many years’ experience within the employee benefits industry. Holding a license with the State of Ohio for Life and Health, he has a breadth of expertise in the health care market. Bodi joined Bravo Wellness in January 2009.

Joe Clark – With vast experience in sales in the health care industry, Clark previously owned an IV therapy pharmacy and home health care company. He also developed an ancillary service PPO network and oversaw sales and marketing for a TPA. Clark joined Bravo Wellness in January 2010 where his knowledge of self-funded and fully insured venues serves clients well as he consults to create the best possible wellness initiatives for their corporate culture.

David McGlennen – Following in the footsteps of his father and grandfather as a third generation insurance executive, McGlennen began his career working for his father, helping to run a successful general agency in Indiana and then in 1995, began consulting for several niche products before joining a global leader in insurance broking and risk management in their employee benefits practice. McGlennen joined Bravo Wellness in January 2009.

About Bravo Wellness – Bravo Wellness offers services to employers and business partners desiring results-based incentive programs for wellness. Clients experience immediate cost savings by linking employee incentives to participation and results. Bravo recognized the potential legal challenges of complying with recent changes in health insurance law, including HIPAA non-discrimination regulations, and has unique expertise in the practical application of wellness regulations for group health plans. Bravo offers its IncentiSoft Solutions platform to employers, including insurance companies, third-party administrators and wellness companies that have already invested in on-site clinics, preferred health coaching relationships or other wellness solutions. Employers can immediately increase their penetration into the employee populations they serve by accessing the compliance and technology platform from Bravo. Bravo Wellness and IncentiSoft Solutions are headquartered in Avon, OH. For more information, visit www.bravowell.com or www.incentisoft.com.

According to recent studies, total health care costs continue to climb, reaching an anticipated $11,176 per active employee in 2011. This is a 7.6% increase from 2010. In Colorado alone, companies’ insurance costs have increased 14.4 percent in 2011, the 10th consecutive year with a double-digit increase. This grim picture of employer health care costs demands action, and that is just what Oakwood Homes has done.

For the past three years, Oakwood Homes has been able to keep health care costs flat by implementing several wellness initiatives. In 2008, they started an active lifestyles program in which employees could earn “Oakwood Bucks” for recording exercise hours each month. Now, by implementing Bravo Wellness’ results-based program, employees are incentivized for living healthy by linking their health care contribution to results, which allows them to mitigate their own costs.

Oakwood Homes’ commitment to health also includes a full gym at their facility, vending machines with healthier options, fresh fruit in the break room every day and a Weight Watchers at Work program. Employees are enjoying the wellness initiatives as well as the cost savings for living healthy, and Oakwood Homes is enjoying the benefits of happier and healthier employees.

In partnership with Bravo Wellness, Oakwood Homes is proactively addressing rising healthcare costs by putting in place innovative programs that renew the employee’s motivation to remain active and healthy. At the recent CDHC Solutions Forum West, held in Denver, Bravo Wellness was able to discuss with many other area employers the value and success of its results-based incentive programs, like the one implemented by Oakwood Homes.

About Bravo Wellness

Bravo Wellness offers services to employers and business partners desiring results-based incentive programs for wellness. Clients experience immediate cost savings by linking employee incentives to participation and results. Bravo recognized the potential legal challenges of complying with recent changes in health insurance law, including HIPAA non-discrimination regulations, and has unique expertise in the practical application of wellness regulations for group health plans. Bravo offers its IncentiSoft Solutions platform to employers, including insurance companies, third-party administrators and wellness companies that have already invested in on-site clinics, preferred health coaching relationships or other wellness solutions. Employers can immediately increase their penetration into the employee populations they serve by accessing the compliance and technology platform from Bravo. Bravo Wellness and IncentiSoft Solutions are headquartered in Avon, OH. For more information, visit www.bravowell.com or www.incentisoft.com.

Said Jim Pshock, “The rapid growth of our organization is an outcome of our exceptional team, flexible service offerings, and

consultative approach to our clients’ needs.  As we further scale our infrastructure to meet the demands of some of the nation’s largest employers, we are honored to have a leader of Dave’s caliber join our ranks.”  With Mr. Campbell on board, Mr. Pshock plans to focus more of his personal attention on Bravo’s IncentiSoft Solutions, a provider of customizable compliance and technology solutions for wellness and insurance companies, third-party administrators and health systems.

“It is a great honor and privilege to be part of this rapidly growing, incredibly dynamic young company,” stated Dave Campbell.  “While Bravo’s success to-date has been truly remarkable, it’s also clear that they’ve only begun to scratch the surface of the potential market for their services.  I look forward to working closely with such talented people and helping the company achieve continued rapid growth.”  Campbell brings 28 years of general management experience in leading healthcare, financial services and technology companies, including senior executive positions with a large, international health screening company and one of the largest financial institutions in the nation.

Bravo Wellness now serves over 175 organizations and typically achieves 92 – 97% participation in the programs it offers.  Although many employers turn to Bravo for full turnkey solutions including biometric screenings, health risk assessments and a wellness toolkit, a growing number of organizations were content with their existing tools but attracted to Bravo’s flexible technology, results tracking and reporting platform.  As a result, Bravo Wellness formed a wholly owned subsidiary, IncentiSoft Solutions, to allow wellness companies, health plans and large employers, private-labeled access to the unique technology and compliance expertise that has been driving Bravo’s success.

About Bravo Wellness

Bravo Wellness offers services to employers and business partners desiring results-based incentive programs for wellness.  Clients experience immediate cost savings by linking employee incentives to participation and results.  Bravo Wellness recognized the potential legal challenges of complying with recent changes in health insurance law, including HIPAA non-discrimination regulations, and has unique expertise in the practical application of wellness regulations for group health plans.  Bravo offers its IncentiSoft Solutions platform to employers, including insurance companies, third-party administrators and wellness companies that have already invested in on-site clinics, preferred health coaching relationships or other wellness solutions.  Employers can immediately increase their penetration into the employee populations they serve by accessing the compliance and technology platform from Bravo.  Bravo Wellness and IncentiSoft Solutions are headquartered in Avon, OH.  For more information, visitwww.bravowell.com or www.incentisoft.com.

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“Results-based wellness is clearly the direction the market is moving,” said Jim Pshock, Founder and President of Bravo Wellness and IncentiSoft Solutions. “The fastest way to scale and meet the market demand is to empower the excellent existing wellness providers in the nation with access to the tools they need to respond to customer demands. IncentiSoft Solutions makes it simple for health-focused organizations to provide HIPAA-Compliant expert consulting and administrative support that drives their participation levels through the roof, creates immediate return on investment (ROI), and technology that converts lab, screening and appeal results into a simple payroll file for their customers to use.”

In just over two years, Bravo has grown from a startup to a leader in providing results-based wellness programs for more than 145 employer groups and nearly 85,000 participating employees. Bravo’s clients are seeing unparalleled employee participation averaging 95%, return on investment of $400 per employee per year and overall lifestyle improvement. The original Bravo Wellness model was geared for “one employer at a time” marketing and often included biometric screening coordination, health risk assessment tools and health coaching through strategic partners. For more information, visit www.incentisoft.com or www.bravowell.com.

About Bravo Wellness

Bravo Wellness offers services to employers and business partners desiring results-based incentive programs 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.

Contacts

Bravo Wellness, LLC
Jim Pshock
440-934-2090
jimpshock@bravowell.com

OR

For Bravo Wellness, LLC
Nikki DiFilippo
216-780-0472
nikki@viaveragroup.com

Michael brings with him over twenty years of sales and executive management experience working in the healthcare industry and has a broad understanding of the various funding arrangements and sales distribution channels associated with employer group sponsored health plans.

“We are pleased to add someone of Mike’s caliber to our talent base, said Jim Pshock, President of Bravo Wellness.  “Mike is a proven leader with considerable experience and will be a perfect fit for us as we continue to experience incredible growth at Bravo Wellness.”

Michael spent much of his career at HealthSmart Holdings, Inc. (formerly Interplan Health Group), where he served as National Vice President, Business Development.  Prior to HealthSmart Holdings, he held the position of President at Chandler Group. He directly engaged in contract negotiations with private employer groups, healthcare consultants, third party administrators and major hospital delivery systems in order to broaden target markets and sales channels.  Michael has also provided consultative services to provider-sponsored healthcare programs, industry producers, health insurance companies and hospital systems in the areas of quality measuring, predictive modeling, clinical integration, product positioning and risk management.  He holds a B.B.A. from Ohio University and is licensed with the State of Ohio for Life and Health.

Mitchell said, “It’s more evident than ever that the next phase of consumerism in health care is the significant role that personal accountability for one’s health choices plays. Bravo Wellness has established itself as the clear leader in this space, and I’m honored to be selected to help guide the strategy.”

Bravo Wellness provides expert consulting, technology and related support services to over 130 employers that have tied employee wellness screening results to their health plan contributions and/or their benefit plan design.  With average participation of 97% and typical first-year return on investment of $400 per employee, the company has experienced tremendous growth since its inception in 2008.

Bravo Wellness is a technology and compliance company that administers results-based incentive programs designed to drive demonstrable health improvement in employee populations. Because 75 percent of health care costs are driven by lifestyle choices, the Bravo program is designed to reward employees who make positive lifestyle decisions.

The Bravo program will be available to Arkansas Blue Cross, Health Advantage and BlueAdvantage Administrators of Arkansas employer customers with more than 50 employees. With the Bravo program, employers can expect a first-year cost savings of 3 to 10 percent, depending on how they choose to structure the program. Along with improving employee health and productivity, the Bravo program has the potential to reduce out-of-pocket expenses for employees.

“Our goal is to always help our current and prospective members live healthier lives,” said Mark White, president and chief executive officer of Arkansas Blue Cross. “With the help of Bravo, we can meet the needs of employers by providing a results-based incentive program and continue to help our members reach their own personal wellness goals.”

“We are thrilled to be selected and have given Arkansas Blue Cross exclusive access to our products and services in Arkansas,” said Jim Pshock, founder and president of Bravo Wellness. “By offering Bravo’s programs, Arkansas Blue Cross has provided employers with a unique opportunity to control costs and improve the health status of their employees.”

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 their employee’s cost for health benefits to participation in wellness programs and demonstrable health improvement 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.

About Arkansas Blue Cross

Founded in 1948, Arkansas Blue Cross and Blue Shield, an Independent Licensee of the Blue Cross and Blue Shield Association, is the largest health insurer in Arkansas. Arkansas Blue Cross and its affiliates have more than 2,700 employees. If combined, the 39 independent, locally operated Blue Cross and Blue Shield Plans collectively provide healthcare coverage for 98 million — nearly one in three — Americans. For more information, visit arkansasbluecross.com.

Bravo Wellness is an independent company that operates separately from Arkansas Blue Cross and Blue Shield. Bravo Wellness does not sell or service Arkansas Blue Cross products and is solely responsible for the incentive management services it provides.

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:

Click here to see the full article and chart.

Within these general areas, there are at least five ways to implement financial incentives:

1. 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.
2. 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.
3. Change Deductible – increase or decrease the plan deductible based upon compliance standards set in the plan.
4. 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.
5. 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.