Clipping health costs in the bud

BY CAROL FLETCHER
The Record

As health insurance premiums skyrocket and small businesses struggle to pay them, insurers are pointing to wellness programs as a way to help offset costs.

Through Web sites, health assessments and seminars, wellness programs act as health coaches to turn employees away from smoking and overeating and toward exercising and eating leaner, and to help them track their health data.

"Employers, large and small, who provide [wellness] programs for employees to address such common health challenges as diabetes management, heart disease, smoking cessation and good nutrition, will play a direct role in cutting health care costs," wrote Michael McGuire, chief executive officer of United Healthcare of New Jersey, a division of the health-care insurer based in White Plains, N.Y., in a column about wellness programs.

Such initiatives began emerging a decade ago and the concept has found its way into the health care overhaul debate.

In July, the U.S. Senate's Health, Education, Labor and Pensions Committee approved The Affordable Health Choices Act that requires health insurance policies to include financial incentives rewarding wellness efforts.

Most insurers' wellness programs include Web sites to determine and track health data. UnitedHealthcare's Web site includes a body mass index to determine body fat as well as heart attack calculators.

Newark-based Horizon Blue Cross Blue Shield of New Jersey's Web site allows employees enrolled in any type of health plan to monitor data such as blood pressure, weight and their progress toward quitting smoking, said Peter Morey, director of product development.

In October, Horizon began offering employers with 100 to 499 enrollees onsite health screenings and lunchtime seminars about issues such as weight management or control of diabetes as part of the premium, said Morey, something that previously required an additional cost.

"A lot of wellness activities seem to be concentrated in the higher end of the market — above 500 employees," said Morey, adding that United is offering activities to smaller employers who might not have the resources to do such programs.

He said insurance brokers are excited about the new offering and Horizon is considering it for even smaller employers.

On the topic of whether health screenings and assessments reduced insurance premiums, Morey said savings would come in the long run if conditions such as high blood pressure are caught early.

Employers participating in wellness programs with Amerihealth Insurance Co. of New Jersey in Mount Laurel can get slight premium reductions — up to 1 percent, said Paul Portsmore, vice president-health services.

So the insurer, which focuses on businesses with 50 to 500 employees, does not charge for wellness committees, health expos and onsite health assessments, said Portsmore.

Additionally, it offers discounts for services such as acupuncture and reimbursements for fitness-center memberships, weight-management programs and other efforts. Amerihealth also provides health coaches and online tools.

At UnitedHealthcare, "enrollment in certain wellness products and programs can reduce premiums anywhere from 5 to 15 percent," for employers, said Mary McElrath-Jones, a spokeswoman for the health insurer.

But insurers agree the key factor to making these programs reduce claims is senior management.

"The accountability of the behavior needs to be on the individual and the employer group," said Portsmore. "There's only so much an insurance company will be allowed to do."