As employers continue to ramp up their use of wellness incentives, employee resistance also is on the rise, recent studies suggest.
While wellness programs in general enjoy broad public support (76 percent of respondents), a majority (62 percent) oppose requiring employees to pay more for health coverage if they do not participate, according to a Kaiser Family Foundation survey. Even more respondents (74 percent) said it was “not appropriate” to charge employees more who fail to meet certain health-related goals.
The Kaiser Health Tracking Poll conducted in June found similar results among working-age adults who get their insurance through an employer. Responses also were largely unaffected when individuals heard arguments for and against outcome-based wellness incentives, according to the KFF report released July 1.
Meanwhile, employers continue to direct more financial resources toward wellness programs and other health benefits, according to a separate survey by the Society for Human Resource Management. “An increase in wellness offerings is a trending tactic for companies looking to save on long-term health care costs often associated with chronic diseases such as diabetes and high blood pressure,” said Bruce Elliot, SHRM manager of compensation and benefits, in announcing the group’s 2014 Employee Benefits report.
The past five years have seen growing use of wellness incentives, SHRM reported. Of the 510 randomly selected HR professionals surveyed, 36 percent are offering “rewards or bonuses” in 2014 for completing certain health and wellness activities — up from 28 percent in 2010, but down from 43 percent last year. Specific types of incentives offered in 2014 included health care premium discounts for:
- getting an annual health risk assessment (21 percent);
- not using tobacco products (19 percent);
- participating in a wellness program (14 percent); and
- participating in a weight loss program (9 percent).
The top wellness benefits offered to manage chronic diseases and other health issues, according to SHRM, included:
- health and lifestyle coaching (47 percent);
- preventive programs targeting employees with chronic health conditions (42 percent);
- subsidies or reimbursements for fitness center memberships (34 percent);
- weight loss programs (32 percent);
- on-site fitness centers (20 percent); and
- nutritional counseling (20 percent).
Richer Plan Designs as Wellness Incentive
Another emerging incentive strategy involves “gating” employees by offering richer plan designs in return for taking certain wellness-related steps, according to a third survey conducted by Aon Hewitt. “For example, employers may offer a basic high-deductible plan to their entire workforce, but make a richer PPO option available to those employees who complete a health risk questionnaire or biometric screening,” explained Jim Winkler, Aon Hewitt’s chief innovation officer for health and benefits.
About one in five employees currently employ this type of gatekeeper strategy, according to Aon Hewitt’s survey of more than 1,230 employers. “Over time, plan design strategies will evolve to be more requiring of employees, and individuals will be held more accountable for their health and for using health care,” said Tim Nimmer, Aon Hewitt’s chief actuary.
Among working-age adults insured through an employer, 48 percent said their employer offers some type of wellness program, according to the Kaiser poll. Twenty-seven percent described the program as participatory, 2 percent said it required meeting actual health goals and 16 percent said their employer offered both types. Of the 48 percent offered either type of program, 63 percent said they participate — 73 percent of women but only 54 percent of men.
Compliance issues regarding wellness programs are detailed in the Employer’s Guide to HIPAA.