Interest in health insurance exchanges grows
More say they would shop for coverage through a health insurance exchange
BY KATHRYN MAYER
More people looking to buy health insurance say they would shop for coverage through a health insurance exchange if they had the opportunity, according to a J.D. Power and Associates health plan study.
A majority of health plan members who purchase insurance on their own say they would likely use one of the state health insurance exchanges (55 percent), while 39 percent of those covered under an employer-sponsored program indicate they would shop for insurance through an exchange if it were available.
And more, the study finds there’s an increased level of interest in state-sponsored health insurance exchanges compared to last year. In 2012, 37 percent of health plan members say they wouldn’t likely use an exchange, compared with 50 percent in 2011 who expected to continue obtaining coverage at work.
The level of interest among those who obtain health insurance through work is an important implication for the future of employer-sponsored care, says Rick Millard, senior director of the health care practice at J.D. Power and Associates.
The study also finds substantial interest among health plan members in private health insurance exchanges, in which an employer might provide employees with vouchers for purchasing health insurance independently. Roughly 41 percent of employer-insured health plan members indicate they would use this approach if it were available.
Want to know what 2025 will look like?
BY KATHRYN MAYER
- Many needs, many models. This scenario is a natural extension of health care as many Americans know it. The scenario forecasts a shortage of primary care physicians, increased emphasis on disease prevention, growth in electronic medical recordkeeping, a shift from employee-based insurance to health insurance exchanges, and growing disparities in access to and quality of primary care based on income and where people live.
- Lost decade, lost health. This scenario forecasts a shortage of primary care physicians, declining income for practicing physicians and more uninsured patients, some of whom resort to black market care and unreliable online advice. Patients with good insurance have access to great care enhanced by advanced technology
- Primary care that works for all. This scenario assumes nearly universal health care coverage, with 85 percent of patients using integrated systems staffed by collaborative teams of health care providers, including physician assistants, nurse practitioners and health coaches who work closely with patients. Seeking to provide better care at lower cost while improving the health of the population they serve, primary care teams join with community partners to address factors that affect a community’s health, including employment, educational attainment, housing, transportation, and access to fruits and vegetables.
- Consumer is boss. Under this scenario, four of 10 patients opt for consumer-directed health plans, which include catastrophic insurance with high deductibles. For the most part, savvy consumers use advanced technologies, including noninvasive bio-monitors, as well as wellness and disease management apps, to stay healthy. Large vendors offer free avatar-based health coaching to consumers who purchase other integrated health products and services. Consumers shop for the best doctor and buy on the basis of high quality and low price.
Economy recovering, but not accelerating
BY PAUL WISEMAN
WASHINGTON (AP) — The U.S. economy's recovery looks enduring. It's just not very strong.
Hiring, housing, consumer spending and manufacturing all appear to be improving, yet remain less than healthy. Economists surveyed by The Associated Press expect growth to pick up this year, though not enough to lower unemployment much.
A clearer picture of the nation's economic health will emerge Friday, when the government reveals how many jobs employers added in April.
"The outlook is for continued moderate growth," John Williams, president of the Federal Reserve Bank of San Francisco, said in a speech Thursday. "Nonetheless, we have nearly 4½ million fewer jobs today than five years ago, and the unemployment rate remains very high at 8.2 percent."
The 32 economists polled by the AP late last month are confident the economy has entered a "virtuous cycle" in which more hiring boosts consumer spending, which leads to further hiring and spending. They expect unemployment to drop from 8.2 percent in March to below 8 percent by Election Day.
But they still think the rate won't reach a historically normal level below 6 percent until 2015 or later. And they predict hiring will slow the rest of this year from a relatively brisk December-February pace.
The government's economic data have been sending mixed signals about the health of the recovery from the Great Recession. Here's a look at the economy's vital signs:
— JOBS
The job market is gradually improving, though not as fast as it had been. From December through February, employers added a strong 246,000 jobs a month. That figure sank to a weak 120,000 in March. The April jobs report could clarify whether March was a one-month dud — or evidence of a more lasting slowdown in job creation like the one that occurred in mid-2011.
The economists in the AP survey foresee average job growth of 177,000 a month from April through June and 189,000 for the next six months. The economy needs to generate about 125,000 jobs a month just to keep up with population growth.
On Thursday, the government said the number of people who applied for unemployment benefits last week fell by a sharper-than-expected 27,000 to a seasonally adjusted 365,000. That pointed to fewer layoffs and a brighter outlook for hiring.
Further cause for hope came in a government report Thursday on worker productivity: It fell from January through March by the most in a year. Declining productivity could be a positive sign for jobseekers. It may signal that companies are struggling to squeeze more from their workforces and must hire to keep up with customer orders.
— HOUSING
The housing market has been a dead weight on the economy. The single-family home market, in particular, is still struggling. House prices dropped for six straight months through February, according to the Standard & Poor's/Case-Shiller home-price index. And Americans bought fewer previously owned homes in March.
The economists polled by the AP worry that the lingering effects of the housing bust are slowing the economy's expansion. They say growth can't accelerate until national home prices finally hit bottom.
Still, spending on home construction and renovations rose from January through March by the most in nearly two years. And housing investment, led by apartment construction, is expected to contribute to economic growth this year for the first time since 2005.
The warm winter may also have led more people to buy earlier in the year, essentially stealing sales from March. Reduced prices, record-low mortgage rates, higher rents and the improving job market appear to be emboldening would-be buyers. Many seem to have concluded that prices won't drop much further, if at all.
And builders are laying plans to construct more homes in 2012 than at any other point in the past 3½ years.
— CONSUMERS
Americans have proved surprisingly willing to spend in the face of a wobbly economy. In the first three months of the year, consumer spending grew at an annual pace of 2.9 percent, the fastest in more than a year.
Some economists doubt that consumers can keep it up. They probably can't afford to. Americans' after-tax income in the first three months rose just 0.6 percent from a year earlier. That was the skimpiest pay increase in two years. People spent more, in part, because they saved less. Economists worry that people won't keep spending more unless their income grows.
On Thursday, big retailers including Costco, Macy's and Target, reported that sales last month came in below expectations.
— CORPORATE PROFITS
U.S. companies earned more money than analysts expected from January through March. They're beating Wall Street estimates at the best rate in more than a decade. Improved earnings have propelled the Dow Jones industrial average up nearly 4 percent since April 10.
U.S. corporations excluding banks and other financial firms are sitting on more than $2.2 trillion in cash, up from $1.7 trillion in 2009. That surplus means they can afford to expand and hire whenever they're confident enough.
— MANUFACTURING
Manufacturing has provided much of the fuel for the U.S. recovery since the recession ended roughly three years ago. American manufacturing expanded last month at the fastest pace in 10 months. New orders rose to the highest level in a year, a signal of more production in coming months. Export orders also rose, despite worries that weaker economies in Europe and China could hold back U.S. exports.
And the busier factories are hiring. Manufacturers added 120,000 jobs a month through March this year, their fastest three-month pace since 1997.
But the economists surveyed by the AP think manufacturers will fill jobs more slowly the rest of the year. If so, that could weaken overall job growth.
Employers fail at measuring wellness program ROI
BY AMANDA MCGRORY
As health care costs continue to rise, employers are on the lookout for ways to reduce spending, and wellness programs are becoming an increasingly popular solution. While research has shown that wellness programs can reduce costs, many employers are failing to measure their return on investment to get an accurate picture of how these programs impact the bottom line, says LuAnn Heinen, vice president at the National Business Group on Health, a nonprofit dedicated to representing large employers’ perspectives on national health policy issues in Washington, D.C.
“It’s important for everyone to look at what they’re spending on wellness per employee and look at that as a percentage of what they’re spending on health care,” Heinen says. “Most employers keep their wellness program investments small – only 2 percent of less of claim costs. There’s a body of evidence in different employer settings and over a number of years that suggests there is a return on investment of $2-3 per every dollar invested. When looking at these figures, a lot of companies might find that they’re underinvesting in wellness and prevention.”
Despite the importance of measuring ROI on wellness programs, it can be a struggle for employers because of the various components, Heinen says. Employees are coming and going, coverage policies could change, new insurance carriers take over – there are so many revolving factors in an employer’s reality that getting a real read of wellness programs can be difficult.
“We have a messy real world,” Heinen says. “The bottom line is you can try to collect and study a lot of data to determine the return on investment, but for all kinds of reasons out of your control, you don’t end up with valid information.”
Although measuring ROI is challenging, that’s not a reason for employers to give up, Heinen says. Instead, Heinen recommends that an employer divides its employee population into two groups: participants and nonparticipants. Between those two groups, an employer can look at the difference in claims over time. However, there are some problems with that approach.
“It’s easier to participate in wellness if you’re healthy, so maybe that person would have cost less anyway,” Heinen says. “Just because you participated in wellness doesn’t mean it was because of the wellness program that those people cost less, but at least you know there’s an association between people in the wellness program who tend to be lower cost, and it can give you that confidence that the more people participating in wellness, the better for your trend.”
An employer can also measure ROI by matching a participating employee to a nonparticipating employee who both represent similar demographics, Heinen says. For instance, an employer can take a nonsmoking 35-year-old woman following the wellness program and compare her claims to another nonsmoking 35-year-old woman who is not participating. These similar demographics do a better job of painting the true claims picture.
“It wouldn’t be a good comparison if all the employees participating were 25 and all the employees not participating were 45,” Heinen says “You want to match based on key demographics that drive costs and then you have a better chance of seeing the differences in the cost profiles is the wellness program and not their age or their smoking status or something else.”
Employers should keep in mind that calculating the success or failures of a wellness program takes time, Heinen adds. Considering the revolving workplace and the time and effort it takes for implementation, employers should give their wellness programs two to three years before they relying on the data.
“It takes a while to get enough people to participate, and then it also takes time to get information on their experiences and make changes,” Heinen says. “You really need at least two years.”
US hiring slows sharply
Employers only added 115,000 in April
BY CHRISTOPHER S. RUGABER
WASHINGTON (AP) — U.S. employers pulled back on hiring in April for the second straight month, evidence of an economy still growing only sluggishly. The unemployment rate dipped, but only because more people gave up looking for work.
The Labor Department said Friday that the economy added just 115,000 jobs in April. That's below March's upwardly revised 154,000 jobs and far fewer than the pace earlier this year.
The unemployment rate dropped to 8.1 percent last month from 8.2 percent in March. It has fallen a full percentage point since August to a three-year low. But last month's decline was not due to job growth. The government only counts people as unemployed if they are actively looking for work.
In April, the percentage of adults working or looking for work fell to the lowest level in more than 30 years. Many have become discouraged about their prospects. More than 5 million Americans have been unemployed for six months or longer, an astonishingly high number almost three years into a recovery.
Stock futures dipped after the report was released.
Employers added an average of 252,000 jobs per month from December through February, a burst of hiring that raised hopes the economy would accelerate. But job gains have averaged only 135,000 in the two months since then. That's below last year's pace of 164,000 per month.
Weak job gains pose a threat to President Barack Obama's reelection. He is likely to face voters this fall with the highest unemployment rate of any president since World War II.
Some economists attribute the weak gains partly to mild winter, which led some companies to accelerate hiring in January and February. That may have weakened hiring in March and April.
"Over the next couple of months we would expect the monthly gains to settle back into a 150,000 to 200,000 range," Paul Ashworth, an economist at Capital Economics, wrote in a note to clients.
But others are concerned that this reflects a genuine slowdown.
"One month can be weather related, two months of weaker than expected job growth is dangerously close to a trend," Dan Greenhaus, an analyst at BTIG, an institutional brokerage firm.
The slowdown could heighten fears that high gas prices and sluggish income growth are weighing on the broader economy.
Economists noted that the job gains are consistent with the 2.2 percent annual growth in the first three months of the year. Faster growth will be needed to accelerate hiring.
The economy must create at least 125,000 jobs a month just to keep pace with population growth. It generally takes twice that number on a consistent basis to rapidly lower the unemployment rate.
Average hourly wages rose a penny in April, to $23.38. They have increased 1.8 percent over the past year, trailing the rate of inflation.
Manufacturers, retailers, and hotels and restaurants all added workers. So did professional services such as engineering and information technology. Shipping and warehousing firms, construction companies, and governments cut jobs.
Hiring in February and March was revised up to show additional job gains of 53,000.
There have been other signs that hiring will improve.
The number of people seeking unemployment benefits fell last week by the most in a year, the government said Thursday. That drop wasn't reflected in the April employment report, which was compiled from a survey taken earlier in the month. But it could bode well for hiring in May.
And earlier this week, the Institute for Supply Management, a private trade group, said factory activity grew at the fastest pace in 10 months and a gauge of manufacturing employment showed that hiring jumped.
Still, service companies expanded in April at the slowest pace in four months, according to a separate ISM survey. And the group said hiring at those companies, which employ roughly 90 percent of the work force, slowed.
The economy expanded at a 2.2 percent annual rate in the January-March quarter, down from 3 percent growth in the fourth quarter. Economists polled by the Associated Press forecast the economy will grow 2.5 percent this year. In a healthy economy, that would be considered average. But faster growth is needed to spur greater job creation.
Employers still not successfully communicating pensions auto-enrollment
By David Woods
Most employers (70%) are aware of pension reform changes but 68% of employees have little or no knowledge of automatic enrolment yet, according to a report from Aviva.
The survey found 43% of employees without a pension said they would remain in a scheme once they were automatically enrolled - but opt outs could be significant.
The challenge of getting Britain's workers saving for their retirement is highlighted in Aviva's first Working Lives Report, which reveals the daily struggle faced by employers and employees as they seek to balance business priorities against personal financial needs.
Surveying UK private sector employees and employers about their attitudes to saving in the workplace, the Working Lives research shows businesses, Government and the pensions industry across Britain have significant work to do in encouraging employees to start putting some of their hard-earned cash aside for their retirement.
Opt out rates from automatic enrolment are also potentially significant, with employers thinking that the typical percentage of employees opting out will be 33%, and a similar number (37%) of employees saying they may choose to leave. But 43% of employees currently without a pension said they would remain within the scheme once enrolled, and of those 8% said they would contribute more. Those that were undecided amounted to 21%.
Employees are most concerned (53%) about how their pay compares to the cost of living, while employers worry most about keeping up with the competition (58%). More than half (56%) of employees agree pensions are the best way to save for retirement but 55% of employees without one say they simply don't have the cash.
UK private sector employers (96%) surveyed said their employees were absolutely critical to the success of the business. And overall, UK employees seemed to be generally happy in their work - with 27% saying they really enjoy their work and 45% saying they quite enjoy their work.
But for both employers and employees - the issue of money is absolutely central to their workplace relationship. Over a third (39%) of employers said they were looking for ways to motivate their workers without 'unduly increasing remuneration' and 46% said they designed their pay and benefits packages carefully to control costs.
While employers recognized the contribution made by employees, their most immediate business concern was a commercial one - how to keep ahead of the competition (58%). However, the highest percentage of employees (53%) said that ensuring their pay kept up with the cost of living was their key workplace concern.
While pensions top the list (56%) as the best way people like to save for retirement, those actually saving into a workplace pension in the private sector right now remains relatively low at 35%. At the same time, the number of employees who say their employer offers a workplace pension (54%) is on the brink of radical change with the start of automatic enrolment.
Of those employees who are offered a workplace pension but neither they nor their employer contribute 55% say they don't have the spare cash to contribute to a pension, 28% say they need to repay debts and 20% say they need to pay for immediate family costs.
Broader workplace benefits are increasingly coming to the fore as employees seek help in bridging the cost of living gap. The top five benefits valued by employees (and which they are offered) are: annual bonus (36%), pension (16%), health insurance (15%), life insurance (14%), and non-financial benefits (14%), such as discounts on products, subsidized gym membership and crèche facilities.
Aviva's managing director of corporate benefits Graham Boffey said: "Aviva is a long-standing advocate of automatic enrolment, but we recognize that Britain's employers are facing the significant challenge of transforming the way they provide pensions and workplace benefits at a time of continuing economic uncertainty.
"When the first companies start to automatically enroll their employees in October this year, we can't expect an immediate step-change in how people save for their retirement - employers and the industry will need to make a long-term commitment to ensuring it's a success.
"Companies are increasingly going to need to find relevant and compelling ways to talk to their employees about their savings and benefits options. And as more people start to use the workplace for managing their money, practical planning tools and clear guidance will be essential.
"While the time, resources and commitment being called for from employers over the next few years should not be under-estimated, there are clear benefits for those who really understand what savings and benefits their employees value, and importantly, how best to discuss them in the workplace.
"Employers willing to put in the time and effort will find themselves in a win-win situation. Broader workplace savings and benefits are a cost-effective way of boosting employees' total packages beyond basic pay, and we know employees want additional and more relevant benefits that help them make the most of their money.
"While Working Lives shows some areas for concern, there are equally positive signs that employers and employees are willing to embrace this period of workplace change and in doing so they will help to re-invigorate Britain's savings culture."
Are rules and regulations around alcohol going to make a difference?
By Penny Ferguson
As an HR director or business leader, are you drawing any parallels between the Government’s approach to dealing with the problems of binge drinking and the way our organizations attempt to create behavioral change?
This may sound like a strange question, but for me there are so many things that resonate, and my question is this: are rules and regulations the most effective way to change the way people behave?
The Government obviously believes so. Binge drinking is, without question, a serious and growing problem, but Government is only dealing with the symptoms, not the cause. Why do individuals feel the need to go out and binge drink?
Probably because they think it's fun. How sad that we have become a nation where many people find fun in a bottle rather than more healthy pastimes. Those who passionately pursue activities and hobbies are much less likely to be among this number, perhaps because they're focused on a sense of purpose and belonging.
Just putting in numerous rules to remove from someone something they want, without their having something worthwhile to replace it with, I have never known to have any significant impact on behaviors. Usually, it just makes them devious, trying to find ways round it. You could therefore argue that you may be creating even more problems for the broader community.
Where will they get the booze from if they don't have the money to get it? If it's 'the only way to have fun', they'll surely find a way – steal either the drink or the money to buy it, maybe?
The same thing is true in our businesses. When we continually create rules and structures to stop people doing certain things or behaving in certain ways, they often invest huge amounts of time in finding ways to get around them.
However, if we focus more on helping people to see how they can really contribute and how they uniquely make a difference to their team and the organization, we may create sustainable change. We may begin to inspire people to embrace their role so they get much more from every working day, which in turn may positively impact on their performance.
Let me put this into a context. How many companies have you worked at where a communication problem was dealt with by appointing consultants? How much real change resulted? Most of the time, when people are asked that question, they respond, 'not a lot' or 'nothing at all'.
So, your problem is that individuals are not communicating and you put in a system to sort it? That won't work. If each and every individual took 100% responsibility for communicating, you wouldn't need a new system anyway.
At home, and I will admit sadly to this being very true of me for many years, you love your children very much so you keep telling them 'what to do' and what 'not to do'. Effectively, you are educating them into not thinking for themselves. You are actually teaching individuals how not to be responsible.
To change the culture of drinking, or to change any culture for that matter, necessitates something very different from putting in new systems. I believe if this is the route the Government goes, then the impact will be negligible and, within a couple of years, they'll be looking to 'upgrade' or put in a new system and the problem will have escalated.
How often have you seen systems merely create a 'fix' rather than bring about lasting change within your organization?
David Cameron talks about responsibility but, if he just keeps putting in systems to tell people how to behave differently, then to my mind he clearly doesn't understand the true meaning.
I wish, for once, the powers that be would start addressing the cause rather than the symptom. Then, and only then, will we begin to address so many of our challenges.
How are you applying this principle in your organizations?
Fitness in Middle Age Lowers Medical Costs Later: Study
By Ellin Holohan
HealthDay Reporter
THURSDAY, May 10 (HealthDay News) -- Subsidizing exercise and fitness-related lifestyles in middle age could significantly reduce the ballooning cost of health care in later years, a new study of more than 20,000 people suggests.
The study, slated for Thursday presentation at an American Heart Association meeting in Atlanta, found that fit middle-aged men and women had significantly lower medical expenses later in life compared to people who failed to stay in shape.
The more-fit study participants had 38 percent lower medical costs many years later, measured by Medicare and other insurance claims from 1999 through 2009.
"We wanted to determine if higher levels of physical fitness in middle age are associated with lower costs later in life," said study author Dr. Justin Bachmann. "We found that fitness confers dividends later in life even when other risk factors such as smoking, high blood pressure and obesity are controlled for."
The implications of the findings give "credence to efforts like Michelle Obama's 'Let's Move' campaign," he said. The First Lady has initiated a project aimed at reducing childhood obesity through exercise and proper nutrition.
Levels of fitness were determined by a treadmill test measuring metabolic equivalents (METs), Bachmann said. The higher the METs, the more fit a person is. People who exercise regularly perform better on the test because they have greater aerobic capacity, which translates into better cardiorespiratory health and lower costs later in life, he said.
The study was a collaboration between the University of Texas-Southwestern Medical Center and the Cooper Institute, both in Dallas.
Researchers screened participants for previous heart attacks, strokes and cancer. Of the 20,489 given a "healthy" designation, 16,186 were men and 4,303 were women, with an average age of 51. When Medicare costs and other insurance payments were compared, the average age was about 72, Bachmann said. The study participants were drawn from the Cooper Center Longitudinal Study, a repository of health-related data from close to 100,000 patients collected over the past four decades.
Many of the study participants were business executives who went to the center for physicals and represent "an unusually healthy cohort," reducing the effect of confounding factors, Bachmann said.
The analysis controlled for health risks, such as smoking, diabetes, high blood pressure, cholesterol levels and body-mass index (BMI). Body-mass index, used to measure the impact of obesity, is based on a combination of height and weight in adults.
Even in the presence of risk factors, better fitness in middle age predicted lower medical costs later.
The least-fit group at the study's onset had higher risk factors across the board. For example, 31 percent of the most out-of-shape men smoked, compared with 9 percent of the most-fit men. About 5 percent of the least fit men had diabetes, vs. less than 2 percent of men in the best condition. A similar pattern existed for women in the study.
Average annual claims for medical costs for the least-fit men, at $5,134, were about 36 percent higher than the average of $3,277 a year for the most-fit men. The average medical claims of $4,565 for the least-fit women were about 40 percent higher than the $2,755 average for the most fit.
Another expert called the study "quite compelling" and connected the results of the treadmill tests to regular exercise, promoting it as a path toward fitness.
"Exercise is the best medicine we have," said Dr. Suzanne Steinbaum, a preventive cardiologist at Lenox Hill Hospital in New York City. Noting that exercise has an impact on blood pressure, diabetes and even mood, she said "the positive effect of exercise on the body is powerful and it's empowering."
Exercise affects "so many chronic conditions leading to major health care costs," said Steinbaum, who also is the hospital's director of women and heart disease. "We should have financial support for people to go to gym facilities."
People who are more fit should "get some benefit" from insurers, Steinbaum said. Society should "give them the ability to become fit," and then "give people a reward when they demonstrate" fitness, she added.
Because the new study was presented at a medical meeting, the data and conclusions should be viewed as preliminary until published in a peer-reviewed journal.
Obesity declining? Fat chance
LAURAN NEERGAARD, AP Medical Writer
Source: Timesleader.com
WASHINGTON — The obesity epidemic may be slowing, but don’t take in those pants yet.
Today, just over a third of U.S. adults are obese. By 2030, 42 percent will be, says a forecast released Monday.
That’s not nearly as many as experts had predicted before the once-rapid rises in obesity rates began leveling off. But the new forecast suggests even small continuing increases will add up.
“We still have a very serious problem,” said obesity specialist Dr. William Dietz of the Centers for Disease Control and Prevention.
Worse, the already obese are getting fatter. Severe obesity will double by 2030, when 11 percent of adults will be nearly 100 pounds overweight, or more, concluded the research led by Duke University.
That could be an ominous consequence of childhood obesity. Half of severely obese adults were obese as children, and they put on more pounds as they grew up, said CDC’s Dietz.
While being overweight increases anyone’s risk of diabetes, heart disease and a host of other ailments, the severely obese are most at risk — and the most expensive to treat. Already, conservative estimates suggest obesity-related problems account for at least 9 percent of the nation’s yearly health spending, or $150 billion a year.
Data presented Monday at a major CDC meeting paint something of a mixed picture of the obesity battle. There’s some progress: Clearly, the skyrocketing rises in obesity rates of the 1980s and ’90s have ended. But Americans aren’t getting thinner.
Over the past decade, obesity rates stayed about the same in women, while men experienced a small rise, said CDC’s Cynthia Ogden. That increase occurred mostly in higher-income men, for reasons researchers couldn’t explain.
About 17 percent of the nation’s children and teens were obese in 2009 and 2010, the latest available data. That’s about the same as at the beginning of the decade, although a closer look by Ogden shows continued small increases in boys, especially African-American boys.
Does that mean obesity has plateaued? Well, some larger CDC databases show continued upticks, said Duke University health economist Eric Finkelstein, who led the new CDC-funded forecast. His study used that information along with other factors that influence obesity rates — including food prices, prevalence of fast-food restaurants, unemployment — to come up with what he called “very reasonable estimates” for the next two decades.
Part of the reason for the continuing rise is that the population is growing and aging. People ages 45 to 64 are most likely to be obese, Finkelstein said.
Today, more than 78 million U.S. adults are obese, defined as having a body-mass index of 30 or more. BMI is a measure of weight for height. Someone who’s 5-feet-5 would be termed obese at 180 pounds, and severely obese with a BMI of 40 — 240 pounds.
The new forecast suggests 32 million more people could be obese in 2030 — adding $550 billion in health spending over that time span, Finkelstein said.
“If nothing is done, this is going to really hinder efforts to control health care costs,” added study co-author Justin Trogdon of RTI International.
What’s the Difference between Performance & Proficiency?
By Mykkah Herner, MA, CCP, Compensation Consultant at PayScale.com
Here at PayScale, we often talk about compensation philosophies answering 3 main questions:
- How do you define your market?
- How competitive do you want to be relative to the market?
- What do you want to reward?
In working with clients, I find they know the answers to the first two questions within a heartbeat. The third question, however, often leads them to stumble and to look to me for guidance. What are the options? What should we reward? At that point, I have to dig in deeper to their organization.
There’s no single right answer for what companies *should* reward. In some orgs, there will be just one thing to reward, in some it will be a combination of factors. At a time when most companies are focused on pay-for-performance, I want to explore this third question a bit further.
What do you want to reward?
Performance
Ultimately, for me, it will always come down to some variant of performance. If your employees aren’t going above and beyond, exceeding expectations most of the time, it’s likely that your organization will stagnate. Stagnation is close to death in a highly competitive environment. The number one question I ask myself when defining a compensation strategy is how am I going to motivate employees to perform? In measuring performance, it is about setting clear expectations, in the form of metrics, for what it looks like to excel and then following up on those expectations.
Proficiency
What’s the difference between performance and proficiency anyway? I see proficiency as one’s ability to perform the tasks required to do the job, having the right skill-set, etc. Performance refers to how well one performs those required tasks, exceeding expectations vs. meeting expectations, and so on. I know that’s simplistic, but breaking it down to that level helps me then think about how I might measure proficiency. Some measures for proficiency include checking that one has skills and ensuring that tasks have been completed.
Tenure
The average tenure in my parents’ generation was 5+ years. My generation can boast a meager 3 years. The average tenure in newer generations to the workforce can be measured in months, not years (usually 12-18, according to one researcher). With that in mind, rewarding tenure can sometimes be helpful to the continuity of your organization, but it still may not be the right motivator for performance. You may have better luck achieving continuity through structural means rather than through compensation.
Other options?
There are plenty of options besides the big three listed above. For some, it will make sense to reward certain skills. I’ve worked with clients who couldn’t get by without their technical staff. For them, targeting a higher percentile for their technical staff was crucial to accomplishing their business goals. For other clients, security clearances are a hot commodity. You know what’s important to your organization. Put your money where your priorities are.
Remember, you don’t have to reward all things equally. You may decide that you want to tie a large part of your compensation to performance, but still give token acknowledgments for proficiency and tenure. But be sure to keep it simple. Explain it easily and succinctly – and maybe you will avoid a few headaches for your payroll team.
Whatever you decide, live it as an organization. Make sure your managers and leaders buy in to your decision around what to reward. Explain your philosophy to your staff so they are clear about what’s important to your organization. And, as with all policy decisions, once you decide what you want to reward, stick to it.