Employers’ Corporate Wellness Incentives Climb to New Heights
Originally posted February 20, 2014 by Michael Giardina on https://ebn.benefitnews.com
With a reported 15% increase in wellness incentive spending within their health care plans, corporate employers have their sights set on improving their workforce’s overall health in 2014 through wellness programs for both employees and their significant others, according to a new survey from Fidelity Investments and the National Business Group on Health.
The fifth annual study finds that corporate employers expect to spend an average of $594 per employee on wellness-based incentives, an increase from 2013’s $521 average. For smaller employers with less than 5,000 employees, the employee average reached $595, a $151 increase from levels reported in 2013.
Approximately 95% of employers plan to offer some sort of health improvement program, highlighting that benefit plan sponsors have labeled wellness programs as an integral part of their benefits program in this post-Affordable Care Act world. Also, 74% note that they offer incentives for employee participation, which is a 12% dip from last year.
“While the use and measurement of corporate wellness programs continue to evolve, it has become clear that many employers understand the value of – and are committed to – wellness-based incentives in their company health plan,” says Robert Kennedy, health and welfare practice leader with Fidelity’s benefits consulting business.
The most popular programs include lifestyle management courses that focus on physical activity, weight and stress management. Disease and care management programs – which look to manage chronic health conditions – were also favored.
Doling out for spouses/HSAs
From the 2014 survey, Fidelity and NBGH found that nearly four out of 10 employers disclosed that their plan will include options for spouses or domestic partners. Last year, results highlighted that 54% set out plans to expand wellness-based incentives to include dependents and roughly half said they were including spouses and dependents in wellness communications.
Average payouts for spouse and domestic partners are expected to reach $530 in 2014. Employers with more than 20,000 employees expect to spend an average of $611 on this group.
Other incentives such as heath savings accounts and flexible spending accounts were expected to incentivize more employees use. Roughly 34% list that they plant to contribute to these accounts in order to bolster disease or care management engagement and 30% hope these deposits will add to weight management programs participation.
“Based on the feedback from this year’s survey respondents, it’s obvious that wellness programs not only play a key role in many corporate health care plans today, but they’ll continue to be an integral part of corporate benefit programs in the future,” says Helen Darling, the retiring president and CEO of NBGH.
Flu hitting younger and middle-age adults hardest this season
Originally posted February 20, 2014 by Steven Ross Johnson on https://www.modernhealthcare.com
Younger and middle-age adults make up the majority of hospitalizations and deaths from influenza this season, matching rates not seen since the 2009 H1N1 flu pandemic, federal health officials said Thursday.
Data collected by the Centers for Disease Control and Prevention show people between ages 18 and 64 have accounted for 61% of flu hospitalizations since September through Feb. 8. That's almost double the average rate of 35% over the past three seasons, according to the CDC's Morbidity and Mortality Weekly Report.
“Influenza can make anyone very sick, very fast, and it can kill,” CDC Director Dr. Tom Frieden said.
Frieden urged healthcare providers not to wait to treat patients with flu symptoms. “It's important that everyone get vaccinated,” he said. “It's also important to remember that some people who get vaccinated may still get sick, and we need to use our second line of defense against flu: antiviral drugs to treat flu illness. People at high risk of complications should seek treatment if they get a flu-like illness. Their doctors may prescribe antiviral drugs if it looks like they have influenza."
The H1N1 strain of the virus, which the World Health Organization said was responsible for about 18,000 deaths worldwide in 2009, has resurfaced this year.
The CDC said deaths from influenza this season are following similar patterns from those observed during that pandemic. As in 2009-2010, about 60% of flu deaths in the past five months have been people between ages 25 and 64.
Flu vaccinations have been effective this season, reducing a person's risk of seeking medical help by about 60%, according to a second report this week in the MMWR.
Stress continues to boil up in American adults: APA study
Originally posted February 12, 2014 by Michael Giardina on https://ebn.benefitnews.com
Are Americans accepting ways to cope with ever skyrocketing stress levels that can make them more productive to employers? New research finds that traditional pressures continue to rise and more needs to be done to relieve this strain.
The American Psychological Association’s annual survey, released Tuesday, finds that stress continues to plague American adults. According to its Stress in America report, 42% say that stress levels have increased and 36% state that these levels have remained constant over the past five-years.
On average, despite reporting that a healthy stress level is 3.6 on a 10-point scale, survey respondents state their stress level is 5.1. APA says that only 10% of these adults actually make time for stress management activities.
Dr. David Ballard, who heads up APA’s Center for Organizational Excellence, explains that in stress “there is a sizeable gap of what people think is healthy and what they are experiencing.”
Ballard notes stresses related to money, work and the economy seem to support this year’s growth among the 2,000 adults who participated in the nationwide study. While “not unusual,” Ballard says the industry needs to act.
“[Employers] have a workforce…trying to be productive and engaged [but] who is overwhelmed,” Ballard says. “To have more than two-thirds of their workforce say that work is a major source of stress for them, it’s clearly something that employers and employees alike need to deal with.”
Individual stress interventions such as relaxation trainings, meditation, exercise or yoga classes and teaching time management skills are just some options for employers.
“The organizations that do take steps to address work stress typically are focusing on individual-level intervention….but this individual level approach by itself typically won’t be enough to prevent the stress from occurring in the first place and keeping it from being a problem,” Ballard continues. “The key is adding…organizational level things that can be done because when you look at what work stress really is, it’s a mismatch between the demands that employees are facing to the resources that they have available to cope with those demands.”
Previously, in February 2013, APA found that 31% of Americans who categorize themselves as suffering from high stress never discuss stress management with their health care provider. Moreover, 32% of Americans say they believe it is very or extremely important to talk with their health care providers about stress management, but only 17% report that these conversations are happening often or always.
In this year’s study, APA lists that stress impacts both sleep and exercise habits. Ballard says that employers can get ahead of the curve by first instituting hiring practices that find individuals who are a “good fit for the job and the organization.” He adds that additional training and development can help to handle conflicts that arise from positions, ambiguity of work tasks and the handling of high workloads.
Also, employers should assess social and work environment issues that can address team compatibility and workplace organization from both the social and physical dynamic, he says.
“When organizations understand that the health of their workforce and the performance and success of the company are linked together, then they’ll take steps that are both for the wellbeing of the worker and for the organization’s performance,” Ballard explains. “This isn’t just about doing the right thing and taking care of your workers, that is all true and it’s important, but it’s also smart business.”
IRS Issues Regs on Wellness Program Incentives
Originally posted January 28, 2014 by Jerry Geisel on https://www.tirebusiness.com
Financial incentives that employers provide to employees participating in wellness programs generally could not be included in determining if an employee is exempt from a healthcare reform law requirement to enroll in a plan offering minimum essential coverage under newly proposed regulations.
Healthcare plan premium contribution discounts are an example of such an incentive.
The Internal Revenue Service (IRS) regulations proposed Jan. 23 and published in the Jan. 27 Federal Register involve the relationship between a premium affordability test established by the Patient Protection and Affordability Act and the financial incentives employers provide for employees to participate in wellness programs.
Under the healthcare reform law, employees are required to enroll in a plan offering minimum essential coverage. If they do not, they are liable for a financial penalty. In 2014, the penalty is $95 or 1 percent of income, whichever is greater.
Employees are exempt from the penalty, however, if the premium their employer charges for coverage is “unaffordable,” which the law defines as greater than 8 percent of household income, and they did not enroll in the plan.
Under the proposed regulations, financial incentives, such as premium discounts for wellness program participation, would be excluded in running the 8 percent affordability test.
For example, if an employer charged employees a monthly premium of $100 for single coverage if they participated in a wellness program and $120 if they did not, the $120 premium assessment would be used to determine if the employee had access to affordable coverage.
In the case of premium discounts offered in connection with tobacco-cessation programs, however, the lower premium offered to employees participating in these programs would be used in running the premium affordability test, the IRS said.
“This rule is consistent with other Affordable Care Act provisions, such as one allowing insurers to charge higher premiums based on tobacco use,” the IRS said.
“There is more of a consensus among regulators on the benefits of tobacco-cessation programs compared with other wellness programs,” said Amy Bergner, managing director of human resources solutions at PricewaterhouseCoopers L.L.P. in Washington, referring to the different treatment for tobacco-cessation programs than other wellness programs.
This report appeared in Crain’s Business Insurance magazine, a Chicago-based sister publication of Tire Business.
Making HSAs and wellness work together
Originally posted January 13, 2014 by Rose Rosa on https://ebn.benefitnews.com
Maximizing the positive impact of a wellness program is a goal of many employers. Much of the discussion around wellness focuses on how to increase employee participation. Doing so remains a challenge for many employers, but there are some innovative approaches employers are exploring.
One concept we’re seeing is tying wellness to health savings accounts. With a HSA, employees can use tax-free dollars to pay for qualified out-of-pocket healthcare expenses, typically including items such as eyeglasses or prescription medications. Now, some employers are expanding use of HSAs to drive wellness participation.
Combining wellness and HSAs is a long-term strategy. However, there can be some immediate benefit for the employer, which typically begins by going from a traditional fully insured plan to a high-deductible plan with a HSA, thereby saving the employer some money right out of the gate.
Here’s how tying a HSA to wellness can work: The employer funds or partially funds a HSA, which is the “carrot” to get employees interested in the account. Over time, some employers introduce the so-called “stick” to maximize participation by requiring employees to meet certain health-related criteria.
Here’s one possible approach:
• In the first year, the employer contributes to the employees’ HSA account (typically, a 50% contribution).
• To receive the 50% contribution in year two, employees are required to complete a health risk assessment.
• In year three, the employer will increase the requirements, perhaps including completion of another HRA, plus biometric testing.
By increasing the conditions that must be met, it creates a natural progression that helps employees become more aware of their health and to do something about any issues identified by the screening. It also demonstrates to employees what they need to do to control their personal health care costs; those who make progress get discounts on their plan, so they become more responsible for their own health and ultimately their own savings. As employees control their costs, they help control the employer’s costs as well.
In the end, it’s a win-win scenario; the combination of HSAs and wellness programs can provide value to both employees and employers. It’s also an effective way to guide beneficial behavior since employees who follow the program are more likely to take steps to become (or stay) healthy. Using this type of program can also be a good opportunity to tie in other health initiatives, such as smoking cessation. One approach is to apply a smokers’ surcharge on the employee contributions (the stick) while also offering smoking cessation programs to help the employee quit smoking (the carrot to avoid the stick).
To make this combined strategy work, education is a vital. HSAs are most effective if employees understand how the program works, so it’s the employer’s duty to teach them. With this approach, employees have greater risk and higher deductibles, but they also have greater control and choice, coupled with an incentive to be healthy. Essentially, this spurs the employee to become a more educated consumer of health care services.
But it’s up to the employer to make the first move.
Workplace wellness in the new age of the ACA
Originally posted January 02, 2014 by Alan Pollard on https://ebn.benefitnews.com
With all the implications that the Affordable Care Act has on employer’s health insurance obligations, it’s easy to overlook its effects on workplace wellness programs. Yet these programs are very much affected by Obamacare.
Now that privacy and equality guidelines that previously only applied to insurers and providers are being applied to all sponsors of health promotion and prevention programs, the feedback we’re hearing is that many employers are either unaware or don’t understand what’s expected of them vis a vis their wellness programs in this new legal environment.
Some organizations that led the charge in workplace wellness in the last decade have mature programs targeting specific conditions such as obesity or smoking. These types of programs in particular face new hurdles presented by the final ruling, yet many companies don’t understand exactly what is needed to become compliant.
Further, some companies that have taken steps to modify their programs to be compliant are finding out firsthand just how complex re-engineering can often be — and how vocal some highly informed employees can be against changes.
For example, the protection of privacy of personal health information afforded by the Health Insurance Portability and Accountability Act has been legislated for a long time, but now puts additional restrictions on workplace wellness programs. How does a company that has long collected this type of information as proof of qualification for a reward or a premium subsidy handle this new obligation?
Other scenarios: How does an employer set up simple employee fitness events like a 5k walk or even a step test to obey the requirements for a reasonable alternative standard for those who cannot participate due to a physical disability or a physician’s recommendation? Or, how do you reward your employees for losing weight in a way that doesn’t alienate them by pressuring them to share sensitive information?
Whatever the structure, you must be able to prove your wellness program is, as the new law phrases it: “reasonably designed to promote health or prevent disease; has a reasonable chance of improving the health of, or preventing disease in, participating individuals; is not overly burdensome; is not a subterfuge for discriminating based on a health factor; and is not highly suspect in the method chosen to promote health or prevent disease.”
After spending more than two decades in the wellness industry, I’m very encouraged by the ACA’s strong recognition of the important role well-designed wellness programs play in promoting health, preventing disease and controlling the rising cost of care. However, the new regulations also include many important design requirements and consumer protections that raise the bar for wellness providers to deliver more professional and evidence-based programs, and for employers to be more aware of privacy issues, fairness and quality outcomes.
For CEOs this presents an opportunity to re-examine and elevate the standards for workplace programs, choosing the ones based on science-based evidence of measurable impact. For those in the wellness industry, this lays down both a challenge and opportunity to improve the quality and sustainability of interventions — especially those aimed at reducing obesity, tobacco use, physical inactivity and mental health.
We urge all responsible parties to thoroughly examine their wellness offerings for the ability to deliver all that the new law demands — and promises. And for employers, it’s important to make sure your business partners can ensure the ACA compliance of their programs.
Top 10 healthiest states
Originally posted December 26, 2013 by Kathryn Mayer on https://www.benefitspro.com
Americans are making “considerable progress” in their overall health, according to United Health Foundation’s 2013 America’s Health Rankings.
Overall, the annual ranking of America’s states found that smoking is down nationwide, as is physical inactivity.
Some states, of course, are faring better than others. Here are the top 10 healthiest places in America.
10. New Jersey
It helps that New Jersey’s residents are among the wealthiest in the nation, as the report finds the healthiest states are often among the nation’s most financially well-off. Additionally, the Garden State has among the most dentists and primary care physicians in the country.
9. North Dakota
North Dakota is one of the healthiest states, despite the fact that it has a high prevalence of obesity. Other factors, including few poor mental and physical health days per year and a low rate of drug deaths, help make this state amongst the healthiest in the nation.
8. Colorado
Colorado has the lowest obesity rate of any other state. A little more than 20 percent of Colorado residents are considered obese. The considerably small obesity rate also helps other factors: In 2011 and 2012, for example, state residents were among the least vulnerable to heart attack and stroke.
A high prevalence of binge drinking and drug deaths still remain big challenges for the state.
7. Connecticut
Connecticut has one of the lowest smoking rates in the nation, and its obesity rate is also relatively low comparatively speaking, at 25.6 percent. Over the past two years, the uninsured population fell from 11.1 percent to 8.3 percent, according to the report. That is also helped by the fact that Connecticut has a high rate of medical professional availability for residents.
6. Utah
There are a lot of factors contributing to Utah’s good health standing: The Beehive State has the lowest smoking rate in the nation at 10.6 percent of the adult population, has low rates of binge drinking, preventable hospitalizations, diabetes, physical inactivity and obesity. But dragging the state down is a low availability of physicians.
5. New Hampshire
The state has one of the highest rates of healthy eating habits and visits to the dentist. Overall, the state is helped by its extremely low poverty rates, which enables residents to better afford treatment and increases the likelihood that they are informed on good health behaviors.
4. Massachusetts
The state is in a health care state all its own because of reforms that went into effect back in 2006. Virtually all of its residents — 96 percent — are insured, and they all seem to use their coverage. More than in any other state, residents went to the doctor to get their cholesterol checked and visited the dentist. The state’s healthy status is also helped by the availability of physicians. In 2011, there were nearly 200 physicians per 100,000 residents.
3. Minnesota
The Gopher State has low rates of physical inactivity, diabetes and premature and cardiovascular deaths. However, it also has a high prevalence of binge drinking and low per capita public health funding.
2. Vermont
Vermont, last year’s reported No. 1 state, is ranked second this year and has ranked among the top five for the last decade.
Vermont has a low uninsured rate. In the past year, the percentage of uninsured population dropped from 9 percent to 7.8 percent of the population.
1. Hawaii
Top-seated Hawaii scored well along most measures particularly for having low rates of uninsured individuals, high rates of childhood immunization, and low rates of obesity, smoking and preventable hospitalizations. But like all states, Hawaii also has areas where it can improve: It has higher-than-average rates of binge drinking and occupational fatalities, and lower-than-average rates of high school graduation.
’Tis the Season for a Slice of Wellness Training
Originally posted November 29, 2013 by Chris Kilbourne on https://safetydailyadvisor.blr.com
At the beginning of this year's holiday season, take a moment to remind your employees that good nutrition is important to good health. Use the video in today's Advisor as a concise and fun way to drop nutrition reminders in among the holiday festivities.
In order to get the nutrition they need every day to stay healthy, employees must develop and maintain healthy eating habits. Here's a video that takes a light-hearted approach toward providing facts about nutrition and the important employee wellness topic of having healthy eating habits.
https://www.youtube.com/watch?v=Hv66ItR_F24&feature=player_embedded
I'm sure you’ve heard that good nutrition is important to good health. But how?
Well, good nutrition helps you in many important ways. For example, eating healthy food helps to prevent diseases like heart disease, diabetes, and high blood pressure and maintain a healthy weight.
In order to get the nutrition you need every day to stay healthy, you must develop and maintain healthy eating habits. Unfortunately, many Americans have very unhealthy eating habits.
Healthy eating means eating three nutritious meals a day, consuming reasonable portion sizes, limiting intake of fat, sugar, and salt, snacking sensibly between meals, avoiding fad diets, and balancing calorie intake with physical activity.
Proper nutrition depends on a well-balanced diet that includes carbohydrates, fiber, protein, and some unsaturated fat. Carbohydrates give your body the energy it needs to function effectively all day. Carbohydrates are found in fruits, vegetables, bread, cereal, pasta, rice, and milk and milk products. In fact, 45 percent to 65 percent of your daily calorie intake should come from carbohydrates. You also need about 14 grams of dietary fiber for every 1,000 calories you eat. Protein is another essential nutrient, and you should get 10 percent to 35 percent of daily calories from proteins.
Most Americans eat more protein than they really need to stay healthy. Protein is found in meat, poultry, fish, eggs, nuts, milk and milk products, grains, and some vegetables and fruits.
Some protein-rich foods such as meat are also high in fat and cholesterol. To keep healthy, you should consume less than 10 percent of your daily calorie intake as fat. Most of your fat intake should be unsaturated, as opposed to saturated, fat. Saturated fat is found in foods such as high-fat cheese, high-fat meat, butter, and ice cream.
Nuts, vegetable oil, and fish are good sources of poly- and monounsaturated fats.
Health experts also say you should consume less than 300 milligrams of cholesterol a day. Cholesterol is a fatty substance found in animal-based foods such as meat, eggs, and whole milk.
Sugar is found naturally in foods such as fruits, vegetables, and milk and milk products. Some foods include added sugar, and these foods are less nutritious than foods containing only natural sugar. To keep healthy, try to avoid added sugar, which provides no nutritional value and also contributes to tooth decay.
Also, remember that fluids, vitamins, and minerals are part of good nutrition, too. You need about eight glasses of water or other low-sugar fluids a day.
Finally, even though you've got a lot of great choices here in your fridge, I'm sure you eat out sometimes. When you do, remember to make healthy choices. Restaurant or takeout food can be high in fat, sugar, and salt, and low in required nutrients. When you eat food prepared outside your home, try to pick lower-fat foods, choose smaller portions, go broiled or baked instead of fried, order a vegetables or salad, and skip dessert.
For more information on nutrition, visit www.blr.com. Here you’ll find lots of information on wellness. BLR® specializes in employee training, so be sure to check out all of their employee wellness training resources as well as other training topics.
Why It Matters
- Giving your employees nutrition information can help keep them healthy and on the job.
- Healthy employees will cut down on your sick leave costs and your healthcare insurance expenses.
- Healthy employees who are eating the right balance of nutritious foods are more likely to be more productive as well.
- The bottom line is that a healthy amount of wellness training can provide a healthy return on investment for your organization.
Survey: Employees still under-informed on ACA, wellness
Originally posted November 8, 2013 by Tristan Lejeune on ebn.benefitnews.com
Only 15.1% of workers at large employers say they are “knowledgeable” or “very knowledgeable” about health care reform and the Affordable Care Act’s public exchanges, and nearly one in five can’t say for sure if their company has a wellness program or not, according a recent survey. The poll’s results, released this month, speak to a population that has confidence in the communication efforts of their benefits administrators, and that points out some serious shortfalls in that communication.
The survey, which spoke with 400 employees at companies with north of 2,000 each, found that only 29.5% could correctly identify times when they can make changes to their health plans, like open enrollment, according to the Jellyvison Labs. Jellyvision, which created ALEX, a virtual employee benefits counselor, says all but one of the employers involved in the survey offer health insurance, but employees still demonstrate large education gaps on their own benefits.
More than 90% of surveyed workers say it’s at least “somewhat important” to understand ACA and its implications, but less than a fifth actually consider themselves knowledgeable. The good news is employee confidence in their employers’ ability to communicate the necessary information is high: nearly 80% think their companies can properly bring them up to speed, and more than one in three rate their confidence levels on this point at eight or higher on a 10-point scale.
Some 77.6% of those polled agree that it is at least “somewhat important” for their organizations to offer a wellness program, but almost one-fifth don’t know with any certainty whether or not their company does so.
“One of the most important things we learned from this data,” says Josh Fosburg, vice president of business development for the Jellyvision Lab, “is employees aren’t getting everything they need to know about their employers’ wellness programs and other benefits. For instance, nearly half of employees in our survey think they have to pay something in order to take advantage of the wellness programming that will help them manage their weight, stay on top of their prescribed medications, or cease smoking. That’s bananas.”
Jellyvision says employers need to “up their communications game” in order to help employees take advantage of everything included in their benefits offerings.
Doctors urged to treat obesity like any other ailment; New guidelines say do whatever it takes to get the pounds off
Originally posted November 13, 2013 by Nanci Hellmich on www6.lexisnexis.com
There's no ideal diet that's right for everyone, but that shouldn't stop the nation's doctors from helping their heavy patients battle weight issues as aggressively as things like blood pressure, according to new obesity treatment guidelines released Tuesday.
The guidelines, from three leading health groups, say that doctors need to help obese patients figure out the best plan, whether it's a vegetarian diet, low-sodium plan, commercial weight-loss program or a low-carb diet.
Still, the most effective behavior-change weight-loss programs include two to three in-person meetings a month for at least six months, and most people should consume at least 500 fewer calories a day to lose weight, the recommendations say.
The guidelines are designed to help health care providers aggressively tackle the obesity epidemic. "The overall objective is quite a tall order: to get primary care practitioners to own weight management as they own hypertension management," says obesity researcher Donna Ryan, co-chairwoman of the committee writing these guidelines for the Obesity Society, American Heart Association and American College of Cardiology.
The recommendations are part of a set of heart disease prevention guidelines released Tuesday.
Nearly 155 million U.S. adults are overweight or obese, which is roughly 35 pounds over a healthy weight. Extra pounds put people at a higher risk of heart disease, stroke, many types of cancer, type 2 diabetes and a host of other health problems.
Health care providers should encourage obese and overweight patients who need to drop pounds for health reasons to lose at least 5% to 10% of their weight by following a moderately reduced-calorie diet suited to their food tastes and health status, while being physically active and learning behavioral strategies.
"The gold standard is an intervention delivered by trained interventionists (not just registered dietitians or doctors) for at least 14 sessions in the first six months and then continue therapy for a year," says Ryan, a professor emeritus at the Pennington Biomedical Research Center in Baton Rouge. If this kind of intensive therapy is not available, then other types of treatment, such as commercial weight-loss programs or telephone and Web-based programs, are good "second choices," she says.
Medicare began covering behavioral counseling for obese patients last year, and under the Affordable Care Act, most private insurance companies are expected to cover behavioral counseling and other obesity treatments by next year.
"There is no ideal diet for weight loss, and there is no superiority between the many diets we looked at," Ryan says. "We examined about 17 different weight-loss diets."
Pat O'Neil, director of the Weight Management Center at Medical University of South Carolina, says, "The diet you follow is the one that's going to work for you. That's good information for the public to have."
The report advises health care providers to calculate body mass index (a number that takes into account height and weight) at annual visits or more frequently, and use it to identify adults who may be at a higher risk of heart disease and stroke. Evidence shows that the greater the BMI, the higher the risk of coronary heart disease, stroke, type 2 diabetes and death from any cause, the report says. "BMI is a quick and easy first step," Ryan says.
The guidelines are being published simultaneously in Circulation, a journal of the American Heart Association; the Journal of the American College of Cardiology; and Obesity: Journal of the Obesity Society.