With average health-care costs rising at double-digit rates, according to a Watson Wyatt health survey, some companies, unable to control the drastic increases, are instead trying to control their employees by making them better health-care consumers.
To that end, the same survey indicates that 69 percent of employers in 2005 were implementing disease-management programs and 40 percent were incorporating lifestyle-behavior change plans, both up some 20 percentage points from 2004.
"The bottom line is that companies are trying to set up a whole new paradigm within the health-care system," said Arlene Weissman, a senior consultant at Watson Wyatt. "They are trying to change it so that people use the system when they are healthy," rather than when conditions have worsened and more medical attention is thus required.
Ivy Silver, principal and founder of the Commonwealth Consulting Group in Jenkintown, which offers insurance-brokerage and employee-benefit consulting to businesses, explained that these programs teach employees about caring for diseases they may have or may be at risk for, determined through online voluntary – and confidential – health-assessment surveys.
"If I have diabetes, I may not know that I have to get my feet checked every year, that I need to get my eyes checked every year, and that I need to have my blood taken," she said.
"Disease-management companies will hire nurses to send literature to you or to call you up – to help coach you through the disease."
'Keeping Employees Healthy'
Fiserv Inc., a financial data-processing system provider based in Brookfield, Wisc., is one such company that takes advantage of these programs and encourages its 22,000 employees to take control of their health. Currently offering seven disease-management plans – for chronic obstructive pulmonary disease, heart disease, depression, asthma, diabetes, congestive heart failure and high blood pressure – the company also covers many preventive screenings and provides a 24-hour behavioral counselor hotline, which allows workers to vent about stress or discuss child-care issues.
"We are recognizing the value of keeping employees healthy, physically and mentally," said Linda Schuessler, manager of wellness promotion at Fiserv. "They are the strength of our company, and we depend on them."
While their program may not be as extensive, WHYY, a public broadcasting station with offices and studios in Philadelphia and Wilmington, Del., also takes a crack at tackling employees' unhealthy habits. Smokers and dieters can take part in puffing cessation programs and Weight Watchers meetings.
Though the cost of the programs are not all subsidized by the company, John Payne, director of human resources and corporate services at WHYY, says the company is still doing its part to improve the quality of employees' lives by offering the classes and making them convenient for employees to attend.
"We expect people to make a commitment to the station, so we want to make a commitment to them," said Payne. "From our standpoint, there is nothing in it for us, except to be a station of choice for employees."
According to Philip Marshall, a vice president for product strategy at WebMD, one of the independent providers of the health-assessment surveys and personalized medical Web sites used by workers, offering financial incentives is becoming increasingly more common.
At Fiserv, for example, besides the obvious plus of staying healthy, employees gain from paying attention to their bodies: Tobacco-free workers receive a discount on their health premiums; expectant mothers who obtain medical care in the first trimester of pregnancy receive a $300 U.S. savings bond; and a small monetary incentive per month is offered to employees who complete the online health-assessment survey.
"From my experience, it's not really that common to [levy] a surcharge [on] those who engage in unhealthy habits," Marshall said, adding that there is a growing tendency to "give financial credit to those who participate in lifestyle or fitness programs."
Still, with or without incentives, not everyone is sold on the success of disease-management programs.
Some health-care consultants say employers are not fully convinced that they can change employees' behavior, and in turn, prevent expensive medical care while saving on health-insurance costs.
In fact, according to Professor Lawton Robert Burns, director of the Wharton Center for Health Management at the University of Pennsylvania, disease-management programs have yet to show the benefits promised.
For some acute conditions, he says, the programs can help eliminate hospitalizations and thus lower costs, but benefits have yet to be seen for long-term chronic diseases – such as diabetes and hypertension – that continually necessitate care and medical attention.
"[The programs] have some appeal to them, but haven't yet demonstrated the cost benefit," he said.
"We're still waiting for the performance to go along with the promise."