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Employer-Based Health Coverage and Wellness Programs Critical to Keeping Workers Healthy, Panel Says

By Danielle Parnass, CQ Staff

July 14, 2008 -- The employer-based health system is crucial to facilitate healthy living among employees and to control spiraling health care costs, said panelists at a Blue Cross Blue Shield Association (BCBSA) briefing on Monday.

"We think that the employer system is a real engine of innovation and change, much more so than the government could be in terms of implementing new ideas, new programs," said Mary Nell Lehnhard, senior vice president of the Office of Policy and Representation for BCBSA. She added that employers can demand changes in care more quickly based on changing workforce and employee needs.

Lehnhard also discussed the need for collaboration between the private sector and government to address chronic illness, which accounts for 75 percent of health care spending and affects every six of 10 Americans, she said.

Research has shown that education programs and activities, such as tracking logs, pedometers, and internal competition, can increase worker participation in wellness programs by at least 21 percent, according to a report also released Monday by BCBSA and Harvard Medical School's Department of Health Care Policy.

But encouraging employees to begin and maintain healthy habits is still a challenge for many employers, according to a separate report also released Monday by the National Business Group on Health, a non-profit organization of mostly 300 large employers.

"We can change plan design, we can increase co-pays, we can put in deductibles, but if the population underlying is still sick . . . you're not gonna do anything other than move the pieces around of an exploding cost scenario," said Helen Darling, president of NBGH.

Darling described employers' approaches to health care over the past five years as "revolutionary."

"They're beginning to understand what they have to change," she said. For example, 83 percent of employers offered health risk appraisals in 2008, an 18 percentage-point change since 2006, the report said.

In addition, a recent NGBH survey showed that 80 percent of employees said employers should actively provide health information. Meanwhile, 66 percent of workers support discounts for employees who show healthy lifestyles. But more than half said they have not seen information to help them compare and assess different health plans or providers and that the medical information available is too difficult to understand.

DTE Energy company in Detroit, a member of Blue Care Network of Michigan's Healthy Blue Living program, reported a decrease in high health risk factors among employees between 2005 and 2008—and a savings of more than $2.2 million from a reduction in missed workdays—after implementing disease management initiatives.

The Health Blue Living program "fundamentally changed the relationship between" doctors and patients, or provider and employees, by changing the focus of health care from "get better" to "stay better," said Richard Lueders, director of human resources for DTE Energy.

Pat Fulcher, vice president of associate services at Food Lion LLC, said the company looked at recent trends to determine what initiatives work best to attract and retain associates by addressing their needs. Fulcher said the company's wellness initiatives have been successful among employees. Programs include nutritional counseling and smoking cessation resources and partnering with the BCBS "Engaging Consumers@Work" program.

In addition, more than 95 percent of Food Lion employees who qualify for case management—another feature of its wellness programs—actively participate, and the number of workers working with a health coach is 29 percent higher than the norm, Fulcher said.

"If we didn't do it as employers, if we were not there to truly show associates that they're valued and what it means to us for them to be well, I'm not sure who would do the work, to motivate, to be innovative, to allow people to understand that their choices everyday affect their lives," Fulcher said.

Health care is not a one-issue problem, but in terms of ensuring health coverage for Americans, employers continue to play a very significant role, said Don Bradley, senior vice president and chief medical officer of BCBS of North Carolina.

"There are going to need to be other plans and programs, but to disassemble the part that is working I think is perhaps foolhardy," he said.

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