Employers step up employee health incentives to improve productivity and save on health insurance.

Many companies looking to trim their healthcare budget have begun to ask employees to embrace healthier lifestyles.

And some are rewarding those who comply with cheaper health insurance premiums. Companies also are relying on scientific data to track employees' efforts-enlisting professionals to help them meet their health goals and looking for innovative ways to ensure staffers stay healthy.

As companies get more serious about shedding health expenses, they are implementing policies that tie employees' insurance costs to their willingness to improve their health. Passing the expense onto the employees who are unwilling to participate in a wellness plan helps companies control their budgets, says Rich Siegenthaler II, president and CEO of Integrated Wellness Solutions in Wooster.

He compares the workers to drivers who speed or cause accidents.

"It's like car insurance," he says. "For years and years and years, bad drivers have paid higher premiums than good drivers. We've accepted that."

Fiscal Fitness

Pressing employees to get healthy makes financial sense, he says. It can temper health insurance premium increases, reduce health care costs and increase productivity, Siegenthaler says.

When companies can demonstrate that their wellness plan has encouraged a significant percent of employees to receive annual physicals, address potential health concerns and embrace healthier lifestyles, they often will experience lower increases in their health insurance costs, he says. Companies will have more leverage negotiating their health insurance costs when they have about 70 percent participation, he says.

The effort also will reduce the nation's healthcare costs, he adds. Seventy-five percent of healthcare spending is behaviorally related and 60 percent can be controlled, he notes. If Americans weighed less and addressed high blood pressure and diabetes risks, they would cost less to insure and spend less on care.

Healthy workers also take fewer sick days and work more efficiently.

Provisions in the Affordable Care Act permit employers to offer employees incentives of up to 30 percent of the total cost of coverage. Employees who choose not to participate in a wellness program could pay an additional $50 to $200 a month for insurance depending on the company's health plan, he says.

It's a concept that employees can embrace, Siegenthaler says. He notes that 75 percent of American adults agree that people with healthy lifestyle behaviors should pay less for health insurance, according to a 2010 Hewitt Associates National Business Group survey.

"We're moving from an era of entitlement to an era of accountability," he says.

Companies do have to be careful that they offer comparable wellness benefits to all employees-even those who work from home or satellite offices. The Affordable Care Act also requires employers to provide an appeal process for employees who feel like wellness policies are unfair.

As companies look more closely at how wellness can impact their budget, several trends are emerging, say Siegenthaler and Rich Menke, DDS, chairman and founder of YourQuest Corporate Wellness Solutions in Worthington.

The use of biometrics to measure a person's health and professionals who are able to help employees achieve their wellness goals are critical, they say.

Biometric screenings examine a person's blood pressure, cholesterol, body mass index and other factors to determine current and potential medical issues. The data helps companies and individuals decide what they want to accomplish through a wellness program. Having baseline data creates a way to engage employees and help them track their progress, Siegenthaler says.

"People have got to understand what these numbers mean," he advises. "It needs to be a teachable moment."

Having the numbers and someone to help you interpret them makes a difference, agrees Menke, whose company assists employers with the promotion of a healthy worksite culture by rewarding healthy lifestyle choices.

Initially, companies thought they could encourage employees to become healthier by simply offering them information about healthy lifestyles, he says.

"The theory was they would change their behavior," Menke says. "That has not been the case."He recommends providing employees with access to mental health counselors who can get to the root of an employee's health issue and help him or her address it.

Mental health counselors have the skills to help motivate people to change, agrees Paul Granello, an associate professor in counselor education at Ohio State University who studies wellness and works with YourQuest.

"Change is not easy," he says. "It takes vigilance. It takes awareness."

Siegenthaler also advocates for a "personal" program that allows employees to engage with a coach whenever they want.

"Employees need direction and hand-holding," he says.

New Partners

Menke foresees wellness programs helping patients becoming better advocates for their own health. YourQuest offers several informational videos designed to help clients lead healthier lives. Several offer tips on communicating with a primary care provider. Taking ownership of your health is an important component of wellness, he says.

He also expects to see primary care physicians or nurse practitioners playing an increased role in employee wellness.

"We think that's the next phase-working with primary care providers," he says.

The effort will require primary care providers, who have long been trained to treat illness, to increase their focus on disease prevention, he says.

He anticipates that primary care providers will get more involved in looking at how patients can improve their health and tracking their efforts to do so.

As primary care providers become more focused on wellness efforts, Menke anticipates that some doctors' offices will become more open to telemedicine-where doctors will treat illnesses like earaches and sore throats over the phone. It's possible that companies could also employ doctors to treat patients at the worksite or over the phone so they can get well faster and with less impact on productivity.

The change will be in keeping with the federal government's focus on holding hospitals and physicians accountable for patients' health outcomes, adds Joe Jacko, a Columbus doctor of internal medicine who has worked with YourQuest.

"The people paying the bills are asserting more control," Jacko says. "They're insisting on more prevention."Melissa Kossler Dutton is a freelance writer.