Employees Get Paid to Exercise, While Some Pay to Sit Out
Rachel Koning Beals
Some insurers and companies are recognizing that preventative health incentives can potentially save lives -- and their bottom line.
There's evidence of continued, if slow, growth in this trend in a recent survey from gym chain Anytime Fitness, which keeps its doors open at odd hours to inspire more workouts. Anytime Fitness members, across its some 1,500 U.S. gyms, received nearly $4 million in health insurance reimbursements for working out 12 or more times per month in 2011. That's up $1 million from 2010, the company's second "Weight of the Union" survey showed.
"We are seeing an increase by both health insurance providers offering this benefit to employees and employees taking advantage of these programs that pay them to exercise," says Heidi Holiday, national director of Healthy Contributions, a fitness incentive consultant and administration company.
There's incentive for all sides to shell out a little more upfront and potentially cut treatment costs later. The U.S. Centers for Disease Control and Prevention, working with the Johns Hopkins Bloomberg School of Public Health, says that without change, some 86 percent of Americans could be overweight or obese by 2030. That means $1 out of every $6 in healthcare costs will be due to heavy Americans.
In one example, insurer Aetna has rebranded itself as a "health-solutions company," a sign of the industry shift toward balancing prevention and treatment. Part of the rebrand involves more direct-to-consumer marketing, and Aetna-sponsored, employer-run incentives such as discounted gym memberships, according to marketing trade publication Ad Age.
One insurer is combining the daily deal coupon craze with healthier lifestyle choices. In February, Blue Cross and Blue Shield rolled out its Blue365 program for some 35 million eligible members. The plan offers discounts on services such as Snap Fitness gym memberships, eDiets.com meal delivery, and Reebok running shoes.
The economic argument is one way to draw more attention to the epidemic. Employment consultancy Towers Watson reports that employers have seen a 36 percent increase in healthcare costs over the past five years.
"High rates of chronic diseases, like diabetes and heart disease, are among the biggest drivers of U.S. healthcare costs and they are harming our nation's productivity," said Jeff Levi, executive director of the Trust for America's Health, commenting in a report called "Healthier Americans for a Healthier Economy." "Workplace wellness and community prevention programs are a win-win way to make a real difference in improving our health and bottom line all at once," he said.
Some companies are acting independent of their insurance plans.
Gyms on company premises and lunchtime meetings for Weight Watchers or other programs are not new, but these are benefits many companies kept up even in a tough economic climate -- some because they're beginning to penalize out-of-shape employees through higher insurance premiums.
Carrot and Stick.
Some companies are taking a different avenue. Preventative healthcare choices are required at some firms, and if they're skipped, employees pay up.
For Cleveland Clinic's 29,000 employees, more than half have enrolled in the company's Healthy Choice plan since 2010, taking advantage of weight management seminars, yoga classes, and more. To draw more participation, the healthcare system, among the top cardiac treatment destinations, is changing the stakes -- a potential 21 percent jump in insurance premiums for unhealthy employees.
Employees who sign up for Healthy Choice agree to see a doctor to determine whether they are at a healthy weight and whether they have one or more chronic health conditions, such as asthma, diabetes, obesity, high cholesterol, or high blood pressure; or if they are a smoker. If necessary, individualized goals are set. If the employee is deemed to be at a healthy weight and falls into none of these disease categories, they can avoid the premium hike with participation in Healthy Choice and frequenting a clinic fitness center, or clinic partner Curves, or by joining the clinic's walking program.
It's hard to find fault with growth in gym and diet-plan benefits coverage (or even, ultimately, with the stick method, given the high-risk national situation). But some critics worry that preventative medicine expense could potentially cannibalize other coverage and care in the short run.
When it comes to seniors and gym incentives, the debate has intensified after the release of a Brown University study in the New England Journal of Medicine earlier this year.
Study findings show that covered gym benefits through select options may be helping Medicare draw healthier seniors to its membership pool and thus lower its overall costs.
Cost-cutting can be a positive development, sure. But critics note that Medicare strictly forbids practices such as denying coverage based on existing conditions. Study writers acknowledged that if every plan offered the fitness benefits, it would no longer be an effective way of selecting for the healthiest members. However, until that day and given the continued incentives to take on more profitable enrollees, insurers may employ other related tactics to cherry-pick desirable enrollees. As healthier participants are corralled in certain plans, the cost burden on enrollees and taxpayers to cover the traditional Medicare format, where participants have greater needs, is higher.
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