At AFSCME, we have been vocally supportive of wellness plans. We have witnessed success at King County and in Illinois. We have also seen some of the pitfalls that can occur during the implementation of these programs at the State of Oregon. We are familiar with them, and know that a small investment up-front, can yield long term savings.
Unfortunately, the City of Portland is not interested in hearing from us regarding their wellness program. Rather than cooperatively design a plan that will work for all of the Unions, they have chosen to force acceptance of “rewards” plan upon the employees at the Portland Housing Bureau. Our experience and research suggests that in order to be successful, a wellness plan must have buy-in from all levels of management, and important stakeholders such as the employee representatives. Without such buy-in, the plan is less likely to see optimal participation and will likely result in reduced savings.
According to a Rand study of wellness plans, 84% of employers offer an incentive based approach. Meaning if you enroll in the wellness program, you receive some sort of additional benefit. Such benefits range from coffee mugs to deep discounts on insurance premiums. Only 2% provide a penalty only approach. According to one study, “a ‘carrot’ incentive-based approach makes more sense for the prudent employer because it encourages and motivates the employee to achieve a healthier lifestyle…”
The City’s plan penalizes the employee by tripling their health care contribution unless they undergo a health care screening. Admittedly, the threshold for maintaining the status quo is low, a simple visit to the doctor. The idea is that if an employee undergoes a health screening they may identify conditions early and, more importantly, become aware of the impact of unhealthy lifestyle choices and make some changes. However, the penalty only approach to force compliance will not inspire people to whole heartedly participate potentially reducing the likelihood of the employee committing to healthier behaviors after the visit.
Of concern, is the fact that some employees will receive a higher penalty for failing to do the screening. Since we charge less to cover a single employee than we do for an entire family, the penalty difference may be as great as $120 a month depending upon the employee. Although the doctor’s visit may not be difficult for most employees, it is likely to be more difficult for single parents, particularly lower income single parents. The City’s plan will result in an increase of approximately $185 per month if these employees covering families fail to comply. Add to this any cultural differences regarding perception and utilization of health care, and we end up with a program that has a high potential for negatively impacting employees who could benefit the most from a well-designed wellness plan.