offered increased health care costs or increased exercise, employees choose action

May 16, 2013

in behavior change,communication,design,incentives,wellness

a study conducted by the university of michigan health system and stanford university found that employees offered the choice to pay more or exercise more chose to get a move on.

according to the university of michigan health system’s website:

“Blue Care Network created a buzz when it implemented one of the largest-scaled financial incentive programs in the country by requiring adults who were obese and in the Healthy Blue Living program to enroll in a fitness program to qualify for lower out-of-pocket health care costs. Enrollees could choose between several programs, including Weight Watchers and WalkingSpree, which uses a digital pedometer to upload walking data on a wellness tracking web site.

“For some families, the out-of-pocket cost of failing to meet the new criteria in one of the wellness programs was nearly $2,000 more per year. Those with medical conditions were exempt if they had waivers from their doctors.”

5,000 steps per day required

the program was actually a little broader than described here. to save the $2,000 in reduced copayments and deductibles, BCN required participants to meet certain health metrics or enroll in a program that helped them move closer to doing so. participants with a BMI equal to or greater than 30 were invited to enroll in a weight management program or walkingspree’s internet-empowered walking program. they could also opt out or obtain a medical waiver. the study looked only at the experience of those who enrolled in the walkingspree program, roughly 50% of the final eligible population.

these participants were issued a pedometer and given access to walkingspree’s website, which includes community forums and other support. to meet the requirements, they needed to maintain an average of 5,000 steps per day in each three-month period. the pedometer, like other trackers, auto-uploaded user data so the data was not self-reported.

some people will take the lumps, some the sugar

when employers roll out these programs, employees have a choice. they can take the lump (the increased costs) or they can take the sugar (the financial incentive). with BCN, 17% opted out of the program and another 5% had a medical waiver and were legally excused from the penalty. a survey administered to those who completed the program found good results and mixed feelings:

  • 97% of enrolled participants met the daily steps requirement
  • 51% appreciated the program’s financial and health benefits
  • 17% initially joined to save money but were ultimately satisfied with the program benefits
  • 31% did not like the program and many noted feeling coerced to join

these are extremely positive figures. and if sustained over time, that’s real change. for those who have worried about the negative consequences of these results-based wellness programs, the authors recognize, “the program’s effect came at a cost of ill-will from some individuals who felt coerced to participate. while most of these members later appreciated the benefits of the program, nearly a third of them did not like the program, even in retrospect.” the authors seem to suggest that the disliking of the program came from the feelings of coercion, but it might also be that the feelings of coercion came from the disliking of the program. seventeen percent also joined to save money despite not really wanting to participate, but they were ultimately pleased with the program, too.

based on the available information, it doesn’t appear the study authors asked any questions before or after the program to see if there were any changes in feelings of loyalty or engagement. that’s too bad. more employers are rolling out these results-based programs that tie results to an incentive. this report gives them food for thought about planning for the possible ill-will. information on its possible impact on engagement and job satisfaction would also be valuable.

it’s important to note as well that one of the study authors is a scientific adviser to walkingspree and a an unpaid consultant to blue care network.

f

p.s. the study contains insights on program design and communication worth the $39.95 download fee.

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washington employer advises new recruits it’s “vegan only”

May 13, 2013

in wellness

lisa-simpson-vegetariani’ve yet to talk with someone about employee wellness without hearing about how an employer allows—if not provides—donuts or cupcakes or something similar at meetings. the underlying message is the employer can’t be serious about wellness if they’re still offering such junk food regularly.

i don’t disagree. but how far is too far? the comments on a post about junk food-free workplaces suggests barring people from bringing in their own food is a bridge too far.

knowing this, i wonder how people will feel about the nonprofit physicians committee for responsible medicine’s (PCRM) decision to bar anything but vegan fare in its office. for those unfamiliar with a vegan diet, it shuns all animal products, including eggs and butter. today, 2% of americans consider themselves to be vegan, according to a gallup poll, with bill clinton the most famous among them.

a washington post article explains PCRM’s thinking:

“PCRM has an office policy mandating that only vegan food may be eaten in its office. The organization, which advocates for healthy eating, preventive medicine and ethical clinical research, is so committed to the rule that it notifies prospective employees of the policy when they receive an offer letter for a job.”

“PCRM decided to go vegan for a simple reason.

“‘We want to practice what we preach,’ said Susan Levin, the group’s director of nutrition education.”

in some ways, PCRM’s vegan policy is similar to tobacco-free workplace policies. PCRM dictates what happens on campus, but not off. in that respect they’re setting policies they feel best support their mission and goals. still, being vegan, even if only before 6, assumes an interest in being vegan and a willingness to do the work. a vegan diet is one of the more restrictive diets. the health benefits associated with it depend on eating mostly fruits and vegetables, whole grains, legumes, nuts, and seeds. and unlike with tobacco users, being non-vegan doesn’t impact the health of your co-workers.

PCRM is doing more than practicing what it preaches. according to the article, they’re helping others make the shift to a vegan diet, too, and studying the impact.

“PCRM has also piloted vegan eating programs at other workplaces in the Washington area. In one instance, they worked with a group of employees at Geico’s Chevy Chase headquarters. The nonprofit asked the insurance group to adopt a vegan diet and offered them weekly instruction on how to make healthy, tasty and cost-effective vegan choices. After 22 weeks, they compared employees in that group to Geico employees who hadn’t received the training. The vegan group lost more weight, reported improved physical health and said they saw a decrease in food costs.”

even with the pilots, it’s unlikely PCRM’s policy will be widely adopted. it seems unique to their culture and perhaps their population. ( at PCRM, one-third of employees already were vegans and another third were vegetarians.) so the policy question is where is the line when it comes to mandating what employees eat?

employers already have many ways to encourage our eating better. they can subsidize weight management programs, lower premiums for hitting certain biometrics, run nutrition and cooking classes. they can discount healthier food items in the cafeteria, bring farmers markets to work, use display tricks to drive up purchases of healthy items. they can even control what’s available in those cafeterias (and the vending machines).

for me, this means the line is drawn on requiring employees to adopt a specific diet, especially a diet practiced by so few and with so many requirements.

what about you? where is the line drawn?

f

 

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tips for getting exercise into the day

May 10, 2013

i’ve been writing on hotseat’s blog about the various ways companies are helping employees get more exercise and movement throughout the day. if you’re trying to figure this out for yourself or your employees, check out these posts: we don’t exercise enough. shocked? employers take different paths to get employees stepping office furniture that makes you [...]

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cohealth checkup: employee benefits trends and disruptions

May 3, 2013

our may cohealth checkup was pre-recorded in las vegas during the human resource executive health & benefits leadership conference. carol and i gathered five thought leaders to discuss the themes bubbling up at the conference. we were joined by andrew gold, VP, total rewards, pitney bowes, janet mcnichol, human resources director, american speech-language-hearing association, vlad [...]

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dishes, daily steps, and behavior change

April 28, 2013

are you familiar with the cycle of aggravation? it goes something like this. you get irritated about something your spouse, parent, child, or someone does and you swallow your irritation. then you observe the irritant again, you can’t swallow your aggravation, and you blow. what the irritant is varies from person to person. it could [...]

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the map to watch: smoker protection laws

April 18, 2013

in a recent post, i offered some thoughts on no-hire tobacco policies. now marketplace’s pulled together a map to show which states have smoker protection laws. generally speaking, these laws prevent employers from implementing no-hire tobacco policies and from firing employees who use tobacco away from the worksite and during non-work hours. the map’s content [...]

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webby award nominations are in: vote for hotseat

April 12, 2013

The Webby Awards cast their vote on excellence. Now it’s your turn. We’re proud to be one of five candidates the Webby Awards selected in the Mobile & Apps: Games category. And since we’re judged by the company we keep, we’re delighted to have these games as our stiff competition: Cut the Rope, Spy vs [...]

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the ethical considerations of not hiring tobacco users

April 12, 2013

as more employers consider how to reduce the percentage of tobacco users in their workforces, one policy in particular has raised eyebrows and hackles more than others: no-hire tobacco policies. today, it’s mostly health care systems implementing these policies barring the hiring of tobacco users. they easily argue the importance of employing a workforce that [...]

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crowdsourcing a keynote closing session on health games

April 8, 2013

on april 24 i’m moderating a panel on health games at the human resource executive health & benefits leadership conference in las vegas. i’ve intentionally constructed a panel with varied perspectives, responsibilities, and backgrounds. my panelists include rajiv kumar, CEO of shapeup, inc.; chris cartter, general manager of meyou health; melissa yoakam, benefits manager for chipotle mexican grill; [...]

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april newsletter covers CVS surcharge “brouhaha”

April 3, 2013

i was almost out the door for vacation when the articles started popping up all over the place about the CVS surcharge. CVS is adding a $600 surcharge to the cost of health insurance for any employee who doesn’t get a health risk assessment. The media did an extremely poor job reporting the story, misreporting [...]

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