Consumers meet wellness benchmarks, reap benefits

DENVER-A UnitedHealthcare initiative underway in Colorado and a handful of other states allows high-deductible PPO plan members to cut their deductibles as much as $4,000 by meeting certain wellness benchmarks. Called Vital Measures, the program launched June 1 in Colorado, Pennsylvania, Ohio and Rhode Island, and is drawing employer interest, says Cheryl Randolph, UnitedHealthcare spokesperson.

She says Vital Measures is the first program to her knowledge that will put cash directly in members' pockets. Specifically, members can earn $500 credits for meeting benchmarks in each of four different categories-body mass index (BMI), blood pressure, LDL cholesterol and tobacco/nicotine use.

Employers who purchase the voluntary plan can choose between "standard" and "generous" benchmarks. In the blood pressure area, for example, these are 140/90 (or less) and 130/85, respectively.

The premium remains the same for all members, so rather than penalizing members for being overweight with higher premiums, for example, the program incentivizes them to engage in healthier behavior, she says.

Currently, UnitedHealthcare offers the program to employers with 100 to 1,000 employees who purchase high-deductible PPOs in participating states, which were chosen largely for their high concentrations of employers offering such plans, she says.

UnitedHealthcare plans to launch Vital Measures nationally in 2008.

"There's been an increasing backlash from employees in firms that offer high-deductible health plans over the fact that there's little coverage of preventive care for healthy employees and families under these plans," says Jim Hertel, publisher, Colorado Managed Care Newsletter. "There's an effort on the part of UnitedHealthcare and other carriers to begin developing new programs that reward healthy employees and give them a positive experience from participating in a high-deductible health plan."

For consumers in states like Colorado, one of the nation's healthiest, sustaining healthy behavior is key.

"It seems unfair that the benefits of making good life decisions are rarely reflected in the way one is treated by one's health insurer," says Tom Clark, executive vice president, Metro Denver Economic Development Corp., a privately funded development engine.

Clark says the solution involves "a four-letter word: cash." Lower monthly premiums aren't nearly as effective as $500 gift cards or their equivalent, he says.

Jim Carlough, regional sales director, Destiny Health, says Destiny helped pioneer this path with its Vitality empowerment plan, whose U.S. rollout began in 2000, reaching Colorado in August.

Rather than discounting deductibles, he says, the program motivates by offering benefits based on fulfilling lifestyle, education, prevention and fitness goals. Members earn "Vitality Bucks" for activities such as taking yearly biometric exams. They also earn discounts on purchases from a 5,000-item online catalog, he says.

"The way wellness has been delivered to customers is a one-size-fits-all program that shotguns information in the hopes that through osmosis, employees get engaged in changing their behaviors," says Rick Ninneman, president of IMA Corp.'s Employee Benefits Division. He says IMA's program, scheduled to debut in August, gives employers a comprehensive health risk management strategy, integrating plan design and incentives that could include discounted member premiums and reduced deductibles and/or copays.

The program calculates productivity impact and estimates how much an employer will reap for every dollar spent. Historically, measuring the return on traditional wellness has been inexact at best, says Ninneman. For employers, the return on the investment is probably the most important factor in any wellness program.