Michigan is seeing a growing number of people enrolled in a new type of health insurance design that focuses on how people’s choices affect their health. It’s a trend we predict will continue to grow.
The first Michigan plan that blended a commitment to a healthy lifestyle and management of chronic conditions into its benefit design was introduced in 2006. Called Healthy Blue Living, the plan’s membership has grown to over 100,000.
The concept is simple. Instead of standard copayments and deductibles for everyone in an employer group, the plan design rewards individuals with lower copayments and deductibles if they make good health choices. Savings can be substantial. For example, an individual committed to a healthy lifestyle might save $1,500 for hospital outpatient surgery. Or an individual who is managing a chronic condition might save $1,000 on the plan’s deductible.
The plan design concentrates on six high-impact health measures — smoking, weight, blood pressure, cholesterol, alcohol use and blood sugar. Why these? They are things a person can control. They have a huge impact on illness and fitness and the likelihood an individual will develop one or more lifestyle diseases, such as heart disease, diabetes and stroke. These three diseases are the leading causes of death in the United States today.
In fact, about 80 percent of large companies nationwide are taking action to improve specific health conditions, such as heart disease, among their employees. This is nearly 30 percentage points above last year, according to Hewitt Associates. Hewitt’s 2009 Road Ahead heath care survey notes that 71 percent of employers say that managing health risk is a component of their health care strategy and 61 percent plan to offer incentives to motivate sustained health behavior change over the next three to five years.
So how does Healthy Blue Living work for the average consumer? One of the first steps when someone enrolls is to visit their doctor to find out where they stand on the heath measures. The member and doctor develop a joint plan to maintain or improve the member’s health. Healthy Blue Living reinforces doctors’ messages about the importance of patients practicing healthy behaviors.
Dr. David Blair, at Advantage Health Physician Network, in Grand Rapids, realized the value of such plans. “It’s a way to encourage cultural change that we’ve all been struggling with for years,” he noted.
Sometimes individuals are surprised at what they learn when they go in for a physical. “If I hadn’t gone in for the screening, I would have never known that I had any kind of heart condition. It’s made my whole family healthier. I’m getting treatment for my heart condition for the first time in my life. We’re getting better preventive care. We’re eating better, and we’re saving money,” said Shawn Bartmanski from Clinton Township. Bartmanski works for Nino Salvaggio International Marketplace, where employees get an extra-special perk — free fruit.
When Maureen Sisco, Human Resources manager for Nino Salvaggio’s, heard about Healthy Blue Living, she immediately thought it was a plan that lined up well with her company. “We try to have healthy foods. We try to provide products that address dietary concerns, and I thought this really makes sense for so many reasons,” said Sisco.
Such plans are typically offered through employers, who play a key role in encouraging their employees to adopt healthier lives. Employers who offer such plans are encouraged to incorporate changes like a smoke-free work environment, to promote physical activity at work, and to provide healthy food choices in vending machines and cafeterias.
“We are committed to creating a workplace that supports employee heath and wellness,” said Richard Lueders, DTE director of compensation and benefits. Lueders, along with several business and health care leaders, went to a press briefing in Washington, D.C. to explain to national reporters how wellness designs like this can help improve health and lower the cost of care.
Individuals enrolled in such plans often have guidance on how to reach health goals. By taking a health assessment offered by the health care company, individuals can learn where they stand and get a tailored action plan to help them meet their health goals. Online coaching offers tools to track progress, exercise videos and podcasts, electronic newsletters and recipes, and health information. Members can also call a certified health coach who provides telephone support and develops a personal plan with individuals focusing on their health challenges.
Another tool to help individuals is enrollment in a free smoking cessation plan offered by a health plan. Valerie Fulmer, from Battle Creek, described how it helped her. “My husband had a heart attack, and I figured that quitting smoking was the one thing I could do for my health. My experience with Debbie, my registered nurse-counselor for smoking cessation, was wonderful. She was the most important part of the program, even more important than the prescription for Nicorette® gum, which is what I used. Debbie knew how to provide the support I needed each week to get through the next week. Knowing Debbie was calling made me more accountable. And it worked.”
Blue Care Network has some powerful statistics that show how its wellness plan has resulted in individuals making changes in their health behaviors. Forty-eight percent of members in the plan for two years reported making at least one change in their lifestyle due to their enrollment.
“The behaviors that are promoted have had a real impact on my health,” observed Robert North, from Whitmore Lake. In only eight months, I lost 90 pounds. What I like the most about the plan is seeing progress. My doctor and I use the health measure to see if I’m within the healthy ranges. Then, we make adjustments to my health plan — together.”
Blue Care Network data shows health status changes that are significant and encouraging. By the second year of membership in its plan, 40 percent of members who agreed to stop smoking did stop, and 46 percent of members who had high cholesterol and 55 percent of members who had high blood sugar are now at acceptable levels.
The wellness-designed health plan is growing in popularity in Michigan. It presents an innovative solution to the problem of rising health care costs by focusing on wellness and prevention. Rewarding members who make healthy choices, the plan gives individuals the knowledge, skills and support to achieve their health goals.