Stricter State Health Plan Could be Influential
North Carolina's plan for helping state employees lose weight and improve overall health could pave the way for other employers looking to keep health care costs down, experts say.
“Employers are starting to understanding lifestyle choices account for the biggest portion of health care costs,” said Claudia Muse, executive director of the WNC Health Coalition, which represents self-insured employers.
“It is not unique, but the fact that the state health plan is doing it gives a lot of employers the idea that we can do this too,” Muse said.
Starting in 2011, the state health plan will put members with a body mass index of 40 and higher on a more expensive health care plan.
The state's health plan executive administrator briefed a legislative panel last week on incentives that will be given to employees. Those include discounts on weight-loss drugs, gym memberships and diets. Members would get access to nutritionists, health coaches and other wellness tools.
People who participate in a weight-management program or have a medical condition that prevents them from reaching the required BMI will be exempt from the new rules.
The move, which includes a similar measure for members who use tobacco products, is intended to encourage people to take responsibility for their health and well-being by engaging in healthy behaviors, and to help keep the health care costs down.
The state estimates claims for chronic diseases related to obesity may be as high as $107.8 million annually.
Financial Incentive To Lose Weight
“We are all paying for unhealthy lifestyle behaviors,” Muse said. “The only thing that works is incentives. You can give people all the opportunity in the world to become healthier, but they won't unless they have sticks and carrots.”
The city of Asheville has taken a carrot approach with The Asheville Project, which helps employees manage chronic diseases. Destiny Mattsson, the city's wellness coordinator, said the city saves $4 for every dollar it puts into the program.
But the city has also seen other programs fail. It was reimbursing employees who attended Weight Watchers meetings, which proved to work, but when the city changed to subsidizing the cost of the program, fewer people were successful, Mattsson said.
“I would say people were almost 50 percent less successful,” she said. “There was not any harm out of their own pockets so they didn't try very hard.”
Local health care experts said that while it may seem harsh, charging more for being obese could be what is needed to curb obesity and health care costs.
“Some people are not going to feel pushed to make lifestyle changes without something financial tied to it,” said Stephanie Kiser, director of health and corporate wellness at Mission Hospital.
Muse said the Metropolitan Sewer District is implementing a plan similar to one the state is putting in place, and that other self-insured employers are looking into ways to curb health care costs.
Lesley Edwards, a dietitian and coordinator of Mission Children's Hospital's child weight-management program, said it could also lead to insurance companies paying for resources like weight management programs.
“Personally, I think it is needed,” she said. “I feel funny saying that because I know weight is a personal thing and people get real sensitive about it, but sometimes we need incentives.”
