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The Wellness Boom

Rapid change in employer health and wellness programs is afoot. For their advocates, change is not rapid enough. Many of us in the workers' compensation community are likely to at least indirectly encounter them.

By Peter Rousmaniere

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Worked down to essentials, two things are happening. First, employers and health insurers are much more adept today than just a few years ago at using financial incentives and the Internet to influence personal health behaviors.Second, employers are investing in more effective ways to detect and manage personal health risks, be they occupational or non-occupational.

Health insurance costs continue to grow. The typical household's net financial exposure to health care costs is growing even faster.The average household's share of premiums, its deductibles, copays and coinsurance has also risen steeply. This has led to new, substantial financial incentives to induce desired health behaviors.These behaviors run the gambit from weight loss reduction programs to selecting a lower cost provider of knee surgery.Reductions in premium burden, deductibles and co-pays and cash rewards are being offered.

And employers are finding that financially shell-shocked households, who really gave up their wage increases to health care inflation in the past decade, are psychologically prepared for these incentives.

Connecticut state employees last fall were offered a new health plan that contained a raft of stiff behavioral requirements in exchange for premium savings off the conventional plan of about $1,200. Ninety seven percent of state employees elected the new plan.

In another recent example, a California pension fund began telling its beneficiaries that if they wanted their knee and hip surgeries performed at hospitals that cost over a specified amount, the beneficiaries would have to pay the premium. The members of the fund conformed to the new regime.

Employers are also deploying new Internet-enhanced programs to steer workers toward better health and lower cost providers. It could be argued that cost transparency in health care is here to stay.

These incentives and new communication tools precipitously lower barriers to influencing the health decisions of households.What does this mean to us?A confident culture of innovation at an employer in personal health will, as surely as the sun rises in the East, lead to creative incentives and Internet tools for lowering work injury costs.

I just learned the other day of a vendor that is giving its injured worker clients personal web pages to help them manage their case, a practice that is spilling over from the personal health care area.

And employers are more fastidious today in detecting injury risk at the hiring stage. "Personality testing" of job applicants can predict higher risk of work injury and possibly, the duration of a work-incurred disability.

A much quicker response to occupational risks is becoming the norm. Worksite clinics, back in fashion in recent years, diagnosis and coach workers about their health issues, whether they be job related or not. They can identify symptoms before the claim is filed.

Many more employers today use the instant telephonic triaging of incidents, using nurses who recommend the appropriate response to an incident in the moment.

More employers are also melding together their disability programs. Employers are more impatient to remove barriers to fast, assured engagement with the worker.

PETER ROUSMANIERE is an expert on the workers' compensation industry. He can be reached at riskletters@lrp.com.

March 1, 2012

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