Problems with Wellness Incentives

ARTICLE REVIEW FORM

Your Name: Suprena Fay

Title of Article: Carrots, Sticks and Health Care Reform - Problems with Wellness Incentives

Author (s): Harald Schmidt, M.A., Kristin Voigt, D.Phil., and Daniel Wikler, Ph.D.

Source: The New England Journal of Medicine

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Author's proposed purpose/goal of the Article: The author's proposed purpose of the article is to analyze the effectiveness of health incentives as a way to combat chronic health conditions that are associated with obesity.

Analysis of Key Issues: Chronic health conditions, especially those that are associated with obesity, are on the rise in the United States. Current health care reform seeks to expand the role of health care incentives. These incentives promise a win-win situation for both employees and employers. For employers, they reduce their health insurance costs and gain a healthier workforce who requires less time away from the office, due to illness.

Under the 1996 Health Insurance Portability and Accountability Act (HIPPA) a group health plan may not discriminate among policyholders based on health factors by varying thee amount of their premiums. Incentive schemes are defended on the grounds of personal responsibility. Although alternative standards must be offered to employees for whom specific targets are medically inappropriate, disadvantaged people with multiple coexisting conditions may refrain from making such petitions, seeing them as degrading or humiliating. These potential problems are important in view of the proposed increases in reimbursement levels. Reform proposals prohibit cost shifting but provisions in the Senate bill could result in a substantial increase in financial burden that do not meet targets.

Conclusions/Findings/Assumption: Incentives, which offer a premium discount or other reimbursement simply for participating in a health promotion program and attainment incentives, which provide reimbursements for only meeting targets. These incentives provide welcome rewards for employees who manage to comply, but may be unfair for those who struggle, particularly if they are not successful.

Personal assessment and reflection: I have mixed feelings on health incentives. On paper, it sounds great, but reality is a different story. Give an individual an incentive and they will lose weight, stop smoking and lower their cholesterol levels but it isn't always that easy. If individuals were able to make these changes on their own, they would. However, what about the individuals who have medical conditions that either makes it hard or impossible to lose