Bruce Japsen, Contributor

I write about health care and policies from the president's hometown

3/25/2013 @ 9:00 - Forbes

Like CVS, More Employers Penalize Workers That Snub Wellness Exams

More employers are moving toward strategies like CVS/Caremark (CVS) to penalize workers who don’t submit to wellness screenings or other health reviews, a new analysis shows.

New data from Aon Hewitt, (AON) the large global human resources consultancy, shows nearly 60 percent of U.S. employers plan to “impose consequences on participants who do not take appropriate actions for improving their health” in the next few years such as completing a health risk questionnaire.

CVS made headlines last week after it began telling workers they must take part in a “wellness review” or face an annual penalty of $600. Such reviews ask them to have physicians determine various health indicators such as weight, blood pressure or body fat.

“More and more companies like CVS Caremark are moving to a more health-centric culture, which includes the belief that employees must be on their own path to better health,” said Jim Winkler, chief innovation officer for health and benefits at Aon Hewitt.  “As a result, employers are increasingly adopting this type of ‘house money/house rules’ approach. Whether it’s through a reward or consequence, they are reserving a portion of their health care dollars for those employees who exhibit good health behaviors or who can show measurable progress toward their health goals.”

Already five percent of companies that offer incentives for participating in a program that helps workers become aware of their health status offer “incentives in the form of a consequence” if they don’t take a health risk questionnaire or participate in a “biometric screening,” which generally includes a blood test for cholesterol or a glucose measurement.

While the penalties are becoming more prevalent, rewards for pursuing good health are far more common. Most companies, or 64 percent, offer monetary incentives of between $50 and $500 to participate in a program that helps workers become aware of their health status. Nearly one in five workers, or 18 percent, offers $500 or more.

The incentives can include reduction of the premium cost that is deducted from a worker’s paycheck or be a cash payment or come in the form of gift cards. The incentives are used in hopes that workers will adopt a healthier lifestyle, lose weight and help workers stay out of the hospital and save the employer money on their growing tab for health care.

“Some companies strongly believe that getting an annual screening and taking an annual wellness review are highly effective tools in early detection and prevention of chronic illness,” Winkler said.

In CVS’ case, a company spokesman said last week that the pharmacy chain wants “to help our employees to be as healthy as they can be, which is why we decided to implement this plan,” according to a report.

Despite concerns about privacy, employers don’t know how the tests turned out or what the employee’s cholesterol reading was. Rather, the employer simply knows whether the worker took the test or not. The tests and screenings are designed to let the employee know whether they should take action to improve their own health.

“Employers offer incentive programs for a variety of reasons, and the decision to use consequences versus rewards depends on the individual organization,” Aon Hewitt’s Winkler said. “Generally, employees are motivated to action more by the fear of loss than the opportunity for gain. For that reason, a growing number of companies are exploring and evaluating a consequence structure as a way to drive employee participation and action.”

Aon Hewitt’s data comes from a survey of nearly 800 large and mid-sized employers with more than seven million U.S. employees. They have their benefits provided by large and medium-sized employers and administered by health plans that include UnitedHealth Group (UNH), Humana (HUM), Aetna (AET), Cigna (CI) and Blue Cross and Blue Shield plans.