When It Comes To Lowering Healthcare Costs Do Workplace Wellness Programs Over-Promise And Under-Deliver?

Don’t get me wrong, I completely support the notion of promoting positive health behaviors and healthier lifestyles. Encouraging such things as regular exercise, good and balanced nutrition, the proper amounts of sleep, and all the things associated with taking better care of ourselves is all good. No question about that.

It’s just that for the most part you could color me the doubting Thomas when it came to believing the narrative that wellness programs definitively lead to lower insurance premiums and other healthcare-related cost savings.

And, it seems that most often that’s how wellness programs have been sold to employers. “Implement a wellness program and you will lower your company’s insurance premiums and other employee health-related costs” has commonly comprised a major part of the wellness sales pitch made to employers.

And many employers, especially large employers, have been buying this cost savings aspect of it. (80% of large employers in the U.S. offer wellness programs*).

I’ve long wondered if these corporate wellness programs provided any direct return on an employer’s investment (Workplace wellness is an $8 billion industry*). We sure haven’t witnessed it either in the way of lower insurance premiums or a decrease in the consumption of medical services and medical claims.

Harvard provides an answer via a major study on the Health and Economic Outcomes of Workplace Wellness Programs.

Results of the Harvard study were recently published in The Journal of the American Medical Association (JAMA). In a nutshell the Harvard study concluded that while there were significantly greater rates of some positive health behaviors among participating employees, there were no significant effects on health care spending.

In other words, when it comes to wellness programs and savings, the Harvard study verdict is in. Under-deliver.

For more on the Harvard study click here.

*Source: Axios

Déjà Vu, Again – Small Group Transitional Relief Plans (pre-ACA) Extended Through 2020

Buried far below the most recent headlines related to eliminating the ACA, The Centers for Medicare and Medicaid (CMS) once again announced that employers in the small group market still enrolled in Transitional Relief Plans (pre-ACA) may keep their existing policies and plans for another year. CMS stipulates that ultimately the discretion for granting an extension again rests with state regulators and the respective participating insurance carriers who continue to make those plans available.  As we learned last year a few insurance carriers (e.g. Aetna) elected not to extend the Transitional Relief Plans beyond 2018. They instead chose to eliminate the option of renewing the old plans thus requiring impacted employers to move to ACA plans or one of the market compliant alternatives (e.g. level funding, MEWA, etc).

For more info click on the link below:

Extended Non-Enforcement of Affordable Care Act-Compliance With Respect to Certain Policies

Three Notable Employer Health Coverage Factoids In The News This Week……

…… that may be of interest only to me.

Amazon, Berkshire Hathaway and JPMorgan Chase Finally Has a Name

It only took eight months. The new nonprofit healthcare company founded by Amazon, Berkshire Hathaway and JPMorgan Chase finally has a name. It will officially be known as “Haven”. (Maybe it’s just me, but with all the introductory splash and all the money being thrown at this thing, but ”Haven”? Conjures up visions more of a retirement home or maybe an RV resort somewhere just of I-95 rather than healthcare innovator.)

Not much is known about Haven. Data, technology, improving employer healthcare, and not-for-profit is about all we know at this point and that’s according to Haven head guy Atul Gawande.

Two unrelated but interesting things to note about Haven:

1. The nation’s largest health insurer, UnitedHealthCare, views Haven as a competitor. And,
2. It wasn’t that long ago (last summer) that billionaire leader of Berkshire Hathaway and Haven co-founder, Warren Buffett, indicated that a single payor healthcare system may be the most effective system for cutting healthcare costs.

Not sure what to make of it or how it will ultimately affect the group health market but it’s still interesting.

Is Health Market Fragmentation the Culprit? The Main Driver of High Costs?

Following up on Buffett’s take, I read this week that the fragmented nature of the U.S. healthcare system (from employer-sponsored group coverage to the individual market to Medicare, and Medicaid, and the V.A., and coverage for Native Americans – is primarily responsible for today’s high cost of healthcare coverage? Could that be an over simplification? How would simply merging those lead to lower costs?

We’ll leave that for others to figure out.

In the meantime, we’ll just keep working hard on finding new and meaningful ways to mitigate the high cost of coverage for our employer groups and their employees.

Buying and Selling Health Insurance Across State Lines

The Interstate sale of health insurance is back in the news this week with the government’s release of a fifteen-page document requesting commentary. Some see this as surefire way to increase competition and ultimately lower the high cost of health coverage. Others see it as simply adding more chaos without much gain. My sense is maybe both. Some short term gain as well as adding to the chaos. Overall, seems like at best it may temporarily treat a symptom but doesn’t won’t move the needle much toward a cure.

We’ll see if it gets traction.

If it does get traction it will be interesting to track the unintended consequences as, sure as shootin’, there will be some.

65Plus Is The Hottest Labor Market Demographic. Here Are Key 2019 Medicare Costs That Employees And Employers Should Know.

Some say it’s the hottest demographic in the labor market — men and women ditching traditional retirement age to work into their 70s, 80s and sometimes beyond.   According to the Bureau of Labor Statistics the 65 and over crowd will make up the fastest-growing segment of the workforce over the next decade.  With that in mind, over the next few months we’ll be providing key bits of information that employers and employees may find helpful as they navigate the best and most cost effective options for health coverage for the 65Plus workforce and their dependents.

First off, 2019 cost considerations for “traditional Medicare”:

2019 Medicare Costs + Coverage

PART A PREMIUM (Hospital Insurance)
Most people don’t pay a monthly premium for Part A (paid Medicare taxes for more than 39 quarters.  If 39 or fewer quarters worked they’ll pay a premium of up to $437).

PART A DEDUCTIBLE + COINSURANCE
– $1,364 deductible for each benefit period
– Days 1-60: $0 coinsurance for each benefit period
– Days 61-90: $341 coinsurance per day for each benefit period
– Days 91 and beyond: $682 coinsurance per each “lifetime reserve day” after day 90 for each benefit period (up to 60 days over your lifetime)
– Beyond lifetime reserve days: all costs

PART B PREMIUM (Medical Insurance)
The standard Part B amount is $135.50 (or higher depending on your income).

PART B DEDUCTIBLE + COINSURANCE
– $185 deductible per year
– After deductible is met, enrollees typically pay 20% of the Medicare-approved amount for most doctor services, outpatient therapy, and durable medical equipment (DME).

2019 PART B + PART D (Prescription drug coverage) INCOME-RELATED MONTHLY ADJUSTMENT AMOUNT (*IRMAA PREMIUMS)
An additional amount that some individuals whose modified adjusted gross income (MAGI) is above certain thresholds will pay for their monthly Part B and Part D premiums.

• 2019 Medicare Part B (Medical Insurance) Income Related Adjustments

• 2019 Medicare Part D (Prescription drug coverage) Income Related Adjustments

Next Up:  The eligible employee’s three main options when it comes to their employer-sponsored plan and/or Medicare coverage.

2019 Medicare_and_You_2019