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Congress Plans Incentives for Healthy Habits ,Wellness Programs, and Devices? How Potentially Intrusive and Disruptive Will It G

Posted May 10 2009 10:42pm

This is what I call a very “loaded” commentary and transparent view of what we are dealing with today.   With Congress looking at incentives with insurance companies and employers, could they live within these realms themselves?   This is the danger zone where those, who are not full acquainted with technology methodologies miss the boat and are perhaps unaware of what is happening in the “real world”. 

Before passing laws it is only my small suggestion that perhaps members of Congress perhaps think about trying to live their lives under these constraints and still function as a human with some quality of life, could it be done?   This is what’s happening on the back side and the entire make up of employer health insurance plans today, not just the fine print, reality of what is being practiced and there are no laws or constraints here, so it’s open game.  We have the privacy advocates, thank goodness who do their best, but again does anyone listen?

Without technology knowledge and a full comprehensive understanding of risk management, nobody is at the controls.  I like and use technology as much as the next person if not more so, but in doing so, this also gives me the opportunity to see how it is and will be mismanaged, and all that is out there.   It is better to educate and have voluntary participation rather than the big brother approaches we are seeing today as everyone is fighting for the dollar. Healthcare suffers and levels of anxiety and anger rise.  We see it every day, but will be educate ourselves and acknowledge that it exists?  That is the million dollar question.  

The devices will come, like it or not as long as risk management controls.   Read about Red Brick Insurance who plans to offer employers a health insurance plan with the option to “electronically connect” the employees.   You could almost bet that their option of not including this service would represent a higher contract, since they will be intervening in the monitoring process.  A couple months ago they landed some additional funding from a VC who must think this will fly. (from a prior post below)

The Health Coach/Insurance Company – Employer plan to uses devices and phones for employees to prove their physical activity

Redbrick’s methods for tracking employees’ commitment to these health plans are surprisingly detailed (though they may smack a bit ofimageBig Brother). For example, it offers an iPhone application that records progress on a person’s walking exercises and beams the data back to Redbrick’s system. Pedometers and watches that do the same are also in the works, VentureWire reports. This might sound a tad invasive, but the company says that employers have the choice whether or not to make employees prove that they are following their custom health maps.

Redbrick’s methods for tracking employees’ commitment to these health plans are surprisingly detailed (though they may smack a bit of Big Brother). For example, it offers an iPhone application that records progress on a person’s walking exercises and beams the data back to Redbrick’s system. Pedometers and watches that do the same are also in the works, VentureWire reports. This might sound a tad invasive, but the company says that employers have the choice whether or not to make employees prove that they are following their custom health maps.

Perhaps could members of Congress test pilot Red Brick for us?   These are the areas they don’t think or know about, but are out there behind the scenes and growing as there is no regulation over this type of activity and unfortunately instead of being pro-active, our Representatives are always re-active and try to fix things after the fact.  Would members of Congress like to have an iPhone electronically attached to read and submit all their daily activities? 

Here are a few other examples from the blog that have been posted:

50,000 Marriott Employees Get Online Health Alert System

The system sends alerts to an employee's doctor if there's a potential problem such as a dangerous drug interaction or a key test that's been missed.imageThe hotel chain is using a Web-based personal health record system from ActiveHealth Management, which is owned by insurance company Aetna.  Marriot gets access to the aggregated data, I which I believe does not identify each individual.  At any rate, more wellness and potentially additional alerts for the patient’s doctor to sift through, but an EHR could do the same. 

Employers in search of ways to help keep health insurance costs low – How far will it go?

With technology on a very fast pace today in healthcare and new devices and means for collecting data, this is an area whereby we need to be aware of what methodologies will be embraced next, in other words, where will technology lead us and what is useful technology and what is considered “intrusive” technology. Nobody is holding back when opportunities are presented and sometimes technology and opportunities for additional income get confused.  When it comes to saving a dollar today and efficiency, the electronic umbilical cord could extend farther than anyone of us could imagine if the check and balance system is not kept in place.

image

Motorcycle-riding, sky-diving, and cigarettes. Should your employer be minding his own business, or yours?

I met someone last week who was quitting his job after 15 years. The company he worked for was  acquired by another firm that had very different rules of conduct for its employees. The new company instituted very detailed guidelines about attire (all shoes must have laces), workspace (no food or drink at the desk), and behavior (no leaning on the side of desks—yes, an actual rule). Further, their health insurance policy had exclusions for items that the executives considered unwise: no coverage for treatments resulting from motorcycle accidents, sky-diving, or sexually-transmitted diseases.

Can companies do that? Certainly, when they’re paying. Whoever pays for insurance can decide what type of treatments will and won’t be covered by their insurance policy. Whenever we allow a third party to pay for our health insurance, we transfer a part of our decision-making power to them.

Customer Service with Twitter – Blue Cross Blue Shield Health Insurance Will find You

Blue Cross will find you on Twitter too.  

On the other side of the coin also remember, everything you put on Twitter is open territory for all to read unless you protect your updates and allow only selected individuals.   Other companies such as Dell are also using Twitter, although I could not see doing a customer support call with PC problems on Twitter, but it might do the trick and put you in contact instead of being transferred around a busy pbx system.  You will be marketed if the hash mark is found by their scanners so if you don’t want to be contacted, don’t talk about them. 

Anthem Blue Cross going after some outsourced HR business?

The insurers will offer you counseling to keep cost down on some of the very services that are denied or cherry picked.

Californians have access to face-to-face counseling with network providers with Anthem Blue Cross.  In addition to competitive Health and EAP benefits, Anthem also offers access to Dental, Vision, Life and Disability. For more information on Anthem's EAP, visitwww.anthemEAP.com.  Anthem's EAP provides confidential, professional assistance when an employee's life and work are affected by personal problems such as relationship, stress, legal or financial issues, career concerns, and anxiety or depression. 

Would a member of Congress try this out for us?

Aetna "Take your Pill" Lottery...

Could your employer through contract negotiations require that you participate in program like this to tie you to a device to make sure you take your medications?

Aetna, through its nonprofit foundation, is funding research to find out whether a daily lottery with cash prizes will help improve patients'imagemedication adherence. The Aetna Foundation last fall gave researchers a $400,000 grant to fund a study at the University of Pennsylvania that will use prizes of $10 and $100 as rewards for taking medication as prescribed.

1-in-10 chance of winning $10 every day they take their medication and a 1-in-100 chance of winning $100. Each day a text message will tell a subject whether he or she has won the lottery, or, if the dose wasn't taken, whether he or she would have won.

Could Congress give this a try and report back to us and see if they think it is worthwhile?

The Muve Gruve Device Measures your Inactivity – Intrusive Technology with a Human Audit Trail?

The makers if this device specifically state on the website they are targeting insurance companies to keep the cost down, so will your carrier/employer be requesting you wear one of these to prove what level of exercise and sleep you may be getting?   How long would members of Congress tolerate wearing one of these themselves I might ask?  Who really needs to know exactly how much exercise you really get other than yourself.  It could be a great tool without the big brother attachments. 

The clip on the Gruve was designed to integrate into the shape of the device and function on virtually any type of clothing or belt to be unobtrusive to the user. The Gruve uses vibration to notify the user it is time to get moving.

A targeted customer base is corporations looking to explore the possibility of reducing the cost of insurance premiums by improving peoples health through prevention rather that treatment and those who need that extra reminder to get up and at it to stay fit.

Would members of Congress try this out for us and see exactly what is reported and it if helps?  Do we have members of Congress who might benefit that could tell us whether or not they like it?

Intrusive Technology for dependents too?

I write quite a bit about new healthcare technology and this article somewhat relates to some of the monitoring devices we are now seeing inimagehealthcare.  Schools in London are now testing the device that is strapped on to a child who is determined to be unruly.  The devices are slated to also help the children recognize their own trigger points and better deal with their anger, something we as humans have done as parents and teachers, so now instead of perhaps a little human intervention, the child is now being left with a device to educate oneself instead of some nice warm direction from a human?

Will children covered by health insurance companies be required to learn at an early age to monitor their heart rate if they are determined to being unruly or have any pre-existing health conditions? 

More Employers Turn to Disease Management

Is this another bad experiment...to contain costs...with off the shelf disease management programs...large companies can mold such a project, but small employers get the "boxed" deal from their carriers and the recommended outsource companies who provide this, many either owned or funded by the insurance companies...bottom line is that your employer is going to want to know how "diseased' you are...

  Small companies, meanwhile, purchasedisease managementas part of their health insurance. With a less focused approach, participation rates are lower.We are not falling off a cliff,” he says, “but we are facing a slow and long-term erosion of our employer-based system.”

Would Congress subscribe to a “Boxed Deal” and let us know how it works for them and their staff?

Medical insurance costs could use a healthy dose of reality – It’s all in the crackers?

Holy crap, is this what could be discussed in the next job interview?  This is just a short excerpt, so read the entire opinion piece at the link below.  This is an interviewer andimageinterview candidate in discussion…the Dorito or the unsalted cracker may make the difference on whether or not the candidate gets the job and the employer is more  engrossed with the potential insurance coverage than the overall skills of the candidate in this mock interview, in other words what is the financial exposure to the employee seems to raise to the top of the concerns, scary, yes, but even if they don’t say it, is it kicking around in the back of their heads? Is is skills or exposure today that counts?  

“But as an employer who buys private health insurance for my employees, I can’t control much of that. But I can reduce my premiums by controlling what my employees eat, drink and do.”

“You can do that?”

“According to the San Francisco Chronicle, one employer not only required his employees to stop smoking, he demanded it of their spouses, too. He enforced his ban through random testing. Employees caught smoking get canned.”

“But what does all of this have to do with me?”

“As your employer, I have every legal right to ask you to authorize access to your medical records. You will eat a healthful diet and forsake bad habits that will add to our premiums.”

Weyco Inc. of suburban Lansing, Mich., performs random testing every three months, usually of about 30 employees. Workers are summoned to blow into a Breathalyzer-like device that measures carbon monoxide levels. If the reading is high, employees take a urine test. If they fail the urinalysis twice they will be dismissed. One person was fired in 2006, a company official said, and none this year.

Would members of Congress work well with being tested randomly with urine tests?

Some Companies Penalize for Health Risks

If you work for a company, be prepared...there are all types of incentives/penalties being implemented by companies relative to health care...an effort to change employee behavior..there are lots of potential legal and privacy issues yet to arise as this becomes more main stream...and some health issues can't be controlled, so as this moves on I'm sure there will be much more on this subject.  As the article states, companies are using both negative and positive incentives and come in many variations.  BD 

In 2009 the company will start reducing pay for employees in its health plan by $10 per paycheck if their BMI — a measurement of body fat through a height and weight ratio — is in the obese range of more than 29.9. The deduction will be $5 per check if they don't meet required cholesterol, blood pressure or blood glucose measurements. Workers will be required to complete an annual health risk assessment and can appeal to have their fees dropped if they show improvement.

"It's a backdoor approach to weeding out expensive employees," legal director Jeremy Gruber said.

Could we have members of Congress and their staff adhere to such a policy?  Would they all meet the BMI range and if not, have deductions made from their paychecks?

Healthcare Is the Number-One Enemy of Small Business – US Small Business Administration

Even the government’s own Small business Administration says Healthcare is the number one enemy, so why do we continue to tie insurance and healthcare to employers?  Is this not an important consideration?

 

Excessive Incentives and Rules – Where Did the Wisdom Go in HealthCare?

Barry Schwartz makes an excellent exhibit of the “hospital janitor” and how the “human” side of his job description is completely not existent. It’s the human side of the job that is left out in the job description.   There’s one real good message for all of us here.image

We have too many rules and it is creating a downward spiral of sorts and we also have excessive incentives, especially in medicine.   It makes you stop and think, is this profitable or is it right?  As an example, risk management is only interested in profitability, thus we end up working with payers that are only perhaps looking at one side of the coin, is is profitable, and the part about whether or not it is right is buried. Doctors fight this all the time, just ask one. 

We use the rules, or other wise called “ALGORITHMS” created in computer code to determine our decision making processes, and the process of whether or not it is right or wrong can get lost in the translation.  SO WHAT CAN WE DO TO BRING BACK THE WISDOM?   Listen to the video and I think there are some real good points made here and ideas to ponder and think about.

All the above examples are what is wrong with employer based healthcare and how technology, if not implemented properly affects the every day quality of life with an individual.  We have a lot of creative individuals in this country with a lot of ideas, but implementation and education is what makes these items succeed, and not greed or saving money as the only focus.

In pushing for employer initiatives, perhaps Congress might investigate and see the real side of how this works and not just the fine print.   It would be nice to see some pro-active action instead of re-active, but that takes a lot of effort and education from all sides, from Congress all the way down the ladder.   This could be an real exercise for Congress with Healthcare to understand the full circuit and not just one side of the issue.  This is one of the reasons I always advocate to have the “Smart People” at the top of the helm, as they are educated and aware up front and we have less catching up from behind. Let’s see some of those Congressional BMIs to start the ball rolling.   BD 

WASHINGTON — In its effort to overhaul health care, Congress is planning to give employers sweeping new authority to reward employees for healthy behavior, including better diet, more exercise, weight loss and smoking cessation.

Congress is seriously considering proposals to provide tax credits or other subsidies to employers who offer wellness programs that meet federal criteria. In addition, lawmakers said they would make it easier for employers to use financial rewards or penalties to promote healthy behavior among employees.

Congress is seriously considering proposals to provide tax credits or other subsidies to employers who offer wellness programs that meet federal criteria. In addition, lawmakers said they would make it easier for employers to use financial rewards or penalties to promote healthy behavior among employees.

Frank B. McArdle, a health policy expert at Hewitt Associates, a benefits consulting firm, said, “Wellness and prevention programs have become a mainstream part of the benefits offered by large employers, and it’s virtually certain that Congress will include incentives for such programs” in its bill. The goals of such programs are to help people control blood pressure, fight obesity and manage diabetes and other chronic conditions.

Growing numbers of employers have adopted wellness programs after finding that they can lower health costs and increase the productivity of workers. Financial incentives include gift certificates and premium discounts or surcharges.

Critics say that holding people financially responsible for their health behavior is potentially unfair and that employers have no business prying into their employees’ private lives. “You are supposed to be paid on the basis of how you do your job, not how often you go to the gym or how many cheeseburgers you eat,” Mr. Maltby said.

If an employer offers financial incentives to employees for lowering cholesterol, losing weight or stopping smoking, the amount of such rewards generally may not exceed 20 percent of the cost of coverage.

Many employers would like to offer larger incentives, and many in Congress want to let them do so.

Congress Plans Incentives for Healthy Habits - NYTimes.com

Related Reading:

Simple Finger Device May Help Predict Future Heart Events – Endo-PAT2000 System
Aetna "Take your Pill" Lottery...
The Human Audit Trail to automatically track your fitness and sleep and a few other things…
The Wellness Programs: Payouts to Those Who Work Out - Insurers give discounts on premiums
High-tech gadgets hit doctor-patient relationships and more..
Allstate testing “brain fitness” software on older drivers
Doctor's Outrage: Asked to Rat on Patients?
The Muve Gruve Device Measures your Inactivity – Intrusive Technology with a Human Audit Trail?

Discrimination and Health Insurance: Big Brother in the Workplace and Beyond

Health Insurance Reserves – How much is in the till, could it be 1 or 2 trillion nationwide?

Express Scripts has a new Employer Plan – Home Delivery by Default

The Cisco Medical Clinic – Company Medical Assistance and Consults On Site

Intrusive Technology?

Healthcare Is the Number-One Enemy of Small Business – US Small Business Administration

Excessive Incentives and Rules – Where Did the Wisdom Go in HealthCare?
Algorithms, Formulas and Investigations leads to AARP suspending sales of some health plans

John Deer Machinery -failure of employer-based health insurance

Medical Tourism Starts at Home - Contracts and Brokering

Rising Health-Care Costs Hurt Small Biz

Medical insurance costs could use a healthy dose of reality – It’s all in the crackers?

Whirlpool suspends 39 workers, says they lied about smoking

Motorcycle-riding, sky-diving, and cigarettes. Should your employer be minding his own business, or yours?

Clarian won't dock workers who fail to meet health marks

Ending Employer-Based Health Insurance Is a Good Idea

More Employers Turn to Disease Management

Employers, Health Insurers Increasingly Use Care Managers To Review Physicians' Treatment Plans, Ensure They Conform To Evidence-Based Practices

Employers get tough on health**

Some Companies Penalize for Health Risks

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