To cut insurance costs, companies help workers get healthy

WASHINGTON -- Companies nationwide are looking to trim their health insurance costs by combating chronic diseases — such as diabetes, obesity and depression — in their employees, corporate and government officials say.

The need for such steps was amplified again Tuesday as a new survey from the Kaiser Family Foundation showed that health insurance premiums for families of four increased 9% this year.

"Just in the past six months to a year, we've seen a much bigger push toward addressing health issues," said Joe Miller, managing director of CHC Wellness, which helps companies assess the health needs of their employees. "What we're doing now is not working."

The upward trend in health care costs can't all be blamed on growing doctors' bills. So, employers have started to provide on-site medical visits, access to gyms, chronic-care plans, smoking-cessation programs and even discounts for those who buy a banana rather than a cookie.

For an employer, costs can be as much as 40% higher in one year for someone who is overweight because of all the issues associated with obesity, including diabetes, back problems, asthma, depression and heart disease, said Kenneth Thorpe, who co-directs Emory University's Center on Health Outcomes and Quality.

"Between 8% and 20% of health care costs is due to the persistent rise in obesity," Thorpe said. "Wellness could make a difference."

As an example, he cited a study he published in the journal Health Affairs about an evidence-based program that reduced type 2 diabetes cases by 71% in Medicare beneficiaries older than 60. It could save Medicare $2.3 billion over the next 10 years if pre-diabetic beneficiaries were enrolled, Thorpe said.

The U.S. Department of Health and Human Services announced a further incentive on Wednesday: It asked businesses to participate in a project to show what happens when private insurers coordinate with primary-care physicians to address health issues. This means personalized care plans, electronic records and preventive care, as well as partnerships with large firms that can offer incentives to their employees.

Tire-manufacturing giant Michelin North America began providing preventive care to all its employees three years ago, as well as chronic-care management for five diseases. Before the program started, only 7% of employees received basic care for diabetes, said company President Dick Wilkerson. Now, nearly 100% do. That cut health care costs for those patients by about $700 a year, he said.

Michelin now has primary-care facilities at all of its major workplaces for use by both employees and their families, Wilkerson said. Patients there can expect a 25-minute visit with a doctor instead of the national average of about seven minutes per visit.

They've seen a 30% reduction in employees classified as high-risk for chronic conditions, as well as an increase in people who work out.

"Already, we've seen huge reductions in our costs," Wilkerson said.

At health insurer WellPoint, employees who receive comprehensive primary care from a company doctor have helped cut health care costs by 14%, said Sam Nussbaum, its executive vice president.