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Employers and employees don't see eye-to-eye on health plans

December 5, 2011
KEYWORDS health / healthy / plans / risk
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company meetingWorkers want four simple things from their employee-provided health benefit plans -- and many are not getting them, according to a new survey from Aon Hewitt, The Futures Company and the National Business Group on Health.

Attempts to control rising costs and adjust to new regulations have caused many employers to make adjustments in their health plans, but those changes are not necessarily meeting the goals and needs of their employees, who want their companies to do more to help them improve their health and get the most from their employer-provided health and wellness plans.

More than 3,000 consumers (employees and their dependents) covered by employer health plans were surveyed to determine their perspectives, behaviors and attitudes towards health and wellness.

While a majority (74 percent) are worried about being able to afford health care now and in the future, they understand that health improvement programs, along with well designed employer-provided health benefit plans, can help them get healthier while also holding down costs.

But, the survey reveals that workers really want four simple things -programs and communication that are easy to use, motivating and meaningful to them, but that also provide personalized information and ideas.

Consumers are telling us that the one-size-fits-all approach to health and wellness isn't working for them," said Helen Darling, president and CEO of the National Business Group on Health."In order to help with their challenges and reduce costs, they want health programs that speak to their individual and families' health care needs."

CDHPs becoming more popular

More employers are introducing health care plans that require workers to take more responsibility for managing their health and the related costs. In fact, a recent Aon Hewitt report shows that 51 percent of employers now offer a Consumer Driven Health Plan (CDHP), up from just 9 percent in 2005.

The good news for employers is that consumers are willing to try CDHPs if the immediate cost savings are apparent. Among those with a choice, most employees (63 percent) select a CDHP because of the lower premium costs. Additionally, 39 percent choose this plan option because their employer contributes to an associated account-Health Savings Account (HSA) or a Health Reimbursement Account (HRA). In fact, among those enrolled in a CDHP who have a choice, over 90 percent will definitely or probably re-enroll. While CDHPs are, in part, intended to encourage workers to take a more active role in their health, the survey findings indicate that they are having a mixed affect on behaviors. Encouragingly, 42 percent are getting more preventive care and 40 percent are looking for lower cost health services options since choosing this plan. More troubling, a sizeable number of workers (35 percent) are sacrificing or postponing care (28 percent) to avoid out-of-pocket costs.

"Employers need to make sure workers aren't sacrificing health and the future costs of poor health for lower costs today," said Cathy Tripp, managing principal Health & Benefits at Aon Hewitt and project leader for the study.

Customization counts

Half of participants (50 percent) want a personalized plan that recommends specific actions they can take to improve their health based on their health status, up 9 percentage points from 2010. Workers are also looking for convenient, one-stop access to information with 40 percent expressing a preference for a wellness website and more than a third (35 percent) want personalized health tips and reminders. Cost is still important: 44 percent would like cost savings tips and a third (33 percent) want cost estimating tools.

Perception v. reality

In addition to shifting a greater share of the cost to employees, companies are also looking at ways to get employees and their dependents healthier. According to consumers, the best way to motivate them to participate in employer-sponsored health plans is by using rewards. More than half of consumers would prefer either non-cash or cash incentives to encourage them to take part in wellness (60 percent), condition management programs (50 percent) or respond to a health risk questionnaire (58 percent).

For employers, getting workers engaged in their health is critical to health improvement and cost containment. However, the survey finds that there is a disconnect between how healthy people think they are and how healthy they actually are. The Centers for Disease Control and Prevention reports that approximately one-third (33.8 percent) of U.S. adults are obese, though only 24 percent of survey participants say they are obese. Similarly, the survey found that more than three-quarters (76 percent) of consumers rated their health as "very good" or "good," while just 15 percent considered their health "fair" or "poor."  While employees may think they're healthier than they likely are, they do acknowledge that their health isn't perfect. Approximately 60 percent of consumers report having at least one health condition with obesity, high blood pressure and back pain most often mentioned.

However, respondents do understand what it takes to get and stay healthy. When ranking what matters most to their health, many (85 percent) say that good health is a result of making smart health choices each day, over two-thirds (68 percent) say that getting regular preventive care ranks in the top three, while 40 percent rank living and working in a healthy environment in the top three. While people know what it takes to be healthy, there are still often barriers to reaching health goals. Most people cite lack of time (42 percent), cost (40 percent) and unwillingness to sacrifice (35 percent) as the leading obstacles to getting and staying healthy. Consumers do acknowledge that there are people and things in their lives that may help move the needle when it comes to improving their health. Nearly three-quarters (72 percent) are influenced by advice from a doctor, almost half (47 percent) from friends or family, and 41 percent from general health websites. Just 13 percent consider health information from their employer a trusted source.

Lack of awareness about health programs

While employers are increasingly offering programs to both workers and their dependents such as biometric screenings, health risk assessments, onsite clinics/pharmacies and Employee Assistance Programs, many employees and their dependents don't seem to be aware of many of these programs. In 2011, more than one-third (36 percent) of consumers did not participate in any health program or service offered by their employer. Among the programs that workers did participate in, blood tests or biometric screenings were the most popular (61 percent participation), followed by health risk assessments (57 percent participation).

Despite low participation, when workers do take part in these programs, satisfaction is extremely high. Almost all (97 percent) of consumers who took part in blood work/biometric screening were satisfied, 97 percent were happy with their on-site clinic or pharmacy, and 92 percent were satisfied with the health risk assessment.

In addition to lack of awareness, and despite the availability of health improvement programs, many consumers don't feel their employers are fully supportive in helping them get and stay healthy. A majority of workers (60 percent) think their company is only moderately-to-not supportive when it comes to their efforts to be healthy.

"Employers may be missing the mark when it comes to health improvement programs being offered to workers," said Tripp. "Workers need to see that their efforts to become healthy are supported by the company. Developing a culture where leaders care and support healthful living communicates to workers that this matters to the company."

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