Healthcare & Wellness Market Survey 2013
William Gallagher Associates (WGA) conducted its third annual market research survey within its client base in order to reassess the effectiveness and various opinions surrounding wellness programs, and the role they play in reducing health insurance costs in the workforce. Why Wellness? Health and wellness initiatives continue to gain traction as businesses aim to to reduce preventable risks among employees such as obesity, high cholesterol and high blood pressure that in turn have a direct correlation to the cost of health insurance. Our third year of data showed that now, more than ever before, employers are addressing this issue through the introduction of wellness programs that encourage them to become more knowledgeable and engaged in improving their health. A 29-question survey was sent to over 1,000 primary insurance buyers, including Human Resources professionals and C-level executives. The questions were in four areas: Current benefits practices Personal opinions on wellness Healthcare programs Opinions on public policy
Executive Summary The goal of WGA s Health and Wellness Survey was to explore the mindset and beliefs of the business community about health and wellness initiatives. Our third year of research sought to revisit the questions asked in our previous two tests in order to draw comparisons, look for trends and gain a clearer picture about the direction of health and wellness programs in the corporate world. While the 2013 results appear to be more subtle in change, it s clear that companies are still very much engaged and focused on employee health and implementing programs to promote change. As employers prepare for major policy changes due to national health care reform, more companies are taking action to address employee health costs and behavior. Under new provisions of the Patient Protection and Affordable Care Act (PPACA), employers will be able to increase the amount in financial incentives that they offer to reward workers healthy choices. Beginning in 2014, companies are allowed to offer incentives equal to 50% of the cost of single coverage to discourage tobacco use. Our survey results showed that employers are not only preparing for these changes, but that they re taking action: the number of respondents who said that they hope to implement anti-tobacco use programs rose nearly 20 percentage points. In addition, more companies are using cash incentives to drive employee wellness incentives and offering weight-loss programs. Employers continue to offer Health Risk Assessments to their employees, and nearly half of all respondents currently offer or plan to offer discounted or free healthy foods in company kitchens in order to reduce obesity and improve employee nutrition. Our 2013 results also proved that employers are not only taking preventative health measures they are also helping employees get fitter. The number of respondents who said they now operate an on-site fitness facility nearly doubled. WGA attended the Boston Business Journal s 2013 Healthiest Employers Awards in March and witnessed this firsthand while listening to several of the honorees discuss the various health and fitness resources they have introduced to employees in their offices and daily workplace environment. For employers who have seen the positive results of their health incentives begin to level off, many have turned to penalties to increase participation. This year s survey found that more employers said they currently use, plan or hope to implement penalties or lost discounts for failure to quit smoking after coaching classes. The same was true for weight management programs: the number of respondents who currently use or will use penalties or lost discounts for failure to reduce Body Mass Index after coaching classes increased 13 percentage points. There also seems to be also less opposition to major policy changes like taxing sugar sweetened beverages and banning advertising of unhealthy foods on children s programs. This year, a greater number of employers agreed that the government should ban advertising of unhealthy foods on children s programs. Having completed three consecutive surveys, this year s responses identified the solid trends and positive changes in attitudes and practices that concern employee health and wellness. Armed with effective tools and by taking a leadership position, businesses can have a lasting impact on their employees lives and well-being and in turn, create a healthier, happier and more productive workforce. For more information on implementing a wellness program please contact WGA at info@wgains.com
Demographics The 2013 WGA survey was fielded in Boston, Massachusetts, which is the corporate headquarters of WGA. 66% of respondents in this year s survey were Human Resources professionals 25% were in a Finance or Accounting Role 3% were in a General Counsel Role 12% were in some other role in the company 67% of respondents were female and 33% were male Age of Responders Age 60-69 13% Age 50-59 40% Age 20-29 9% Age 30-39 9% Age 40-49 29% Industry Breakdown 25% High Technology 9% Healthcare 6% Manufacturing 18% Biotechnology 9% Financial Institutions 2% Public Entity 6% Professional Services 6% Real Estate 2% Aviation 16% Other 11% Non-Profit 4% Venture Capital
Wellness Initiatives Health Risk Assessments Health Risk Assessments are one of the most widely used screening tools in the field of wellness and health promotion. These tests are often the first step in a multi-component program to promote healthy living amongst employees. They usually consist of an extended questionnaire, a risk calculation or score, and some feedback with a health advisor or online report. This year s results found that over half (59%) had a Health Risk Assessment program that was either currently in use (16%), plan to implement within the next 12 months (6%), or have hopes to implement one in the future (37%). This is an overall 9% increase in Health Risk Assessment activity since our first survey in 2011. 41% Currently In Use, Plan to Implement, Hope to Implemnt 59%
Company Approach Of the companies that have implemented Health Risk Assessments, most are opting for positive reinforcement like cash incentives/gift cards and recognition programs rather than penalties for failure to reach health benchmark goals (failing to quit smoking, reduce BMI). When asked how these companies encouraged participation in wellness initiatives: Cash Incentives 54% 42% Gift Cards Heath Plan Contribution Differential (i.e. a 10% discount on payroll deduction) Eligibility for More General Health Plans 13% 13% 42% Extra Health Reimbursement or HSA Contributions Recognition Program (Awards, Prizes, Etc)
Biometric Screenings Biometric Screenings are evaluations intended to identify potential medical problems. Some biometric tests include blood pressure, cholesterol levels, even nutritional analysis of employees. Survey responses showed that close to half (43%) were either currently using this screening process (15%), planning to implement it within the next 12 months (3%), or hope to implement it in the future (25%). 57% 43% Currently In Use, Plan to Implement, Hope to Implement Anti-Tobacco Use Programs The number of companies who said they hoped to implement anti-tobacco use programs rose nearly 20%, from 20% in 2012 to 39% in 2013. Those with no plans to implement these programs decreased 8%. 60 40 20 0 2012 2013 20 39 Hope to implement at some time in the future 58 50 No Plans 50% 6% 5% 39% Currently In Use Plan to Implement in the Next 12 Months Hope to Implement Some Other Time in the Future
Weight Loss Programs Attitudes about weight loss programs have also improved among employers. The number of companies who said they either currently use, planned to implement (next 12 months) or hoped to implement a weight-loss program rose from 46% in 2012 to 58% in 2013. Those with no plans to implement these programs decreased by 12%. 42% 20% 3% Currently In Use Plan to Implement in the Next 12 Months Hope to Implement Some Other Time in the Future 35% No Plans 42 54 2013 2012 Use, Plan or Hope to implement 46 58 0 20 40 60 Note: Many health plans offer such programs with their plan
Discounted / Free Healthy Foods in Company Kitchen Attitudes about nutrition continues to improve among employers. Since 2011, the number of companies who said they either currently use, planned to implement (next 12 months) or hoped to implement a program that brings discounted/free healthy foods into their company kitchens has risen 10%, from 30% in 2011 to 40% in 2013. 2% 26% 60% 12% Currently In Use Plan to Implement in the Next 12 Months Hope to Implement Some Other Time in the Future Use, Plan or Hope to implement 30 40 2013 2011 No Plans 60 70 0 20 40 60
Do you operate an on-site health club/fitness facility for the benefit of employees at any of your locations? Companies are encouraging employees to stay active by offering paid or reduced-rate gym memberships or building onsite fitness facilities. This year, the number of respondents who said they now operate or planned to open an on-site fitness facility nearly doubled. 22% Yes 78% No Note: While attending the Boston Business Journal s 2013 Healthiest Employers Awards in March, WGA witnessed this firsthand while listening to several of the honorees discuss the various health and fitness resources they have introduced to employees in their offices and daily workplace environment, including Crossfit gyms, personal trainers, yoga studios and more. This year s data showed an overall 10% increase in the number of companies currently operating or planning to open onsite fitness facilities, from 12% in 2012 to 22% in 2013. The number of companies with no plans to implement these screenings decreased as well. We expect these trends to continue as more businesses take advantage of corporate gym memberships as well as office-designs that accommodate physical activity during the workday. Do you operate an on-site health club/fitness facility? Yes or plan to open this year 12 22 2013 2012 No 78 88 0 20 40 60 80
Healthcare Provider Question We asked a series of questions regarding healthcare providers to gauge personal opinions on how health and wellness programs impact employees. Should healthcare providers increase Categories of Family Status (from beyond the traditional Single, Single plus One, Family categories?) Currently In Use 32% Plan to Implement in the Next 12 Months 57% 11% 0% Hope to Implement Some Other Time in the Future Do you apply penalties (or lost discounts) for employees whose spouses have the availability of coverage elsewhere but choose to enroll spouses in your plan, or a working spouse contribution? (i.e. if an employee covers their spouse and that spouse has health insurance from their own employer, the employee will pay more to cover that spouse.) 2% 5% 12% Currently In Use Plan to Implement in the Next 12 Months 81% Hope to Implement Some Other Time in the Future
This year s data showed an overall 12% increase in those said they currently use, plan or hope to implement penalties or lost discounts for failure to quit smoking after coaching classes, from 7% in 2012 to 19% in 2013. The number of companies with no plans to implement these penalties decreased 12 percentage points. Do you impose penalties (or lost discounts) for Failure to Quit Smoking after Coaching/Classes 81% 19% Use, plan or hope to implement penalties penalities No plans to implement 81 93 Use, hope or plan to implement penalties 7 19 2013 2012 0 20 40 60 80 100
This year s data showed an overall 13% increase in those said they currently use, plan or hope to implement penalties or lost discounts for Failure to Reduce Body Mass Index or other weight objectives after coaching classes, from 3% in 2012 to 16% in 2013. Do you operate penalties (or lost discounts) for Failure to Reduce Body Mass Index or other weight objectives after Coaching/Classes? 84% Use, plan or hope to implement penalties 16% penalties No plans to implement penalties 84 97 Use, hope or plan to implement penalties 3 16 2013 2012 0 20 40 60 80 100
Do you offer variable premium contributions based on years of service at your company? 13% 2% 3% 3% Currently In Use Plan to Implement in the Next 12 Months 79% Hope to Implement Some Other Time in the Future I Don't Know Do you offer variable premium contributions based on salary categories? Currently In Use 8% 6% 3% 4% Plan to Implement in the Next 12 Months 79% Hope to Implement Some Other Time in the Future I Don't Know
Use of a Tiered Network Plan Design Do you use a tiered health plan where each tier is based on cost and quality? Currently In Use 21% 54% 15% 1% 9% Plan to Implement in the Next 12 Months Hope to Implement Some Other Time in the Future I Don't Know Note: In this type of plan, the patient's benefits are based on which tier the provider is a part of, and patients impact what the plan pays at the point of service. In-House Physician Assistants/Doctors on Premises Do you operate an on-site medical facility or have employed health care providers (nurse, physician assistant, etc.) at any of your locations? Currently In Use 85% 7% 5% 3% Plan to Implement in the Next 12 Months Hope to Implement Some Other Time in the Future
Policy Opinions Similar to our last year s findings, research shows that the corporate world still harbors strong anti-tax beliefs due to uncertainties about job growth and economic recovery. At the same time, 37% of respondents said they would support an added tax on sugar sweetened beverages in order to reduce obesity in society. This could take the form of a 10 or even 25 cent per can fee or an upward adjustment to the state sales tax rate. Respondents were still torn on the question of whether the government should ban advertising of unhealthy foods on programs aimed at children in order to reduce obesity in the population. Thirty-nine percent opposed the ban, while 49% supported it and 12% were undecided. This finding was well within the margin of error and could eventually win public support through a targeted campaign. Would support an added 37% tax on sugar sweetened beverages 49% Would support an advertising ban of unhealthy foods Should States Tax Sugar-Sweetened Beverages in order to reduce Obesity in Society? 45% 18% 14% Charge Current Overall State Sales Tax Rate Charge 10 Cents Per Can Charge 25 Cents Per Can 12% 11% No Tax No Opinion Should Government Ban Advertising of "Unhealthy Foods" on programs aimed at children in order to reduce Obesity in the population? 39% 49% 12% Yes No No Opinion
This year s data showed an overall 10% increase in those who said they would support an advertising ban of unhealthy foods on programs aimed at children in order to reduce obesity, from 39% in 2012 to 49% in 2013. Yes 39 49 No 39 52 No opinion 8.5 12 2013 2012 0 20 40 60 80 Should Providers (Hospitals) be allowed to offer fixed cost health benefits directly to Insurance buyers like your company without an insurance company as an intermediary? 43% Yes 15% 42% No No Opinion
Do you think the current Reimbursement System works? 53% 17% It Works 9% 21% It's Adequate for the Job It's Broken I Have No Opinion Some advocates and government officials want to change how health care providers are paid from the current fee-forservice system. In this vision, providers would be paid a fixed amount (a budget) based on the number of patients that select them. If the provider meets certain quality measures, they would also receive a bonus for delivery of good care. Should the government force the adoption of this reimbursement system? 29% Yes 35% 36% No No Opinion William Gallagher Associates is a leading provider of insurance brokerage, risk management and employee benefits services to firms with complex risks, within industries that include technology, life sciences, financial risks, health care, renewable energy and clean tech and environmental services. info@wgains.com www.wgains.com WGA InsureBlog blog.wgains.com