Crazy idea? Perhaps not.
Nearly 80% of the cost of US health care is based on the treatment of eight chronic disease conditions: Obesity, diabetes, cancer, lung disease secondary to tobacco use, mental health, high blood pressure, heart disease, alcohol/drug abuse. And, at least 75% of these chronic medical conditions are preventable! This means that if an individual throughout their life actively practiced “healthy living” by having a healthy lifestyle, it is highly unlikely that they would develop more than one of these chronic medical diseases.
The current reality in the US is that people are developing preventable chronic disease(s) which are not only costing higher health care insurance premiums but also increasing out of pocket costs in the form of co-insurance and co-pays. In addition, an employer is paying increasingly higher health care premiums for their employees since they generally contribute 70% or more of the total premium for each employee.
This trend highlights America’s health care dilemma. We spend over $11,000 per person every year on health care, more than any other country, yet our life expectancy is below the average of other high-income countries and for the first time in nearly 100 years, our life expectancy has plateaued and begun to decline (the exception being a brief drop that occurred during WWII).
Behavioral factors — unhealthful eating, a lack of exercise, smoking, excessive use of alcohol and especially obesity — are among the reasons.
We need to address these cost drivers.
Behavioral economists for years have done research to determine how best to incentivize people to live healthier lives. What has emerged from these studies is that money, either given, or especially effective if taken away can change an individual’s behavior enough to move the needle towards healthier living and reduce health care dollars spent.
Employers have been looking at this strategy for the last 5-10 years and have reported variable success with respect to return on their investment with these programs.
I have recently become involved in such a program with the Cleveland Clinic as a partner. The Cleveland Clinic has the country’s most successful incentivized employee wellness program for their own 60,000 employees. Cleveland Clinic employees for a decade have been financially incentivized to lose weight, quit tobacco, better manage diabetes and high blood pressure and to exercise.
This program is now available through a partnership with Bravo Wellness LLC, also located in Cleveland, so that any business can engage the Cleveland Clinic’s evidence based and clinically proven wellness techniques to improve the health of their employees. The goal is not only to improve employee health, but to reduce employer health care spending and to put more money in the pockets of the employee.
So, yes, we should pay people to be healthier. The Cleveland Clinic Employee Wellness model proves that financial incentives can improve lives and save money for all parties. Now it is available to many.