March 1, 2006
King County achieves stunning level of participation in new wellness focused health benefits plan
King County employees are electing to join a wellness program designed to cut county benefit costs at a rate among the highest in the nation. This month nearly 90 percent of King County employees and their covered partners signed up for a new health benefit plan by taking a wellness assessment, exceeding expected participation by nearly 30 percentage points and putting King County on track to save millions while improving employee health.
"We have given employees the opportunity to take ownership of their health and they have participated in numbers that exceed industry standards for excellence" said King County Ron Sims. "This is yet another example of how King County employees embrace change as we meet the challenge of fiscal pressures that demand that we do business differently."
"King County is in the process of setting an important standard in employee health improvement at a time when employers are looking for innovative approaches to cutting health care costs," said Dr. Jeffrey Harris, MD MPH MBA, Professor, Health Services at University of Washington. "The norm for participation in a wellness assessment is in the 20 percent to 40 percent range, with 70 percent being the norm with sizeable financial incentives."
"No more than 5 to10 percent of the employers who have implemented a wellness assessment with incentives have a participation rate of 90 percent or higher," said Seth Serxner, PhD MPH Principal, Mercer Human Resource Consulting. "This provides a successful case study when employers across the country are looking for innovative ways to cut health care costs by improving employee health. The fact that this innovation comes from government, which is often viewed as less open to change, is particularly noteworthy."
More than 17,400 employees and their covered partners took a wellness assessment in January as a first step in participating in the new health benefits plan that rewards healthy lifestyles and disease prevention. The high participation rate exceeds anything seen nationally by the independent company that conducts the wellness assessment for the county. A comprehensive and aggressive outreach effort and a strong partnership with labor unions representing county employees are credited for the high participation rate.
Starting in 2007, the county's health plans will have three out-of-pocket expense levels – gold, silver and bronze, where members who earn gold pay the lowest out-of-pocket expenses and bronze the highest. Members earn gold, silver or bronze depending on their level of participation in wellness activities. Benefits coverage is the same for all three levels, but the deductible, copays and out of pocket maximums are different. For example, the per person annual deductible for the highest level of participation, or gold level is $100, and for the lowest, or bronze, it is $500.
Unlike punitive approaches being adopted by organizations across the country where, for example, smokers are dropped from insurance roles, King County's innovative approach focuses on prevention and rewards healthy choices. For example, smokers are encouraged to participate in smoking cessation programs and are rewarded for that participation. In addition, there are no costs to the participant for smoking cessation services or products, such as patches or gum, to help them quit
Members enroll in the new program by taking a wellness assessment which immediately earns them silver. The wellness assessment, administered by an independent company, provides the basis for an individual action plan. If a person also completes their individual action plan, they earn the gold out-of-pocket expense level. A person gets bronze if he does not take the assessment or complete an individual action plan.
The individual action plan is shaped by a person's level of risk for developing a chronic disease, determined by questions on the wellness assessment. If a member is categorized as medium or high risk, they get a personal coach to assist them with their personal action plan. If a member is low risk, they log and report their continuing healthy habits for their individual action plan. All members, regardless of chronic diseases or unhealthy behaviors like smoking, have an equal opportunity to be eligible for gold as long as they participate in the program.
Individual action plans range from starting to exercise regularly, to making healthy food choices to more effectively managing diabetes. The program is voluntary and benefits coverage remains the same.
"We are promoting a culture of wellness in the county," said Sims. "In the end, our employees will benefit by living longer, healthier lives, and the cost savings will help us provide a higher level of service to King County residents."