Wellness and The Health Plan Design

Wellness and The Health Plan Design
We now have over ten years of data in the U.S. which supports this fact: well designed consumer-driven health plans curb the incidence of lifestyle disease. The slickest corporate “wellness program” is not worth the investment unless the employer’s health plan is consumer-driven. Specifically, a plan design which requires the plan participant to see and share in the ACTUAL cost of treatment. A well designed plan is an HSA-Qualified health plan where the employer “seeds” each participant’s Health Savings Account ($500 – $1,000) during the first few years of the plan.

For example, consider Type II Diabetes. According to the American Medical Association Type II is 100% attributable to lifestyle choices. Upon diagnosis of Pre-Type II Diabetes, the doctor usually provides the patient with a choice: improve diet and increase exercise OR take medication. Under a traditional health plan, the plan participant will consider the ease of paying a monthly copayment for a drug versus the perceived pain of reducing fat/sugar and exercising 3-5 times a week. Under a consumer-driven health plan, plan participants are required to pay the negotiated cost of a drug before satisfying the deductible. This monthly cost is 5-10 times higher than a traditional plans’s copayment. Of course without changing diet and exercise the patient will have to continue to take the medication indefinitely. Comparing the effort involved with diet and exercise versus the cost of a monthly maintenance drug tips the balance toward positive lifestyle changes. Over ten years of data supports the Health Savings Account holder will choose diet and exercise over pills, resulting in reduced claims and PREVENTION of additional diseases associated with fat, sugar and a sedentary lifestyle.



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