More Carrot Than Stick

Cut Costs

Financial concerns were one important reason for Ridgeview Medical Center in Waconia to undertake a wellness incentives program. “We needed to reduce our health insurance costs,” says Robert Stevens, Ridgeview president and CEO. “We had high deductibles and health reimbursement accounts.”

Last fall, Stevens engaged RedBrick Health, a Minneapolis-based consulting firm that specializes in wellness plans, to set up Ridgeview’s program. Like others of its kind, the program starts with a voluntary health risk assessment. In exchange for completing the assessment and signing up on line to receive regular health-related information via e-mail, employees receive $75. About half the employees signed up—and Stevens was astonished by the results.

“I had a misconception about how healthy our employees were,” he recalls. “Sixty-two percent were 20 percent or more above their ideal body weight. We started to target people who have the greatest opportunity to change. People could receive incentives of up to $300 for changing certain behaviors.”

Ridgeview also set some specific financial goals for the program. For example, the organization wants to reduce the need for Lipitor by 25 percent. The drug, which controls cholesterol, is the most prevalent prescription in Ridgeview’s plan. “There’s a percentage of people who, through exercise and weight control, could be removed from the drug,” Stevens explains.

Those employees can see gradual monetary rewards as they make incremental improvements to their cholesterol readings. “If my cholesterol is at 220 and I bring it to 205, I qualify for part of the reward; if I get it down to an average of 180, I get 100 percent,” Stevens explains. Participating employees are supported with a range of coaching programs, which may include on-site classes, online programs, or telephone sessions with a counselor.

The organization also has set similar goals and coaching programs to target other risky behaviors. Noting that 12 percent of employees smoke, Stevens says, Ridgeview wanted to reduce the number to 8 percent within a year. The center has already achieved that aim.

Ridgeview’s overall goal is to reduce its health insurance costs by 10 percent within three years—and already the organization has made progress in that direction. “Of the eligible employees, about 15 percent are actively engaged in classes,” Stevens says.

Change Behavior

Despite the popularity of gift cards as a reward, Kyle Rolfing, CEO of RedBrick Health, argues that such incentives alone cannot sustain a strong program. Instead, he says, “We’re looking to connect the financial cost of health care to the 50 percent of costs that are driven by peoples’ individual behaviors.”