Critique

2007 Koop Award Winner

Lifestyle Rewards -- We Energies Health Enhancement Initiative

The following are verbatim remarks made by the reviewers:

Program Strengths

A:

• We Energies has done a very good job of collecting HRA data and has used incentives to maximize participation.  They have also done a very nice job of analyzing this data.

B:

• Clear program goals, including health and financial outcomes, are aligned with supporting program design
• Integrated strategy encompassing health management, safety, work-life balance, disease management and supportive work environment, all supported by incentive program
• Well-designed and clearly communicated incentive strategy with menu of program options to accommodate entire eligible population. The one exception to clear communications is that it was not clear from communications how qualification for some incentives is measured.
• HRA administered annually to assess trends in health risks and related health outcomes and link to program participation
• Financial outcomes analysis, including direct medical costs and two indirect cost components – absence and workers compensation.

C:

• Seemingly well-designed comprehensive health management program.
• Uses a $300 incentive amount (pre-tax) to encourage a range of Wellness participation, completion and achievement purposes.
• The program has been in operation for approximately 10 years.
• Uses U of M’s HRA and data analytics.
• Have continued to examine health risk relationship to annual health costs.
• Proportion of health cost due to excess risk has declined from 25.7% to 19.6% of total claims cost over the last three years.
• Participant health care average cost growth rate had largely stabilized at 8.9% over 6 years while non-participants experienced a 13.3%].
• $264 was identified as the average annual savings per participant.
• They are monitoring risk migration and its implication for health cost experience.
• They have provided evidence of peer reviewed article, but the article was a descriptive look at the health risk prevalence and health cost relationships of the work force rather than an evaluation of the effectiveness and impact of the We Energies program.

D:

• Good longevity, excellent participation rates
• Good incentive (up to $300)
• Corporate commitment
• U. Michigan evaluation
• Solid trend-based cost savings
• Risk factors down around 20%
• JOEM peer-reviewed evaluation

E:

• 85% participation since inception – annually 50+% participation
• Annual incentive of $300 to participate (which is high)
• U of M longitudinal analyses of cost trends show different cost increase gradients for participants vs. non-participants
• Fig. 3 shows significant risk reduction comparing 2006 and 2003 in most risk categories
• Generally well structured incentive program

F:

• Overall a good program and well written application.  They were able to demonstrate cost outcomes and favorable risk reduction.
  

G:

• Participation greater than 50% annually.  Program sustained since 1998.  Makes up to $300 available as an incentive based on achieving select wellness criteria.  Based on HRA has documented reduction of high risk and growth of low risk populations. 
• Compared participants and non-participants, documenting a difference in the growth of health care costs equating to $264 less per employee per year in the participant group.
• HRA used to drive “wellness” interventions.Condition coaching strategy in place.

H:

• Published study results; assessment of time away from work as well as medical, Rx costs. 
• Good comprehensive programs.