In an effort to reduce the cost of health insurance and encourage healthier living, this state will roll out its own wellness program on Jan. 1, which has some university officials concerned.
The program will require state employees and non-Medicare-eligible retirees and their spouses to participate or pay penalties that increase over time, according to the state Department of Budget and Management.
“The main goal of the program is to slowly improve the health of our covered population,” said Anne Timmons, DBM employee benefits division director. “By doing that, it will allow us to flatten the trend line that we can avoid cost shifting to the participants.”
The program will follow a carrot-stick model that gives state employees incentives to fulfill certain tasks, such as completing a set of healthy activities or participating in a chronic disease management program. Incentives include waiving patient costs for primary care visits, generic drugs that treat chronic conditions and X-ray or lab work.
The health activities require participants and their spouses to select a primary care physician, complete a health risk assessment and discuss the results with their physician by Sept. 30, 2015. Failure to comply by the given date will not result in penalties, but noncompliance past 2015 will result in fees starting at $50.
“Nobody is sure what questions are going to be asked on this health risk assessment,” said David Rieger, assistant director for benefits in this university’s human resources office. “Because there was not a sample of the risk assessment questions … people weren’t sure what was going to be asked of them.”
Dale Anderson, university human resources director, believes the program’s goal is positive, but the state’s approach of reaching it concerns him.
“A lot of people object to forcibly having to do this,” Anderson said. “No one likes to be told how they are going to manage their own medical issues. It sort of comes off as the state is interceding in that.”
Disease management programs are meant to address chronic illnesses like diabetes, heart disease and high blood pressure. In 2013, the state spent $832 million in benefits for chronic disease treatment, according to the DBM.
In addition to participating in healthy activities, disease management program participants will engage with a care manager, who will give them a set of treatment guidelines. Members who do not follow through with the treatment recommendations must pay $275 in 2017 and $375 in 2018.
There are also concerns within the university and the University System of Maryland about communicating the details and requirements of the program to employees who do not speak English as their first language.
The University Senate’s Staff Affairs Committee submitted a report to the Senate Executive Committee, highlighting its concerns and providing recommendations so the university system can better disseminate information about the program.
“It’s even confusing for us English speakers, and imagine for someone who is not,” committee Chairwoman Gloria Blackwell said. “Fifty dollars, for me, is nothing — sometimes. Fifty dollars for someone who makes $11 an hour or less than that is going to have an impact.”
Timmons said the DBM put notices in the health insurance open enrollment packets that went out and held presentations across the state, including three on this campus. However, Blackwell believes this still might not be enough and does not help non-English speakers, who may need the information presented to them in a different way.
The committee report also went to Anderson, who plans on sending it to other university system human resource directors.
The program “is not going to be that shocking as it evolves and as people get used to it,” he said. “Right now it’s just the concept that throws you.”
