The historic yet overwhelmingly complex Patient Protection and Affordable Care Act (PPACA) will strongly affect all aspects of medical care delivery, for better and worse. The 907-page mega law features wellness prominently and uses the word wellness 86 times. The most pertinent wellness issues are in the Prevention of Chronic Disease and Improving Public Health Section (Title IV).
Key Wellness Provisions
-Provide small business grants to help pay for a wellness program.
-Allow premium discounts of 30-50% based upon wellness engagement.
-Launch a National Prevention and Health Promotion Strategy.
-Research and evaluate best practices and ROI.
-Communities will benefit from a major healthy lifestyle campaign with $500M of national funding with high visibility.
-Employers don’t want to be trailblazers and need to know what works best. Funding to support research and evaluation will highlight the most effective health and wellness strategies.
-Requiring health plans to cover the most effective preventive services at no additional cost will address health conditions before they become more dangerous and costly.
-Small businesses will be among those who benefit most. Small organizations will finally have a financial incentive for wellness through $200M in wellness grants for employers with 100 employees or less who work 25 or more hours weekly.
-Employees who are actively engaged in prevention and wellness will have lower medical costs. Employees who can improve will be provided with incentives to join a program and improve their health. Premium differentials allowing a 30% discount for employees who are engaged in wellness will incentivize employees in health care decision-making and lower premiums for employers who provide strong wellness programs. Health and Human Services has the authority to increase this amount to 50% based upon the impact on reducing medical costs.
-Polices cannot be cancelled because a person gets sick and people with pre-existing medical conditions can buy health insurance without higher premiums.
The Bottom Line
The right wellness program improves health conditions
and costs. The best results are achieved by partnering with an established wellness firm and working together with your leadership, health plan and health system. Government reform will provide increased awareness and funding. Although reform may change or improve, it will not be repealed. Businesses will do well to learn about the provisions that are launching and to leverage the prevention and wellness opportunities within the bill.
About Scott Foster and Wellco
Scott Foster is President of Wellco, based in Michigan. Wellco works with organizations who want to measurably improve health costs and conditions. Wellco specializes in health ROI systems, health risk appraisals, corporate wellness programs, speaking, and consulting. Wellco the developer of the award-winning HealthHammer (TM), the first and only Zero Trend Appraisal (R) system to help companies accurately benchmark and fully achieve flat health costs over time. For more information, visit www.wellcocorp.com or call 248-549-4247.
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