PPACA Rules on Wellness Programs Could Push Participation

John Commins, for HealthLeaders Media , November 26, 2012

The new rules create guidelines for health-contingent wellness programs that couple financial and other incentives with biometric targets such as weight loss, tobacco use cessation, and lower cholesterol.

In particular, Mills supports the clarity around the outcomes-based incentives for metrics. "That will be very welcomed by employers and will drive participation. It diminishes a lot of the anxiety that employers are feeling around discrimination and what sorts of limits should we have around the incentives and what parameters."

For employers, the proposed rules increase from 20% to 30% the maximum permissible reward for the cost of health coverage, and increase the maximum reward to up to 50% for tobacco cessation programs.

"I don't expect a lot of employers will rush to impose 50% penalties on smokers or 30% penalties on somebody who doesn't get their cholesterol under control," says Roger Reed, senior vice president, clinical services at wellness services provider Health to You, a subsidiary of HCA. "It's just another way to say to the consumer, 'Look, we are going to let your employer impose incentives but we are going to cap it so this is as far as they can go.' In working with employers across the country, we aren't seeing a lot of people saying, 'Boy, when these rules come out, we are going to hammer our employees with these incentives.'"

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