Employer Tie Financial Rewards, Penalties To Health Tests, Lifestyle Choices

This article is by Kaiser Health News (Appleby, 2014) goes into details whether incentives can help promote healthy lifestyles.  It gives example of various organizations.  Every year employees of Swiss Village Retirement Community have their check up done.  That helps to determine how much they pay for their health coverage.  For example, those who manage to keep level of smoking, obesity, BP and cholesterol below a certain level, get discounts on their premium.  Similarly, employees of Jones Lang LaSale, get cash discount upon meeting a certain targets.  Even though proponents of such approach agree that financial benefits help make healthier choices, the studies so far have been inconclusive.  On top of that supporters of those already suffering from chronic diseases fear of discrimination. 

The management of Swiss Village feels that this approach has helped slow down the increase in their health care cost.  And at the same time, helped keep employee health in focus.  Further, the health screening is being gradually extended to family members who are covered by insurance.

The article strongly supports the idea that such programs should be voluntary.  They should not be a condition for offering coverage.  And there should be a reasonable alternative for those who cannot achieve the medical goal.  Although there is not general agreement about what that alternate would look like.  The perception is that they are not voluntary as portrayed, as you are charge premium not participating. 

Taking the example of Broward County, which recommends employee participation in screening programs, and charges them if they decline.  Those who participate are offered disease management program for asthma, high blood pressure, diabetes, congestive heart failure or kidney disease.  This was disputed by the state of Colorado, which necessitated that the program be accredited, not penalize workers for not participating or not meeting the benchmarks.  This and other legislations recommended provision for alternatives and raised their concern that linking test results to insurance premium can result in discrimination.

They do raise the point rather strongly that by making deductibles higher, the employers are making life tougher for those already sick.  Though the employer contest this claim as they feel as they are the ones paying for insurance cost, they have every right to impose such measures. 

From the available data so far, it is hard to gauge the impact on the health care bill of employers.  Although have been reasonably successful in taking employee off smoking, the results for obesity have been less remarkable.  That could be due to the fact that the latter is multi-factorial.

Overall, I would agree with such financial incentives as they not only save money but also help keep one healthy.  I would call it an example of positive discrimination.  It may be called as loss of privacy by some, but they should see it as a greater good for themselves. 

It is indeed a good idea to involved the spouses or other family members in the screening process, especially if they are also covered by insurance.  It becomes necessary because employees are known to take leave because of illness in the family.  So, that would be loss of productive days even though the one employed is not sick. 

There is a lot of mention that the screening programs be voluntary.  I would party agree that agreeing to participate should not be a condition for employment.  But, there should  be disincentives for not participating.  As for alternatives for those who are unable to achieve the medical goals, there could be a few alternatives.  One of the possible one could be to pay them a fixed amount, which will allow them to purchase coverage from health care exchanges.  Also those who are suffering from  non-lifestyle diseases should be exempted as it of no fault of their own.  Included in this list should be those whose condition cannot be reversed by changing lifestyle behavior, such as those in advanced stages of Diabetes, Cardiovascular diseases, Cancer, etc.  With insurance cost of those undergoing assessment getting reduced, resources can be freed up for those critically or with disability.  Another option for those already having health problems is standard premium with penalty or best plan from exchange, whichever is lower.  Either way, health problem should not be a condition for employment. 


Appleby, J. (2014). Employers tie financial rewards, penalties to health tests, lifestyle choices – kaiser health news. [online] Retrieved from: http://www.kaiserhealthnews.org/stories/2012/april/02/employers-financial-rewards-penalties-health-tests.aspx [Accessed: 2 Jan 2014].

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