Hello
[Apols for cross-posting on HEN, AAHPN and the incentives lists, and for shameless self-pimping:]
As many on this list may know, but some may not, current US regulations permit socalled “wellness incentives” for things like not smoking, meeting BMI or blood pressure targets, and similar. Up to 20% of the cost of coverage of an employee may be provided (ie, assuming annual costs of $4700, in principle, something around $900 may be offered).
The health (insurance) reforms currently before congress may increase the cap to 30%, in some cases to 50%. Of course, as with everything else in the plans, it is somewhat uncertain whether these provisions will go anywhere. However if they do progress, depending on implementation, there may be significant equity issues. Already established initiatives of some benefit consultants also give reason to worry.
Colleagues and I put together a short commentary that looks at the proponent’s assumptions regarding personal responsibility; the carrot-stick question; and implications for the physician-patient relationship. Our main concerns regard the impact the polices may have on affordability; we urge not to increase levels; and to monitor closely the equitability of programs.
In case this is of interest to list members, the piece can be accessed here: http://healthcarereform.nejm.org/?p=2630&query=home Any views would be most welcome, and in particular it would be great to hear of examples people have come across where incentives have been implemented in a way that shift cost in inappropriate ways.
Best wishes and a happy New Year to you all,
Harald
PS
For any questions etc that you do not want to share with the list please email me at [log in to unmask] and please note that this email has been sent in a personal capacity and should not be seen in any way as a communication from the Nuffield Council.
___________________________________________
Harald Schmidt
Harkness Fellow in Health Care Policy and Practice
Harvard School of Public Health
677 Huntington Avenue, Room 1108B
Boston, MA 02115
Tel: 617.432.7904 or: 617.432.6892
Email: [log in to unmask]
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