More than one-third of U.S. workers would consider dropping their employer-provided health insurance if they become eligible to purchase similar coverage through other avenues, according to a survey of more than 3,000 American workers and their dependents.
The survey was conducted in March 2010 by consultancy Hewitt Associates and the National Business Group on Health (NBGH), a nonprofit association representing large U.S. employers. It found that most Americans use and appreciate the value of employer-sponsored health care coverage. Moreover, employees overwhelmingly would prefer and expect to see their employers continue to provide coverage in the future. However, more than one-third (35 percent) would consider dropping employer coverage if they were eligible to purchase similar coverage for a lower cost in the marketplace.
Five Key Insights
The Hewitt/NBGH survey offers five key insights into how employees and their dependents view health care, intended to help employers assess their current and future health care strategies.
Insight #1:
Employees know how to get healthy, but many aren't taking action. Employees and their dependents are more involved in managing their health and health care options than ever before and know what actions will lead to better health:
• Most (84 percent) believe making smart choices in daily life leads to good overall health.
• Almost three-quarters (72 percent) think good health is a result of getting regular preventive care.
But this understanding does not seem to be translating into individuals taking actions that will improve their health directly:
• Only half of employees think they do a great or good job of eating healthy.
• Less than half (46 percent) reported doing a great or good job of exercising on a regular basis.
Insight #2:
Participation in health programs is low, but satisfaction is high. Employees and dependents say they know what actions they need to take to get and stay healthy, but participation in many employer-provided health improvement programs is not as high as employers would like. Respondents ranked the following among the most popular programs:
• Biometric screenings (ranked highest by 61 percent of respondents).
• Online health information tools (53 percent).
• Health risk questionnaires (41 percent).
Stress management programs and employee assistance programs (EAPs) were the least popular, with just 9 percent participation in each.
Despite low participation rates, the Hewitt/NBGH survey shows that workers who take advantage of available programs, tools and services are generally satisfied with them. The programs with the highest employee satisfaction rates include:
• Blood screenings (ranked highest by 91 percent of respondents).
• On-site health centers (83 percent).
• Physical fitness programs (78 percent).
Assistance with stress reduction/management and help with claims resolutions were among the programs with the lowest levels of satisfaction (60 percent and 59 percent respectively).
Insight #3:
Internal motivators can be just as effective as financial ones. Many employers presume that offering cash incentives in exchange for participation will generate the best results and incent employees to participate in health care programs. However, employees are equally motivated by intrinsic factors and the use of incentives/penalties:
• Nearly half (48 percent) say they would complete a health risk questionnaire without an incentive because it is "the right thing to do," versus 29 percent who would participate with an incentive and almost the same number (28 percent) who would complete it to avoid a penalty.
• 44 percent would participate in a wellness or health improvement program offered by their employer because it's the right thing to do, versus almost a third (32 percent) who would participate if they were incented and 30 percent who would participate under threat of a penalty.
"The reality is that we all need a nudge at times to make the right health choices, and we learned through this research that the nudge doesn't always have to involve money," said Joann Hall Swenson, a principal and health engagement leader at Hewitt Associates. "Financial incentives can work well, but organizations should also harness the power of intrinsic motivators like people wanting to stay alive and well for their families. The trick for employers is finding the right blend of motivators that works for their population."
Insight #4:
Skepticism and confusion get in the way of healthy actions. Further complicating the disconnect between workers' intentions to get healthy and their actions, a majority of workers and dependents are confused when it comes to what information to trust about their health. The top employee obstacles to making informed health care choices were:
• Not knowing which information to trust (58 percent of respondents).
• Confusion over what is covered by the plan (54 percent).
• Not knowing how much things cost (47 percent).
• Inability to see a doctor quickly when needed (42 percent).
"Companies need to remove as many barriers as they can that get in the way of employees taking the right actions—whether those are administrative, financial, geographic or environmental," said Cathy Tripp, a leader and principal in Hewitt's Health Management practice.
Insight #5:
Workers want targeted and personalized communication. To help cut through the clutter of health care messages, employees and their dependents are asking for more personalized communication that is relevant to them:
• Almost half (44 percent) want customized, targeted reminders that are appropriate for them based on factors such as their age and gender.
• 41 percent would like personalized health program recommendations.
• 40 percent requested online personal health records.
"Workers know what they need to do to manage their health, but unfortunately that's not enough," said NBGH President Helen Darling. "To turn this knowledge into positive actions, individuals need very specific tools, tactics and motivation. As employers consider making changes to their health care benefits in response to health care reform, they have a great opportunity to revitalize their existing strategy and create programs that will promote workforce health and productivity and hold down overall health care costs."
Stephen Miller is an online editor/manager for SHRM.
Related Articles:
Automated but Personalized Reminders Improved Medication Adherence, SHRM Online Benefits Discipline, May 2010
Employers Weigh Health Care Strategies, SHRM Online Benefits Discipline, March 2010
Employers Change Health Benefits to Cut Costs, Alter Behavior, SHRM Online Benefits Discipline, March 2010
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