Over the last few months, we’ve received a number of questions about the Affordable Care Act and how it affects small businesses.
In addition to tax credits for providing health insurance to employees, the Affordable Care Act offers many small businesses incentives for creating wellness programs—things like smoking cessation seminars, reimbursement for gym memberships and insurance discounts for healthy employees. These wellness programs can drive down the cost of your company’s (and the nation’s) healthcare significantly. Giving employees a blueprint for better health and making a dent in your insurance costs can translate to a competitive edge in the marketplace.
Under the Affordable Care Act, many small businesses can reduce their insurance rates by 30 percent based solely on the wellness of their employees. As the rationale goes, an employee who has his or her immunizations (flu shot, tetanus, etc.) and meets the five “normals”—normal blood pressure, a normal waist circumference for his height, normal cholesterol, normal blood sugar, and no nicotine or tobacco products in the urine—will have a lifetime healthcare cost up to 50 percent below the average American’s.
Now that you see the big picture, here are some of your questions—and our answers—on how to make this all work in real life.
Q: I want to improve the health of my employees to save on insurance costs, but I have no idea where to start. Any advice?
A: There are four guiding principles to lowering healthcare costs and help employees be healthier:
1. Change the culture.
To help your employees understand the importance of improving their health, you have to educate and motivate them. Start by sharing these impactful facts: America is almost twice as expensive for healthcare costs as a percentage of GDP as Canada and Europe and three or four times as expensive as Mexico, China and India; we have twice the chronic disease of Canada and Europe and four times that of Mexico, China, India and Japan; four factors—tobacco use, physical inactivity, food choices and non-managed stress—are responsible for the vast majority of chronic disease.
Then tell them the good news: We all have it within our control to improve our health and lower everyone’s health costs. People’s perceptions are best changed when led by a CEO and management in a team effort. Emphasizing why health is important to everyone’s job, the company and the person’s own life can go a long way.
2. Improve the environment.
Make your company a place where healthy behavior is easy and a no-brainer. This involves everything from declaring it a no-smoking environment to eliminating unhealthy junk from cafeterias and vending machines and fostering physical activity.
3. Introduce wellness programs.
People are most successful making behavior changes when they’re supported, so providing tobacco cessation and stress-management programs, fitness seminars and other offerings is key. These equip employees with specifics and game plans, which are important.
4. Provide incentives.
A Health Reimbursement Account (HRA), which pays back employees for qualifying out-of-pocket medical expenses, is great for people who are already healthy, but isn’t cost-effective or a path to better health for those who need major lifestyle changes. To get real results, it’s better to use those aforementioned immunizations and five “normals” as incentives. Make sure employees understand that when they reach these goals they will save money, or receive some reward from the company.
Q: I’ve heard there are links between exercise and increased productivity. So does the CEO have a real reason to frown on the 20-minute afternoon walks I take with my co-workers?
A: There is research showing that taking a break of 10 minutes every two hours improves productivity and more than pays for itself. As for those longer walks, you’re probably discussing business, so you’re not necessarily losing out on work time (and it counts toward the 10,000 steps that should be our daily goal). We often conduct one-on-one meetings as walking meetings so both parties get some physical activity while talking shop.
You might also encourage your CEO to look into a few standing desks or treadmill desks for employees to take turns using.
Q: At my business we seem to lose a lot of work time to smoke breaks. How can I curb this habit in my employees without alienating them?
A: Offer free smoking cessation programs. Only about 4 to 7 percent of people are able to quit on their own, without any help, but that statistic rises to 25 percent or higher when medications, counseling and other techniques are used.
You’ll also want to ban smoking anyplace on your campus, and don’t allow smokers any more time than all your employees get for breaks. Yes, you might alienate a few, but you’ll make everyone healthier: A handful of studies have found that in cities and countries where smoking was banned, the heart attack and hospitalization rate for nonsmokers dipped as much as 25 to 35 percent two years later. As for absorbing the cost of the free quit-smoking program, take a long-range view of things: The savings in insurance costs and lost work time will far outweigh the costs of the programs.
Q: I’d like to organize a weight-loss contest at our office. How can I ensure maximum participation?
A: The key is to make it a fun, supportive, collaborative effort. We recommend having everyone choose a buddy or team as opposed to flying solo—no one wants to go it alone.
Giving employees tools and programs to follow makes it easier. At our clinic, we saw the largest participation when we offered multiple programs to help—free Curves and Weight Watchers memberships as well as free online weight-loss coaching. We also utilized social media to provide motivation and raise awareness of upcoming challenges.
To make it even more tempting, consider rewarding the winning team (or everyone who reaches a certain weight-loss goal of, say, 10 pounds) with a chance to win a prize drawing. You could even poll employees to see what they think would motivate them to get involved—like a day off, a party or a cash prize.