Dakota County, taking a cue from private-sector efforts to control health costs, will dole out about $440,000 in financial rewards to employees who score well on such health and fitness key metrics as weight, body fat, blood pressure and cholesterol levels.

While wellness programs have become increasingly common in the workplace, officials believe Dakota may be the first Minnesota county to reward employees who adopt healthier lifestyles. The hope is that savings on health claims by the county’s 1,800 employees will eventually save taxpayers money.

“We pay a lot in health care benefits,” said Dakota County Administrator Brandt Richardson. “We know the underlying factor in this is healthfulness. It’s a challenge for our society.”

The county had been facing 12 percent annual increases in health care costs, Richardson said. “You compound that, and it’s worth taking a risk.”

The results-based approach is more ambitious and costly than previous efforts. The new program will pay about 10 times as much in insurance discounts as the county paid under its previous wellness program, in the form of one-time rewards to employees who complete an online health assessment.

In addition to the financial incentives, the county will pay $264,000 to myHealthCheck, a Life Time Fitness company, to run the program.

But the county is hopeful that program will eventually pay for itself through lower health care costs.

“The goal is that it’s self sustaining” after three years, said Nancy Hohbach, the county’s director of employee relations.

To get the program started, the myHealthCheck staff measured each participating employee for cholesterol, weight, body fat, heart rate, blood pressure, flexibility, strength and other measures. Lab work followed. Results, delivered by a health coach in a private conversation, establish a score that determines who qualifies for an insurance premium reduction of $25, $35, or $45 a month. Employees then are offered discounted health club memberships, activities, classes and athletic events to help them eat well and exercise consistently.

Progress will be measured with a second round of screenings next fall, when new scores will be issued for 2015.

A health credit score

Seeing their health score and understanding why they got it and how to change it helps people improve their health, said Jeff Ridgway, director of strategy and business development for Life Time Fitness’ total health division.

“It’s like a credit score for their health — it’s motivating for them to see that number rise from year to year.”

About 900 employees of the county, the state’s third largest, took the first health screenings last August.

Dakota County employee Erin Stwora, an assistant division director who says she already exercises and eats well, said she is pleased to have the program at work. “The incentives for it are great. Who can argue with wanting to be healthy and having the organization you work for reward you for being healthy?”

But not all employees are on board with the Dakota County plan. The wellness program has not won the endorsement of the union representing about 650 employees, the American Federation of State, County and Municipal Employees (AFSCME), which says it could unfairly penalize workers who have chronic health conditions.

Union officials said they’d be open to negotiating a results-based plan that offers incentives for such things as stopping smoking or exercising. “We would oppose a results-based plan that presumes a person can’t manage their chronic disease because they aren’t trying hard enough,” said spokeswoman Jennifer Munt.

Unionized nurses at Allina Health, where the myHealthCheck program is in its third year, also have resisted the program. At Allina, which has 22,000 participating employees, the company is also using other wellness programs — including Weight Watchers, coaching and smoking cessation programs — to lower medical and pharmacy costs.

The first year was a big shift and employees didn’t feel as comfortable having wellness based on their health risks, said Jodi Morris, benefits manager for Allina. But with a possible discount of $39 a month on insurance premiums tied to the screening, employee participation now is high, she said. “We are seeing employees wanting to make changes in their lifestyle to get healthier.”


Approaches evolve

Employers are still experimenting with the best way to keep health care costs down. Of large employers with wellness plans, about 55 percent offer biometric health testing, and of those, 10 percent use the results to reward or penalize workers, according to a Kaiser Family Foundation survey of employers released last fall.

Other local governments in Minnesota are trying their own approaches, but none has yet taken its wellness efforts as far as Dakota County.

Hennepin County takes $15 off the copay for doctor ­visits and Ramsey County takes $20 off the copay for doctor ­visits for employees who take a health risk assessment and participate in wellness ­activities.

New in Hennepin County this year is the replacement of an “open access” insurance program with unlimited numbers of hospitals and doctors with two networks that will control costs with more coordinated care and records, said Jeremy Zajicek, benefits manager in Hennepin County Human Resources.

Hennepin would like to move toward results-based incentives if it can find measurements suited to all cultures and body types, he said.

Dakota officials said they had to try something new.

A 2012 HealthPartners health assessment among county employees found that 36 percent were overweight and 27 percent obese. It determined that nearly 56 percent had poor nutrition and nearly 36 percent were completely inactive, leaving 40 percent of county employees at risk of developing heart disease or diabetes even though the previous wellness program included Weight Watchers, yoga, zumba classes and strength training.

People participated, “but there was no way of measuring whether that was having any effect at all on the health of the employees and our medical claims,” Hohbach said.

MyHealthCheck gets results because when people are given a motivating incentive to get healthier, they take action and they “take the time to understand what their issues really are,’’ said Matt Nyquist, vice president of Life Time’s total health division.

Dakota County Commissioner Mike Slavik of Hastings said the program had given him a new understanding of what he can do to ­offset a history of heart disease in his family. He learned what kinds of meals he will have to eat to take off weight and lower cholesterol to gain the top incentive.