Schafer: Distilling health to a single number

The future of employee wellness programs may be an individual health score, much like a consumer has a credit score.

The idea is that a person with a health score will care about it and try to raise it. Good things happen if it goes up -- including breaks on the employee-paid portion of health insurance.

Allina Health of Minneapolis is one of the larger companies to adopt this scoring approach. Just last weekend, Allina completed assessments and personal coaching in its first year of broadly using myHealthCheck, a model developed by Chanhassen-based Life Time Fitness.

The result for an Allina staff member is a single number from zero to 100, based upon factors the employee can control.

The scoring system seems simple enough for participants to grasp. It relies on a blood test rather than taking an employee's word on questions such as tobacco use.

Life Time's myHealthCheck factors data including blood pressure, the ratio of "good" and "bad" cholesterol, blood glucose, evidence of smoking and body fat.

Life Time just landed three new users in the Twin Cities, according to a spokeswoman, but its key partner is Allina. They consider their relationship a partnership.

His firm uses a biometric scoring system much like the one Allina got from Life Time. Kelly said the firm got its start in 2006 based upon frustration with how little accountability there was in a typical corporate wellness program.

"For the 30 years corporate wellness programs have been around, they have been, and mostly still are, participation based," he said. "You get some kind of credit for participating regardless of the outcome. What we wanted to do was expect an employee to reach an outcome, to manage their health, to improve their health, to be compliant with a doctor's recommendation."

HealthCheck360° has about 140 employer clients with 60,000 employees and consults with other companies with thousands more.

The idea behind health scoring is not to be punitive, and Kelly talked about how his firm's scoring can be fair.

A person with a score of more than 90 is very fit, with blood pressure that is controlled, a low percentage of body fat and no evidence of smoking. As he could not really do much better, a financial incentive on health insurance premiums is earned just by staying at an upper level.

A much smaller group of people with a chronic health condition, or perhaps a genetic predisposition to disease, may never get a great score. They can still earn the full incentive by showing they comply with doctors' recommendations on care.

Kelly said implementation never fails to raise the overall health of an employee group.

For a health care provider like Allina, the temptation is to see the use of health scoring as a test of an approach it wants to someday integrate into services it brings to market.

That isn't the case, at least not yet. Robert Wieland, a physician who leads Allina's clinic system, and Steve Wallner, vice president of compensation and benefits, described a thought process not much different from managers of any self-insured company.

"We are trying to bring our population to a better health status," Wieland said. "We may learn lessons" that could be applied to other patient groups, he said, but that was not why myHealthCheck was deployed.

"If you score well you can get up to $1,690 of credits toward your [2013] premium," Wieland said. "We did not set the threshold very high, and we actually believe the majority of employees that participated will get the full credit."

Once the company gets aggregated data it will tweak wellness programs. Wallner said Allina wants to strike a balance between offering facilities, training and other support on the one hand and encouraging accountability on the other.

The accountability piece is gathering momentum. The global human resources consulting firm Towers Watson & Co., with the National Business Group on Health, surveys large employers annually, and it reported 10 percent of respondents were rewarding or penalizing employees based on personal biometric health data in 2012, but that 23 percent intended to implement it in 2013.

Kelly said very few employees grumble as health scoring comes to the workplace, even those with health issues or suspicions of employers' motives.

It's about the money. Kelly said a reward "is the most effective way to drive behavior change."