Design Levers Used to Promote Healthy, Cost-Effective Behaviors


By Stephen Miller June 14, 2010

Most U.S. employers use some elements of value-based design (VBD) in their health benefits programs to promote healthy behaviors and rein in unnecessary costs, according to a survey conducted by Buck Consultants and The Center for Health value Innovation, an information exchange for value-based design. The value-Based Design 2009 survey studied 100 U.S. employers in 16 major industries, reporting on more than 1 million covered people, including retirees. Key results are shown in the table below.

Levers to Promote Healthy Behaviors​
value-based design uses benefit design and delivery levers to improve health outcomes and curtail unnecessary spending through behavior change. Survey respondents indicated that they:

Use incentives as part of their prevention/wellness programs.


Use incentives to promote disease management compliance.


Reduce or waive co-pays for choosing the lowest cost appropriate site of care (e.g., urgent care, convenient care, on-site services, medical travel).


Waive employee cost sharing for a yearly screening exam.


Use incentives for chronic care management (e.g., to promote compliance with treatments for high blood pressure or elevated cholesterol before heart disease develops).


Provide incentives for the use of employee assistance programs.


Cover depression under care management program.


Provide insurance premium incentives for completion of a health risk assessment.


Provide incentives for financial counseling (seeking to reduce employee stress levels).


Source: The Center for Health value Innovation and Buck Consultants.

Staying the Course

According to the survey respondents that currently have value-based design incorporated into the health program for employees, 79 percent made no changes in 2009. Additionally, more than one-half of these companies (56 percent) expected to make no changes in these benefits in 2010.

“This survey examines the experience of companies of all sizes and sectors with a value-based design in place for two or more years,” explained Cyndy Nayer, president and CEO of the Center for Health value Innovation. “In particular, this survey demonstrates increasing focus on employee assistance programs, depression and financial counseling, which ties in with our goal to expand the definition of VBD and link it to total health and performance. We see a growing expansion of value-based design, linking the health and wealth of the individual to the health and wealth of the organization.”

“Despite the recession—when employers are more likely to cut expenses by changing their benefits—few of the organizations using VBD changed their benefits structure,” added Michael Jacobs, a principal for Buck Consultants. “The survey responses prove that organizations using VBD understand the vital importance of this approach.”

According to Jack Mahoney, chief medical officer of the center and former corporate medical director for Pitney Bowes, “One common measurement of improved VBD activity is that 74 percent of survey respondents indicate that employees are now getting preventive exams and annual screenings. We see this as a tipping point and envision landmark changes ahead as more employers embrace VBD to drive change by improving the health and productivity of their workforce.”

Stephen Miller is an online editor/manager for SHRM.

Related Articles:

Insurance Alone Won't Make for a Healthier America, Most Believe, SHRM Online Benefits Discipline, June 2010

value-Based Insurance Design Sparks Increased Interest, SHRM Online Benefits Discipline, February 2009

Quick Links:

SHRM Online Benefits Discipline

SHRM Online Health Care Reform web page

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