With the controversy swirling around the Affordable Care Act and launch of health insurance exchanges, it’s easy to lose sight of a Megatrend the 2010 law could accelerate: healthier people!

Affordable Care Act Megatrends 1, 2 and 3, respectively Uncertainty, Re-imagination and Consumer-Directed Health, will inevitably lead to a new culture of personal health responsibility as a keystone of employer-sponsored health benefits.

History will judge healthcare reform on many levels, including by the success of the exchanges, the response of individuals and employers, the effect on health costs and insurance premiums, the burden of employer compliance mandates, the impact of subsidies on the federal budget deficit, entitlement spending and taxes, the reduction in the number of uninsured, now roughly 50 million, and the involvement of government in healthcare, with Medicare, Medicaid and now “Obamacare.” But at the end of the decade the biggest test may be whether Americans are healthier. Read more.

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ACA Megatrend #4: Healthier People

Thu Oct 10, 2013

With the controversy swirling around the Affordable Care Act and launch of health insurance exchanges, it’s easy to lose sight of a Megatrend the 2010 law could accelerate: healthier people!

Affordable Care Act Megatrends 1, 2 and 3, respectively Uncertainty, Re-imagination and Consumer-Directed Health, will inevitably lead to a new culture of personal health responsibility as a keystone of employer-sponsored health benefits.

History will judge healthcare reform on many levels, including by the success of the exchanges, the response of individuals and employers, the effect on health costs and insurance premiums, the burden of employer compliance mandates, the impact of subsidies on the federal budget deficit, entitlement spending and taxes, the reduction in the number of uninsured, now roughly 50 million, and the involvement of government in healthcare, with Medicare, Medicaid and now “Obamacare.” But at the end of the decade the biggest test may be whether Americans are healthier.

In this sense, healthier people will be the most decisive ACA Megatrend.

Meanwhile, as employers are pushed to aggressively manage ACA cost and compliance pressures, they will increasingly see the potential of wellness initiatives to help contain costs—including developing new concepts of “wellness” based on value outcomes.

Spurred by the healthcare reform law’s special incentive for employment-based wellness designs, i.e., up to 30 percent discounts for participation in health-contingent and other programs, employers will invent new value-based wellness opportunities. Indeed, employers will leverage the law’s incentive flexibility not only to offer but to drive participation in wellness programs. 

This is already happening. Consulting firm Towers Watson in a recent survey found that some 70 percent of employers have “outcomes-based incentives” either in place today, planned for 2014 or under consideration for 2015 or 2016.

Employers and participants are redefining the vocabulary of “wellness”—to encompass new and more proactive strategies built around health management and personal responsibility. As ACA implementation unfolds in 2014, 2015 and beyond, employer health plans will increasingly shift from Defined Benefit to Defined Contribution models. As with 401(k)-type retirement plans, employees and their families will assume more responsibility for costs, plan choices and, of course, outcomes—in short, for their personal health management.

To be sure, employers will help employees navigate the health care waters so that employees have the knowledge and resources to take more ownership of personal health.

The key elements of the new designs are clear: employee engagement; risk targeting; innovative web portals; high-risk case management; nurse navigators; health and wellness seminars; employee communication campaigns; health and fitness activities; weight loss and smoking cessation seminars; new social media like Twitter, Facebook and Yammer; and, of course, wellness solutions that offer a variety of engaging resources and tools that empower employees to be healthy, engaged and productive. Ceridian LifeWorks is a leader in providing such solutions.

By 2020 ten years will have passed since President Obama signed the Affordable Care Act into law. By then it will be possible to judge the success or failure of the most sweeping piece of social policy legislation since Medicare in 1965.

Will the state exchanges be working to make affordable insurance available to the uninsured? Will employers still be sponsoring top quality employee health benefits? Will the number of uninsured be significantly reduced? Will the U.S. still boast the best medical care system in the world? Will skyrocketing health costs have been contained? And most importantly, will Americans be healthier than they are today?

If employers help build, with working families, a new workplace culture of outcomes-based wellness, healthier people will almost certainly be the answer.