SWEET HOME ALABAMAJulius Young, WorkersCompZoneFriday, August 22, 2008, 04:38 PM - Medical treatment under WC
Californians like to think of themselves as the ultimate trendsetters. From beach volleyball and skateboards to iPods and iPhones, it tends to happen here first.But consider Alabama. There's a cutting edge place for you. Hey, it's not Santa Cruz, Venice Beach or Cupertino, but even Tuscaloosa can generate a trend now and then. The State of Alabama plans to start surcharging obese state workers for part of their healthcare coverage. State workers who aren't fat will continue to get coverage for free. Those who don't meet the weight goal (a body mass index of under 35 or lack of progress thereto) will be paying $25 per month. Smokers are already surcharged in Alabama.
Other states have been experimenting with various financial incentives to promote wellness and reward healthy behavior. It's doubtful that we'll see these kinds of penalties in California workers' comp. As a statutory scheme, using a stick rather than a carrot will probably never fly politically. But it would be interesting if an insurer offered incentive programs to disabled workers to help keep them in shape. In an era of rising medical costs, might it be cost effective for an insurer to actually give small financial incentives (slightly higher indemnity payments?) to workers who met certain performance incentives? Incentives to workers who demonstrated motivation in their treatment regimen or progress dealing with associated problems such as obesity?
Granted, the current prevalence of utilization review and ACOEM guidelines seems to discourage such an approach. Try being a lawyer fighting for a gym membership or a structured weight loss program for a worker who wants to keep in shape. Sometimes you can win these fights, but it's a battle. But thinking outside the box wouldn't it be cost effective for a large insurer like SCIF to provide some gym or pool facilities or gym discounts where workers could keep in shape under proper supervision?
Silicon Valley companies have long recognized the advantages in this type of approach. In the comp arena it won't be effective for everyone. But getting the worker active is the whole concept behind functional restoration. The problem is that most injured workers have no workout equipment and no concept of how to get started. Keeping motivated is hard and the risk of reinjury is higher without training. And many workers are afraid to be too active lest they be accused of comp fraud. This is one concept that Arnold would understand.Stay tuned.
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