Buried as Section 2705 of the Patient Protection and Affordable Care Act (ACA) is a provision of potentially momentous importance. Beginning in 2014, employers may use up to 30% of the total amount of employees? health insurance premiums (50% at the discretion of the secretary of health and human services) to provide outcome-based wellness incentives. Such rewards can ?be in the form of a discount or rebate of a premium or contribution, a waiver of all or part of a cost-sharing mechanism (such as deductibles, copayments, or coinsurance), the absence of a surcharge, or the value of a benefit that would otherwise not be provided under the plan.?
Although it may seem obvious that charging higher premiums for smoking (or high body-mass index, cholesterol, or blood pressure) would encourage people to modify their habits to lower their premiums, evidence that differential premiums change health-related behavior is scant. Indeed, we?re unaware of any health insurance data that have convincingly demonstrated such effects.
via Redesigning Employee Health Incentives ? Lessons from Behavioral Economics ? NEJM.
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