Controversial Wellness Strategies.

Here’s more evidence that wellness programs pay for themselves –

Over the last two years, one organization in five has seen significant betterment in employees’ health status – and began to stabilize their costs – according to one study.

Among firms noting improvement, almost two-thirds (64%) feature wellness programs offering incentives for healthier lifestyles.

Here are three twists on traditional incentives that’re getting good results –

1. Health coach outreach

Many firms require workers to work with an individual health coach to get a discount on monthly premiums or earn cash incentives.

The most common set-up –  on a regular basis, the worker must set up appointments with and report to (either over the phone or face to face) his or her health coach.

But experience has shown there’s often a high dropout rate.

People  get off to a great begin – and they’re enthusiastic about the incentive – but once they realize there’s some effort involved, they lose interest.

The good news –  Firms have found a simple-to-arrange alternative that keeps  individuals  on the right track. Rather than requiring workers to contact the health coach, a growing number of organizations require participants to take calls from the health coach.

Potential result –  Fewer folks fall off the wagon. There’s no outreach effort involved, and the health coach keeps individuals  accountable.

2. Nutritional education/therapy

A newer – and cost-effective – feature in the battle against employee obesity –  offering an employee nutrition-education program administered by a expert nutritionist.

Just 11% of organizations – 18%  of big employers and 7.5% of small to medium ones – have such programs, according to SHRM’s most recent benefits survey.

Even fewer offer (via their EAPs) nutritional therapy for individuals  with consuming disorders. But available data on these programs shows they typically pay for themselves.

The stronger the firm’s emphasis on teaching healthy eating, the faster and more dramatic the reduction in major health claims.

Common plan features –  lunch and learns featuring healthful food choices, giving out nutrition-linked gift cards and extending obesity-prevention incentives to individuals ’s family members.

3. Assertive smoking cessation

A small, but rapidly growing number of companys are taking more aggressive measures to avoid the costs associated with employees who smoke.

The step could be broken down into three levels of aggressiveness and potential risk/reward.

Level one –  the business installs a wellness program in which non-tobacco use workers and those who commit to maintaining a healthful weight receive financial incentives that lower their share of monthly premiums.

Level two –  the employer disqualifies job candidates who smoke from hiring consideration. Alternatively, some firms require health risks assessments as a condition of being hired.

Level three –  the company docks pay or fires staff members who fail to control their lifestyle-related health risks.

Example –  Clarian Health made news last fall for sending notice to staff members that as of Jan. 1,  2009, individuals  who smoke or chew tobacco would start be charged $5 per paycheck.

Are these strategies legal? at level one, the answer is a certified yes. health insurance portability and accountability act (HIPAA)s non-discrimination rules permit such incentives within limits.

In a nutshell, it’s legal to reward employees who quit smoking but illegal to punish those who try and fail. If an worker tries but fails to quit smoking, you’re still legally obligated to give them another shot next year.

Also keep in mindthat, by law, the size of the reward or penalty under your wellness program can’t exceed 20% of the sum cost of coverage.

At levels two and three, it remains to be seen when such policies would hold up in court. Proceed with caution.