Ninety-six percent of the employees covered by the state health care plan have enrolled in a new wellness plan that was the subject of controversy surrounding a union concession package earlier this year.
The plan requires members to get recommended preventive care, and requires those with certain chronic conditions to participate in disease management programs. People who don’t participate will be required to pay an additional $100 a month in premiums and face a deductible.
The participation rate is far above the 50 percent rate that Gov. Dannel P. Malloy’s administration estimated in projecting that the health enhancement plan would save $102.5 million a year in the first two years, primarily from the added premiums people who don’t participate would pay.
The plan is aimed at encouraging state employees and their families to get preventive care in hopes of reducing the need for more costly interventions if people become ill.
“One of the Program’s goals is to reduce costs by focusing on prevention, rather than expensive acute care that often results from lack of coordination of health care, particularly for certain chronic conditions such as diabetes, asthma, heart disease/heart failure, high cholesterol or hypertension,” Lembo said in a statement released by his office. “It will help our workforce and their families live healthier lives by identifying medical issues early through prevention and better management of chronic conditions, which, left untreated, are costly and compromise quality of life.”
The plan was developed as part of a concession package for unionized state employees that the Malloy administration has said will save $1.6 billion over two years. But critics have questioned whether the health plan savings are realistic since employees would be required to receive screenings and exams and any potential health care savings are likely to come in later years. The legislature’s nonpartisan Office of Fiscal Analysis said it could not assess the savings figures because it did not receive sufficient data.
When the plan was first presented, many unionized state employees raised concerns about the health care changes. The unions rejected the deal in June, but passed a clarified deal last month.
People in the Health Enhancement Program will be required to get age-appropriate wellness exams and screenings, such as Pap tests, colorectal cancer screenings, mammograms and vision exams. Those who are in the dental program would also need to get regular dental cleanings.
People with diabetes, asthma, chronic obstructive pulmonary disease, heart disease, heart failure, high cholesterol or hypertension will be required to participate in an education and counseling program for the condition. They will not be charged any copayments for office visits to address the conditions, and will pay reduced copayments for drugs related to them. People or families that comply with the program will get $100.