PEBB enrollment, HEM, obesity, health
Lovely day to do your PEBB enrollment. The online system is pretty painless. Think about signing up for a health savings account, because last year's changes increased co-pays and deductibles and you want to pay those with non-taxed income. The new twist to the Health Engagement Model: they give you a lump sum and take it away if you don't do exercise or weight loss classes. While Kitzhaber's HEM sounds like a good idea for controlling health costs, the data are not encouraging. The NYT just reported that a major study of the effect of diet and exercise interventions on heart disease, with random assignment and an 11-year-panel of 5,145 people (obese diabetics) couldn't find any benefits. The treatment group lost weight, but there was no health improvement. 10/20/2012.
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As someone very familiar with the research, bottom line to these type of programs is that they are financially successful in reducing healthcare costs but it is because they keep the healthy, non-overweight people that way. They are very poor at reducing health care costs in obese, unhealthy individuals. The cynical perspective is that once they develop 3 indications for increased healthcare costs (e.g., overweight, low exercise, smoking, over drinking, diabetes, etc.), you can forget trying to help them. The best investment is keeping the healthy people healthy and not letting them slide into poor health.
ReplyDeleteI add the following data point (n = 1) to the discussion about the potential for improved health for obese diabetics, having been one: I reversed diabetes and returned triglyceride and cholesterol levels to normal, and eliminated all medications, by reducing body mass by 40% through diet and exercise. (In the study mentioned above, subjects lost an average modest 5%, which is probably why no effect was observed.) I am happy to have prevented Oregon from spending untold amounts on my current and future medical care, although the benefits to myself are far greater. However, I am reasonably confident that had HEM been in place at the time, it would have played no role in these changes. I have yet to complete my open enrollment/HEM classes, because I do not relish spending my time hearing from these folks about how to live a healthy lifestyle.
ReplyDeleteLast year the myProvidence company screwed up their data report to PEBB and left off everyone who was double covered. Initially the solution we got was to print a webpage and fax it. Seriously.
ReplyDeleteI talked to a tech support guy at myProvidence, and he knew that they screwed up the transfer, but said PEBB was refusing to accept corrected data.
Eventually it got sorted out without having to resort to technology from the 1980's.
This sample of 1 thinks this is a complete waste of my time. To save $17.00 a month I created logins for my wife and I and completed the surveys and videos for both of us. I'm pretty sure she won't benefit from that. Am I alone in treating this thing as a meaningless hoop to jump through?
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