Employers rethink wellness efforts under new law

At Manufacturers Chemicals, based in Cleveland, Tenn., employees get $150 if they meet health goals established with a nurse, based on a semi-annual assessment of their health risks, including routine blood work. And just for participating in the assessment, employees get a $35 gift card to Walmart, said Melody Alexander, human resource manager.

But in order to keep offering those incentives -- a major driver of participation in the company's wellness program -- and still be in compliance with a new federal law, the chemical manufacturer must strip the health risk assessment of questions related to genetic information, including family medical history.

Ms. Alexander said she worries that without that family history, "we can't be as proactive. If an associate has a prior history of cancer in the family it's not something we can head off at the pass and recommend they seek (screening) services through the chronic care program."

The Genetic Information Nondiscrimination Act, which went into effect last year, prohibits discrimination in employment decisions -- like hiring, firing and promotions -- based on genetic information. The law also doesn't allow companies to offer incentives for employees to participate in health risk assessments if those surveys ask about family history.

Proponents say the new law is a necessary addition to close loopholes and create consistency between widely varying state laws regulating the use of genetic information. But some businesses are concerned the law will hinder their efforts to evaluate workers' health, get at-risk workers involved in health management programs and hopefully avoid expensive medical claims down the road.

"It's a problem," said Jerry Burgess, president and CEO of Health Care 21 Business Coalition. The nonprofit association of employers ... "The law, in trying to do the right thing ... has sort of over-stepped its bound and is doing damage to (efforts) to control health care costs."

REDUCING RISK

Health risk assessments are an increasingly common component of wellness programs that aim to improve employee health and save employers in health care costs, human resource managers say.

More than half of all employers give their employees health risk appraisals, and 20 percent more plan to do so in the future, according to a 2009 survey from Aon Consulting, which provides consulting on management and human resources for businesses.

"Every company is trying to reduce the health care costs and one of the reasons for doing a health risk assessment is so they can reduce those risks" for high-cost health events, said Dr. Teresa Baysden, medical director of corporate wellness at Mohawk Industries. Mohawk began a wellness program a few years ago, which includes health risk assessments for employees. Wellness coordinators have removed family history-related questions from its assessments, since the company does offer incentives for participation, Dr. Baysden said.

The Hamilton County government and the city of Chattanooga have done the same, HR managers say.

Under the new law, health insurers can cannot make underwriting decisions about who to cover and premium costs based on genetic predisposition to diseases that haven't yet manifested, said Mary Thompson, spokeswoman for BlueCross, in an e-mail.

BlueCross also removed questions about family history in its personal health assessments for its own employees, she said.

Dr. Baysden of Mohawk's wellness program said she has mixed feelings on the new legislation.

"I understand why this sort of (privacy) concern exists, but you really have the problem of educating the patient about what makes them more at risk for things like cardiovascular disease" if you can't question family history, she said.