March 22, 2013
Should CVS Require Workers to Submit to Medical Screenings?
Retail businesses, large and small, are trying to hold down the cost of health insurance. The quickest way to do that is to have healthy employees who have little need for the insurance. To that end, CVS is requiring its roughly 200,000 workers a simple choice: Have an annual medical screening and provide the company with health stats such as weight, body mass index and cholesterol levels, or pay $600 a year more for coverage.
CVS, for its part, maintains that undergoing the exam and providing the health information is purely voluntary. On the other hand, voluntarily withholding the information will cost each worker $50 a month.
To be sure, CVS is not alone in asking employees to agree to healthcare screenings. Macy’s reportedly offers a similar $50 per month incentive to employees enrolled in certain of its health plans which, for a couple, can represent a $1200 annual savings. The Washington Post, citing an Aon Hewitt survey, found 83 percent of employers offer some type of incentive for workers who have tests done. Of those, 79 percent provide rewards for taking the tests while five percent hand out a penalty for failing to do so. The remaining 16 percent offer a combination of rewards and penalties.
"The general philosophy has been you tend to want to reward people for those behaviors," Stephanie Cronk, a senior vice president at Aon Hewitt, told the Post. "But there’s also a very strong body of literature that says [penalty] has a greater impact."
- The CVS health-screening debate – The Washington Post
- CVS asks workers to submit to medical screening – 7 News/WHDH.com
- CVS pours fire on debate about health penalties vs. rewards – The Denver Post
- ‘Voluntary’ policy at CVS for medical info dishes out $600 fine for non-compliance – The Washington Times
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Discussion Questions
Is the new CVS health screening policy the best way to get its workers in shape? Should CVS either penalize or reward individual employees based on the annual test’s results?
Poll
We would probably like to think that it is not the BEST way—that repeated positive mentionings might be the best way. However, it may well be a very effective way. The reward part (we’re continuing to cover you at our cost) is easy. The punishment side needs to be employed carefully—not all medical problems have an obvious preventable cause and an employee who develops such a problem should not be punished.
What does HIPPA have to do with it? Please set me straight.
Here’s what I read: “CVS, for its part, maintains that undergoing the exam and providing the health information is purely voluntary.”
I can understand CVS and other companies wanting to encourage their employees to be healthy. Using incentives (not penalties) is almost altruistic. Showing proof of examination and that certain tests were done could be appropriate for receiving the reduced premium advantage.
Exposure to personal health records crosses the boundary of privacy as I know it. Even if it were to be condoned (or agreed upon by employees) how does CVS insure security and confidentiality of that data?
And did I miss the part where CVS will use this information as part of a performance review or suitability for continued employment?
Help me out here. What do I not understand?
I definitely understand the logic and cost savings behind having healthy employees, and therefore, it’s tough to argue. But this trend will cause a very different type of social problem and economic issue for those who are not allowed to have jobs because they don’t have perfect health.
God, that’s creepy. I really wish we could get business out of the business of health care, but the only way to do that is to create a single payer system. This does not seem to be part of our national DNA.
I’m not feeling happy about CVS at the moment, and I hope its employees find other places to work. I interviewed there a lifetime ago, and as soon as I saw they were drug-testing everyone who worked there, I walked away on principle (yes, really, on principle).
In a free market that’s the only way to “just say no.” Walk away. Employment with any particular firm is “voluntary” too.
I understand the merits of a healthier population bringing down the cost of health care and insurance, but in this case and similar ones the real issue is privacy. The punitive aspect of the policy (the extra $50 premium per month) might or might not stand up to the privacy guidelines in HIPAA and other legislation—somebody with more expertise would need to weigh in (so to speak) on that subject.
Does CVS intend merely to punish employees who don’t subject themselves to the health screenings, or do they plan to provide incentives (in the form of lower premiums) to those who lose weight, manage their cholesterol, and otherwise improve their health profile? I’m skeptical on the second possibility.
Tough questions. Many people don’t ever have a physical, so may not have any idea that they have high cholesterol or high blood pressure until it’s too late and something has happened to them. Forcing/encouraging people by an employer rather than a spouse , family or friends (I think therein lies the issue and the rationale for the series of articles), to have a basic checkup may help many people realize that they have something that should be attended to before it becomes a more serious issue.
As to what works better, the question is, are you more willing to undertake an action because of a reward, or to keep what already have? In many cases, the latter has proved to be the case.
Other than the convoluted idea that healthcare is related to employment, this makes tremendous sense. Healthcare is a cost to companies. Companies must find ways to cut costs. If this cuts costs, do it.
Oh, we should care about the health of our employees? Come on, this is business.
Carefully placing words like voluntary and confidential into a corporate contract or offering does not remove the possibility of wrong actions occurring. At face value, this attempt to reduce healthcare costs may prove to be a little toxic for the company. Time will tell.
I agree with Joan’s comment—how can penalizing employees for not providing test results to their employer be okay with HIPPA requirements? Providing proof that the tests were conducted is one thing—the results can remain private between the doctor and patient. Providing test results to employers when the results can impact your employment (paying a higher amount for insurance) seems to be the kind of thing HIPPA was designed to avoid.
Penalizing or rewarding employees is a good incentive. I get it, sick employees cost more than healthy employees. Like any organization, members need to be fit and well in order to keep them winning. It’s in the best interest of shareholders that health costs be kept to a minimum.
The key here is what happens next. Are “pre-existing” employees suddenly economically disadvantaged because of their physical conditions? Are, say, obese people not hired in the future?
Do potential hires have to submit to pre-employment physicals and, if they have high cholesterol or blood pressure, are they likely to be passed over?
The best way to change behavior is through positive reinforcement. Instead of making people pay more for being out of shape why not reward them financially when they get in shape?
As retail becomes more reliant on hiring from an aging population it will have to reset its expectations. Sure, an army of hard bodies might reduce insurance pool costs, but is it realistic to believe an army of hard bodies will be flocking to retail for lifetime employment?
This is clearly a case for carrots, not sticks.
IMHO this just one of the problems with Employer Based Health Insurance. Small employers try to avoid plans all together and larger employer try to limit hours to avoid providing benefits and yet the individual market is costly and historically fraught with risks.
So rather than criticize CVS for clearly cold-blooded but absolutely logical business decisions, why not join a movement to bring US policy in line with other Advanced Economies and figure out a better solution to providing coverage?
When people won’t take responsibility for themselves, it is not their employer’s responsibility to babysit them. No employer has an obligation to provide anything beyond a safe workplace. The provision of health insurance is optional and the conditions of the provision of ANY benefit is at the discretion of the employer.
If you want the insurance, but don’t want to comply with the conditions, then move to a different employer. This policy may not be designed to get employees in “shape.” It may be designed to get rid of high risk employees! In many cases, employees who don’t take care of themselves don’t take care of their employer either.
Jack Pansegrau nailed it. Everything else is essentially just rearranging the deck chairs on the Titanic. Short-term, however, I’d be moving more chairs toward the carrot side of the deck, rather than the stick side.
I understand the thinking and logic behind what CVS is doing. Other posters have listed the benefits, but I agree with Paula Rosenblum. It’s creepy.
“Yet I’m actually surprised there’s as much interest in the news as there seems to be. CVS is hardly the first company to make such a request.” Washington Post
CVS’ faux pas, to the extent that they committed one, seems to have been a semantic one: describing as “voluntary” something that is clearly coercive. (And I’m amused by people who object to government “nannyism,” however minor and justifiable—e.g. wearing safety belts—but have no problem with similar edicts from employers … because employment is “voluntary”).
Beyond that, we find ourselves on the ever popular “slippery slope” of privacy vs. efficiency, and the obvious questions of “what next” and what—if anything—is it NOT OKAY to require. And the slope will get even more slippery as new technologies allow for all kinds of intrusiveness that didn’t exist in the past…because it was impractical to attempt them, not because people didn’t have the nerve to try.
It’s not just about good policy. For CVS, and any other company in the healthcare sector, it’s about corporate culture and serving your clients in an authentic manner.
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We would probably like to think that it is not the BEST way—that repeated positive mentionings might be the best way. However, it may well be a very effective way. The reward part (we’re continuing to cover you at our cost) is easy. The punishment side needs to be employed carefully—not all medical problems have an obvious preventable cause and an employee who develops such a problem should not be punished.
What does HIPPA have to do with it? Please set me straight.
Here’s what I read: “CVS, for its part, maintains that undergoing the exam and providing the health information is purely voluntary.”
I can understand CVS and other companies wanting to encourage their employees to be healthy. Using incentives (not penalties) is almost altruistic. Showing proof of examination and that certain tests were done could be appropriate for receiving the reduced premium advantage.
Exposure to personal health records crosses the boundary of privacy as I know it. Even if it were to be condoned (or agreed upon by employees) how does CVS insure security and confidentiality of that data?
And did I miss the part where CVS will use this information as part of a performance review or suitability for continued employment?
Help me out here. What do I not understand?
I definitely understand the logic and cost savings behind having healthy employees, and therefore, it’s tough to argue. But this trend will cause a very different type of social problem and economic issue for those who are not allowed to have jobs because they don’t have perfect health.
God, that’s creepy. I really wish we could get business out of the business of health care, but the only way to do that is to create a single payer system. This does not seem to be part of our national DNA.
I’m not feeling happy about CVS at the moment, and I hope its employees find other places to work. I interviewed there a lifetime ago, and as soon as I saw they were drug-testing everyone who worked there, I walked away on principle (yes, really, on principle).
In a free market that’s the only way to “just say no.” Walk away. Employment with any particular firm is “voluntary” too.
I understand the merits of a healthier population bringing down the cost of health care and insurance, but in this case and similar ones the real issue is privacy. The punitive aspect of the policy (the extra $50 premium per month) might or might not stand up to the privacy guidelines in HIPAA and other legislation—somebody with more expertise would need to weigh in (so to speak) on that subject.
Does CVS intend merely to punish employees who don’t subject themselves to the health screenings, or do they plan to provide incentives (in the form of lower premiums) to those who lose weight, manage their cholesterol, and otherwise improve their health profile? I’m skeptical on the second possibility.
Tough questions. Many people don’t ever have a physical, so may not have any idea that they have high cholesterol or high blood pressure until it’s too late and something has happened to them. Forcing/encouraging people by an employer rather than a spouse , family or friends (I think therein lies the issue and the rationale for the series of articles), to have a basic checkup may help many people realize that they have something that should be attended to before it becomes a more serious issue.
As to what works better, the question is, are you more willing to undertake an action because of a reward, or to keep what already have? In many cases, the latter has proved to be the case.
Other than the convoluted idea that healthcare is related to employment, this makes tremendous sense. Healthcare is a cost to companies. Companies must find ways to cut costs. If this cuts costs, do it.
Oh, we should care about the health of our employees? Come on, this is business.
Carefully placing words like voluntary and confidential into a corporate contract or offering does not remove the possibility of wrong actions occurring. At face value, this attempt to reduce healthcare costs may prove to be a little toxic for the company. Time will tell.
I agree with Joan’s comment—how can penalizing employees for not providing test results to their employer be okay with HIPPA requirements? Providing proof that the tests were conducted is one thing—the results can remain private between the doctor and patient. Providing test results to employers when the results can impact your employment (paying a higher amount for insurance) seems to be the kind of thing HIPPA was designed to avoid.
Penalizing or rewarding employees is a good incentive. I get it, sick employees cost more than healthy employees. Like any organization, members need to be fit and well in order to keep them winning. It’s in the best interest of shareholders that health costs be kept to a minimum.
The key here is what happens next. Are “pre-existing” employees suddenly economically disadvantaged because of their physical conditions? Are, say, obese people not hired in the future?
Do potential hires have to submit to pre-employment physicals and, if they have high cholesterol or blood pressure, are they likely to be passed over?
The best way to change behavior is through positive reinforcement. Instead of making people pay more for being out of shape why not reward them financially when they get in shape?
As retail becomes more reliant on hiring from an aging population it will have to reset its expectations. Sure, an army of hard bodies might reduce insurance pool costs, but is it realistic to believe an army of hard bodies will be flocking to retail for lifetime employment?
This is clearly a case for carrots, not sticks.
IMHO this just one of the problems with Employer Based Health Insurance. Small employers try to avoid plans all together and larger employer try to limit hours to avoid providing benefits and yet the individual market is costly and historically fraught with risks.
So rather than criticize CVS for clearly cold-blooded but absolutely logical business decisions, why not join a movement to bring US policy in line with other Advanced Economies and figure out a better solution to providing coverage?
When people won’t take responsibility for themselves, it is not their employer’s responsibility to babysit them. No employer has an obligation to provide anything beyond a safe workplace. The provision of health insurance is optional and the conditions of the provision of ANY benefit is at the discretion of the employer.
If you want the insurance, but don’t want to comply with the conditions, then move to a different employer. This policy may not be designed to get employees in “shape.” It may be designed to get rid of high risk employees! In many cases, employees who don’t take care of themselves don’t take care of their employer either.
Jack Pansegrau nailed it. Everything else is essentially just rearranging the deck chairs on the Titanic. Short-term, however, I’d be moving more chairs toward the carrot side of the deck, rather than the stick side.
I understand the thinking and logic behind what CVS is doing. Other posters have listed the benefits, but I agree with Paula Rosenblum. It’s creepy.
“Yet I’m actually surprised there’s as much interest in the news as there seems to be. CVS is hardly the first company to make such a request.” Washington Post
CVS’ faux pas, to the extent that they committed one, seems to have been a semantic one: describing as “voluntary” something that is clearly coercive. (And I’m amused by people who object to government “nannyism,” however minor and justifiable—e.g. wearing safety belts—but have no problem with similar edicts from employers … because employment is “voluntary”).
Beyond that, we find ourselves on the ever popular “slippery slope” of privacy vs. efficiency, and the obvious questions of “what next” and what—if anything—is it NOT OKAY to require. And the slope will get even more slippery as new technologies allow for all kinds of intrusiveness that didn’t exist in the past…because it was impractical to attempt them, not because people didn’t have the nerve to try.
It’s not just about good policy. For CVS, and any other company in the healthcare sector, it’s about corporate culture and serving your clients in an authentic manner.