The time is ripe. Rewards and incentives are everywhere but we lack a coordinated approach:
- Under the Stimulus package, $19B in provider incentives were created for the use of electronic health tools.
- Under ObamaCare, companies can spend 30 percent (and in the case of smoking cessation) 50 percent of annual premiums on rewards for healthy behavior. It is one of the few provisions of ObamaCare that Republicans and Democrats agree.
There is even progress under Medicare and Medicaid.
- There is a bill in front of Congress called the Medicare Better Rewards of 2013 which reward Medicare beneficiaries with up to $400 in incentives for healthy behaviors. More importantly, it is supported by two democrats – Senator Ron Wyden (Oregon) and Thomas R. Carper, (Delaware) and two Republicans – Rob Portman (Ohio) and Michael B. Enzi (Wyoming).
- On the Medicaid side, the Medicaid Incentives for Prevention of Chronic Diseases provides for $100 million healthy behavior program to urge Medicaid members to ditch unhealthy habits through rewards. http://www.netquote.com/health insurance/news/medicaid-incentives-program.aspx#ixzz2p01Y9QNZ.
The time is ripe for a national policy. The following is a construct of the Healthy America Rewards Act of 2014. The Act uses financial incentives as a cornerstone policy to fix the American healthcare system by providing monetary rewards to individuals for taking actions that save the system money. The Act’s basic elements are as follows:
- Consumers can earn up to $5,000 in financial incentives tax free
- Providers can earn up to $25,000 in financial incentives tax free
- All reward types are tax free (i.e., today some rewards such as gift cards and debit cards are taxable while premium reductions and other health rewards are tax free)
- Tax deductible for businesses
- All elements of incentives – the incentives and the administration – are included in medical treatment under medical loss ratio calculations of ObamaCare
- Medicare restrictions limiting dollar value of rewards removed and limited to $5,000 per year
- Medicaid restrictions limiting dollar value of rewards removed and limited to $5,000 per year
- Anti-discrimination does not apply if people opt in as long as reasonable alternative standard is offered to them to earn the same incentives
- Does not violate rebate laws
- Tax incentives or credits for companies that employ incentives
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