Dr. Paul Summerside, CEO of Aurora BayCare, Green Bay, had a number of interesting insights:

•  In regard to Fitness/Wellness of their employee group (about 450 at BayCare), they take the position that "It's All About Nutrition and Fitness."  If a person does the right things in those areas, all the other benefits will follow and they will need the medical system services, including prescriptions, at a bare minimum.  Thus, they incent for Fitness ... and evaluate QUARTERLY employees on a range of fitness performance elements ... situps, pushups, step test for aerobics, and the like, with performance thresholds adjusted for age.  The better a person does, the less he/she will pay for his/her health insurance plan ... and has a chance QUARTERLY to show improved fitness, and earn an even lower premium.

•  "Trying doesn't matter.  The only thing that matters is success."

•  As an employer, "if you don't change the actuarial metrics of your employees, don't expect any insurance cost improvements."

•  As an employer, "we feel the responsibility to put in place programs and incentives that help them achieve success in these areas.  But we will reward only on achievement, not 'trying.'"

•  "People have to know in advance what they'll be measured on, and the consequences.  The tests have to be reasonable and achievable, and easy to understand."

•  There are FIVE AREAS you have to impact:  OBESITY, EXERCISE, SMOKING, ALCOHOL in moderation, and SEAT BELT USE.

•  From a medical cost standpoint, this is what you are dealing with relative to norms:

--  Obesity will cost you about 40% more.

--  Smoking will cost you about 10% more.

--  Exercise will reduce your costs 10%-15%.

•  Of interest, even though they are a medical organization, they don't include Health Risk Assessments as part of their program.  They feel that the knowledge gained about risk factors in an HRA should be already known  and worked on with a physician, and that it drives higher costs through use of drugs to control risks ... rather than a better lifestyle to do it (nutrition, volume, vigorous exercise).