UnitedHealth Is Big On Its Workers Getting Skinny

Sept. 22--UnitedHealth Group Inc. is doubling down on weight-loss programs for workers.

This month, about 100,000 people in the Minnetonka-based insurance giant's employee health plan will be offered a new weight-loss program called Real Appeal. It includes one-on-one coaching, a weekly online television show featuring celebrity chefs and entertainers and complimentary blenders for making smoothies.

It combines science and entertainment to tackle obesity and diabetes, the company says.

"Real Appeal is about more than just losing weight, it's about feeling great and having fun," Seth Tuckerman, the program's chief executive, said in a statement announcing the effort.

The enhanced effort at UnitedHealth comes as the jury is still out on whether programs that promote healthier lifestyles can be justified in terms of their financial return on investment.

"We have not been able to find that changing lifestyle actually results in savings here at the U," said John Nyman, a University of Minnesota professor who has studied the cost-effectiveness of the U's employee wellness program.

More than one-third of American adults are obese, according to the U.S. Centers for Disease Control and Prevention. Annual medical costs for people who are obese are $1,429 higher than those who maintain healthy weight, with obesity costing the country an estimated $147 billion in 2008, according to the CDC.

To reduce health care benefit costs, more employers are offering general wellness programs, according to the Society for Human Resource Management. Such programs can have a variety of features, including "disease management" for people with certain chronic conditions that can lead to costly hospitalizations.

While more employers have been offering disease management as part of wellness programs, the share targeting weight loss has held steady at roughly 33 percent, according to the trade group for human resource professionals.

Why it matters

"A number of health problems are associated with excess weight and other types of preventable and chronic conditions," according to a report this summer from the Society for Human Resource Management. "These conditions affect the health and well-being of employees and also have a significant economic impact on businesses."

UnitedHealth Group employs about 14,000 people in Minnesota. For several years, workers at the company have had access to a diabetes prevention program with the YMCA that provided tools for weight-loss and fitness.

Participation has been modest, however, compared to a recent pilot of the new program in Ohio, said Tuckerman, who heads up Real Appeal, the California vendor that's developed the weight-loss program. Less than halfway through a 52-week pilot of the program, 37 percent of participants at-risk for heart disease or diabetes due to weight had achieved the target weight loss of 5 percent or greater.

The new program touts "star-studded video content," among its features. It's a contrast to the old program, which required participants to provide blood samples so clinicians could monitor the impact.

"We don't have to get their blood," Tuckerman said. Real Appeal "doesn't try to attract people by scaring them."

Participation in the weight-loss program is voluntary, he said, and there aren't financial incentives to encourage participation at UnitedHealth Group.

"One of the habits most associated with lasting weight loss is that you replace either a snack occasion, or perhaps breakfast or even lunch, with a healthy smoothie as a habit," Tuckerman said, adding that Real Appeal supplies recipes, too.

As the nation's largest health insurer, UnitedHealth Group will offer Real Appeal to health insurance customers in its UnitedHealthcare division. The company is an investor in Real Appeal.

Science and motivation

This summer, UnitedHealth Group Chief Financial Officer Dave Wichmann said during a conference call with investors that the program "merges proven science in diabetes prevention with motivational, multimedia weight and lifestyle management programs."

Nyman, the U researcher, did not comment on the particulars of Real Appeal, or UnitedHealth's employee program.

At the U, lifestyle management programs aimed at better diet, more exercise and less smoking hasn't paid for itself, Nyman said. The U has seen savings, however, from the disease management portion of the program, which has covered the overall costs, Nyman said.

Research from the Rand Corporation has underscored these points, with researchers calculating a return of $3.80 for every $1 invested in disease management, but a return of only 50 cents for every $1 in lifestyle management.

Even so, employers continue to be interested in lifestyle management programs, Nyman said, noting that the federal Affordable Care Act encourages such programs.

One of the challenges with demonstrating savings from lifestyle changes, he said, is that it could take many years for avoided health care costs to materialize. Plus, the longer it takes to see any such savings, the more likely the cost benefit will be realized by a different employer as workers change jobs.

"I think a lot of employers and maybe the vendors are going way from return-on-investment arguments, and trying to capture a broader measure of the benefits from this," Nyman said. "Does this actually improve someone's health? Does it improve their performance at work? Does it mean they're away from work less?"

Twitter: @chrissnowbeck

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