MINNEAPOLIS — Sandy Brezinski savored the savings last week when her preferred brand of organic tortilla chips went on sale.
Not only did her grocery store discount the item to $2.99, a program offered through her employer’s health insurance knocked another $2 off the price.
“You get that for 99 cents,” Brezinski said. “How good is that?”
More health plans are dabbling with programs that provide discounts at the grocery store for healthier foods, a concept that Minnetonka-based Medica brought to the Twin Cities about five years ago.
Kentucky-based Humana launched a program for grocery discounts in 2012 in conjunction with Walmart that continues to grow. Minnetonka-based UnitedHealthcare, which is the nation’s largest health insurer, began offering in 2015 a similar program in Wisconsin, and has recently expanded it to three more states. Both United and Medica use technology from a vendor in Plymouth that is marketing the program directly to employers, as well.
Nearly 10 years ago, the supermarket model was embraced by a large health plan in South Africa, and research shows the program has made a difference in getting people to buy healthier food, said Roland Sturm, an economist with Rand Corp.
But the goal of controlling health care costs with such programs by helping people avoid health problems is a long-run proposition that will be “very subtle,” said Sturm, who has published research on the South Africa program. Too often, he said, the benefits from wellness programs are overhyped.
“Of course healthier lifestyle will keep people healthier, and that in the long run will have an effect on health care costs, no doubt,” Sturm said. “Will it be this miraculous program that by giving people subsidies for healthier food or gym benefits you can save thousands of dollars in health care costs? No, that’s ridiculous.”
Card or mobile app
Medica makes the grocery discount program called “Healthy Savings” available to certain employer groups without listing an extra charge. Health plan members receive a card or mobile phone app that they scan at the grocery store to tap the savings.
Each week, the vendor that runs Healthy Savings e-mails a list of discounts. They apply to foods that an outside group called Guiding Stars has determined fall in the healthiest one-third of items in a typical grocery store.
Neither employers nor Medica receive information on specific food purchases by members, just the quantity of discounts used by individuals.
“In November of 2017 we went over the $1 million mark that members had saved,” said Ken Dickson, a senior director for product strategy and development at Medica.
The insurer says 217,530 enrollees are eligible for the program, of whom 62,710 people (29 percent) went online to learn about the program and set up their card or app for use. Nearly 30,000 people, or 14 percent of all those eligible, have actually used the program. The average savings: $2.51 per market basket.
UnitedHealthcare didn’t provide specific figures, but Angela Loberg, an executive for the insurer’s business in Wisconsin, said: “We’re not just beer and brats — our numbers in Wisconsin are actually higher.”
Health plan members like the program because they find it can be more expensive to make healthy choices at the grocery store, Loberg said. After launching in Wisconsin in 2015, UnitedHealthcare expanded the program to Illinois and is now introducing it in New Jersey, New York, Northern Virginia and Washington, D.C.
The program might be particularly appealing in southeast Wisconsin because “Milwaukee sometimes is called the ‘coupon capital,’?” said Terry Frett, senior benefits consultant with R&R Insurance Services in Waukesha. “People do really look for value.”
Employers that buy “fully-insured” products, meaning they pay UnitedHealthcare to take the financial risk for medical claims, aren’t charged separately for the program. Instead, the cost is baked into the standard product. Those employers appreciate that UnitedHealthcare is offering more wellness benefits, Frett said.
The interest has been more muted among “self-insured” employers, he said, because those groups see an extra cost for the program.
Medica and UnitedHealthcare hire a Plymouth-based firm called Solutran to provide the Healthy Savings program. None of the companies released financial details.
Solutran has piloted a program where employers can participate in Healthy Savings even if their health insurer doesn’t. It’s been growing quickly, the company says, and this year will be made available to employers in all parts of the country.
“Everything is preloaded on the member account,” said Chad Kelly, general manager for the program. “They don’t have to clip coupons or click coupons,”
Behavior change is the goal
Not everyone is a believer.
The Connecticut-based health insurer Cigna says it piloted a food coupon program several years ago, but found it wasn’t very effective in leading to sustained behavior change, said Joe Mondy, a company spokesman. Instead, the insurer offers health coaching to help people change eating habits, as well as money toward health insurance costs for people trying to improve health through diet and exercise.
Rebecca Ervasti, the human resources director with the Metropolitan Area Agency on Aging, said her group also is trying out financial incentives as part of a broader wellness program. Based in North St. Paul, the agency has health insurance with Medica, but employee Joan Diercks said she hasn’t used the Healthy Savings program because she goes to a discount grocery store that doesn’t participate.
“A lot of the coupons, when I looked them up, it was the more expensive products to begin with — so it would be name-brand or organic or something like that,” Diercks said. “You would be saving a little bit, but I don’t buy those products.”
The ultimate goal is a connection between healthier eating and reduced future health care spending for people with conditions like early onset or Type 2 diabetes, said David Martin, an executive vice president with Associated Benefits and Risk Consulting who advises employers on wellness programs.
One factor employers will consider before implementing a program like Healthy Savings, Martin said, is whether it actually gets a significant number of workers to change behavior and start buying more healthy foods.
“Employers who have a heavy focus on their wellness program might want to invest in something like this,” he said. “Those who are looking for really hard return-on-investment numbers are going to have a little bit harder time justifying programs like this, but that doesn’t mean there isn’t a value. Hard ROI can be tough to prove with wellness programs.”