"The broader, more important point," Zirkelbach says, "is that health plans are providing services that beneficiaries want. They are responding to the demands of consumers—particularly at a time when there is broad agreement from across the healthcare system that we need to do more to encourage people to live healthier lifestyles, to get preventative care, and to take better care of their health. Health plans have pioneered the types of programs on the commercial side and in public programs to help patients better manage their health and live healthier lifestyles. That is showing demonstrative results in improved health, better health outcomes, and lower costs."
Trivedi says he hopes the study will make policy makers more aware of the consequences that even relatively small changes in benefit design can have on a program. "To the extent that policy makers want plans to just compete on their ability to provide high quality service to enrollees and reduce costs, that they should be aware that subtle changes in insurance benefits can have big results," he says.
The idea that health insurance companies might be using fitness benefits to cherry pick healthier enrollees has been a subject of speculation in healthcare economics circles for several years but Trivedi says there hadn't been empirical data to back up the idea before his study. "That is what we enjoyed about this study— that we could finally put some numbers to this phenomenon that people have been speculating about for some time," he says.