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HMO health plans were also more likely than point-of-service (POS) or preferred provider organization (PPO) plans to offer preventive care, the researchers found. Half of the employers in the survey used PPOs, 37 percent used HMOs and 20 percent used POS plans.

Harris and colleagues also found that only one-third of the employers used some sort of incentive to get their employees to use the preventive programs. Larger employers were more likely to offer a financial incentive, such as a lower insurance premium rate, while mid- and small-sized employers used incentives such as time off to use the services.

Despite the fact that the Public Health Service and other clinical guideline groups give high priority to preventive services such as quitting smoking, insurers and employers are still skeptical about them, says Marguerite Burns, a researcher at the Center for Tobacco Research and Intervention at the University of Wisconsin Medical School.

Burns and colleagues recently published a study showing low rates of coverage for tobacco cessation programs among state government employers. The researchers found no single explanation why the states did not cover the service.

"It really ranged from not even having it on the agenda -- which begs interesting questions about how potential benefits reach the 'agenda' -- to costs, to a view that smoking cessation therapy is not very effective," she says.

Harris and colleagues agree that employers may not be covering "lifestyle modification" programs because they feel the programs do not work or that they aren't cost-effective in the short run.

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Contact: Jeffrey Harris
jh7@u.washington.edu
Center for the Advancement of Health
30-Dec-2005