US Cities, Counties Focus On Health Risks And Costs

Although rising health care costs are a primary concern among America's local governments, most jurisdictions do not offer preventive and disease management programs targeting their stated top health issues, according to a survey of local governments released today by ICMA, the premier local government leadership and management organization, and sponsored by leading employee benefits carrier, CIGNA.

This may soon change. As the CIGNA/ICMA Local Government Employee Health Survey found that municipal and county administrators are planning to implement health improvement incentive and reward programs in the next few years.

The survey results will be discussed during a news event on Monday, October 8, from 10 a.m. to 11 a.m. in conjunction with the 93rd ICMA Annual Conference. The event will take place in Room 330 of the David L. Lawrence Convention Center, Pittsburgh, Pa.

Key survey findings include:

-- The top three health concerns nationally as identified by local government professionals are obesity/weight management (51%), heart disease (42%), and stress management (38%)

-- Only one-third of municipalities and counties said they offer programs to address such health issues as asthma and cancer; however, looking ahead, another 20% of local governments indicate plans to offer disease management programs during the next five years

-- The number of local governments that offer rewards to employees for participating in wellness or disease prevention programs is expected to double -- from 27% to 58% -- within five years

Planning for the Future

"Health care and its costs are a chief concern for our nation's local governments, and the choices we make over the next few years will have implications for both governments and our citizenry," said ICMA Executive Director Bob O'Neil. "Because many local governments rank among their region's largest and most high-profile employers, they can serve as models in establishing healthy living and wellness and can help lead the transition to a very different way of thinking about health care."

"Our survey found that an increasing number of city and county governments are planning to ramp up health improvement programs in the near future," said CIGNA Health Care Vice President, Government Segment, Sheila McGinley. "For example, in the next five years local government administrators who say they plan to offer health risk assessments will increase from 40% to 64% , and the percentage of municipalities that offer rewards for using high-quality, cost- efficient providers will nearly double."

"In addition, more local governments are considering offering their employees consumer-directed health plan options," McGinley said. "According to survey respondents, 30 percent of municipalities say they plan to offer a Health Reimbursement Arrangement (HRA) or Health Savings Account (HSA) plan within the next five years."

Thoughts on GASB

Despite the potential impact of Government Accounting Standards Board (GASB) regulations that will require local governments to report future liability costs of retiree health benefits, most respondents said that their local government does not have a strategy in place to address the proposed regulations.

Among those respondents that say they have a plan in place to address GASB; the top three future strategies are funding HRAs or HSAs, prefunding retiree medical liability, and discontinuing early retiree medical benefits for new hires.

The study was developed in conjunction with the ICMA Health Care Advisory Group and was conducted by ICMA and sponsored by CIGNA. The survey was mailed to 8,013 local governments-all municipalities with a population of 2,500 and above and all counties with an elected executive or a chief appointed official. More than 2,200 local governments responded to the survey, representing a response rate of 28%.