Rewards-based Health Plans Aim to Keep Workers Lean

Local employers discover that giving employees incentives to stay healthy helps everyone’s bottom li
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When former King County Executive Ron Sims, now deputy secretary of the U.S. Department of Housing and Urban Development, launched the Healthy Incentives Program in 2005, he started biking to work. He lost an impressive 60 pounds and dramatically reduced his blood pressure, cholesterol levels and body mass index (BMI). “And he did all of this in a public way,” says Brooke Bascom, communications director for King County’s Employee Health and Well Being Program. “He did not ask employees to do something that he wasn’t willing to do himself.”

In light of health care reform, more local employers are following Sims’ lead, pulling out all the stops with rewards-based health plans aimed at keeping workers lean, and betting that an ounce or two of prevention will go a long way toward staving off chronic disease and paring down health care costs.

In Healthy Incentives, the cost of an employee’s medical insurance depends on how committed the person is to the three-tiered system—gold, silver and bronze—with the out-of-pocket cost predicated on a person’s agreement to try to become healthier, not on actual results. From belly dancing to gardening to Latin-rhythm-inspired Zumba classes, King County workers have embraced the workplace wellness culture. More than 15,000 workers who have agreed to an extensive self-assessment and a subsequent action plan have qualified for coveted gold status, says Bascom, earning them big breaks on insurance costs. Gold-status participants pay an annual family deductible of about $900, while participants who qualify for the less strenuous bronze status have to shell out about $2,400 per year. The difference is significant for individuals as well. Single gold-status members pay a $300 annual deductible, while bronze-level members pay more than $800.

In a relatively short time, the program has netted huge financial benefits, and Healthy Incentives participants are not the only ones saving money. Employee contributions in the 2010–2012 benefits years, says Bascom, will save taxpayers from spending $37 million for increased deductibles, co-insurance and co-pays.
Even more impressive is that King County workers have made huge strides in improving their overall health: They are smoking less, eating healthier and limiting alcohol consumption. What’s more, healthy people are staying healthy while those with compromised health seem to be getting better, according to 2009 results.
ClearPoint (clearpoint.com), a Seattle-based employee benefits consulting firm, is at the forefront of consumer-driven health care with on-site biometric testing and year-round coaching on exercise, nutrition and stress management for employees. For the past five years, the company (which was acquired by San Diego–based Alliant Insurance Services in 2008) has signed up more than 30,000 participants in rewards program, including about 10,000 in a ClearAdvantage program Premera Blue Cross. “We have seen a reduction in large catastrophic claims by catching things as early as possible and preventing the deterioration of employee health,” says ClearPoint managing director Kevin Overbey.

The convenience of on-site biometrics is like preventive medicine, says Overbey. Workers can monitor their weight, blood pressure, blood sugar, cholesterol and triglycerides just steps from their workstations. Employees who take part in the program pay less for their health plans than those who opt out. Local companies taking part in ClearAdvantage include WatchGuard Technologies, Isilon Systems and Mike’s Hard Lemonade.

With nearly 3,000 employees in Washington and Alaska, Mountlake Terrace–based Premera Blue Cross believes that paying attention to basic health indicators can go a long way toward preventing illness. Premera has introduced a Know Your Numbers program that encourages staff members to keep tabs on biometrics such as blood pressure, blood sugar, total cholesterol and BMI.

Last spring, Valley Medical Center in Renton launched an initiative through Tangerine Wellness (tangerinewellness.com). It’s a voluntary weight-management program offering employees free online tools that allow them to log their weight, count calories, track exercise and even communicate with coworkers. At the end of each quarter, worker teams that meet defined weight-loss goals earn reward points that can be redeemed for jewelry, electronics, sporting goods and cookware. They get reduced rates at The Fitness Center of Valley Medical Center, and participants pay less for medical insurance than workers who don’t.

So far, Valley Medical has seen positive weight-loss changes in its employees, says Barbara Mitchell, senior vice president for human resources and marketing. She notes that in the first quarter last year, participants reported a collective weight loss of 1,504 pounds, an average of more than three pounds per employee.

Few can argue the potential benefits to a company’s bottom line and to workers themselves when they are exercising more, eating well, and drinking and smoking less. But how much privacy are employees giving up when they embrace a company’s reward-for-wellness plan? “We stress privacy of information,” says Overbey. “We protect the employee’s information and assure that all aspects are HIPAA [Health Insurance Portability and Accountability Act] compliant and that the employer does not see individual results.”

While some critics claim that reward-based plans penalize individuals who opt out, Overbey counters that the opposite is true: As individuals get healthier, he says, insurance rates decrease for the entire group.

And then there’s the fun factor. Kathleen Stine, the clinic supervisor at King County’s North Public Health Center, takes part in a Zumba class at work and says, “It’s more like a night out at a club than exercise.”

Stine adds: “People seem to enjoy the convenience of an exercise class right in the building where they work. Folks have also cited the camaraderie as a key benefit—whatever issues might be going on in their day-to-day work are all left outside the door when Zumba starts.”    

Meet the YIMBYs, Seattleites in Support of Housing Density

Meet the YIMBYs, Seattleites in Support of Housing Density

A new movement is saying yes to urban density in all its forms
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Ballard homeowner Sara Maxana (with daughter Nani) identifies as a YIMBY, and supports more housing density, including in single-family areas

Sara Maxana is exactly the sort of person you might expect to see getting involved in her neighborhood meetings. A single mom with two young kids, Maxana lives in a single-family 1931 Ballard bungalow of the type many neighborhood activists are fighting to preserve. Ballard, where the population grew 26 percent between 2010 and 2014, is ground zero in Seattle’s density wars, which pit pro-growth advocates, many of them young renters who moved to the city within the last decade, against the longtime homeowners sometimes disparagingly known as NIMBYs, for “not in my backyard.”

What you might find surprising is that Maxana isn’t a NIMBY. She’s one of a growing group of people who say “yes in my backyard,” coining a new acronym: YIMBY.

Maxana, who once worked at the sustainability nonprofit Futurewise, had more or less retired from politics. But she got re-engaged after Mayor Ed Murray proposed the Housing Affordability and Livability Agenda (HALA) in 2015. The plan (see sidebar, below), which proposes higher density across the city—including the addition of more backyard cottages and basement apartments in single-family areas—quickly became divisive.

Maxana started identifying as a YIMBY because she felt Seattle decision makers needed to hear a positive story about the changes that are coming to the city. She began speaking up at public meetings, studying the details of HALA and tweeting as @YIMBYmom, a quiet rebuke to those who say all urbanists—i.e., people who believe that cities should be dense, culturally vibrant, diverse places with lots of different transportation options—are single, transient renters with no ties to their community.

By embracing the YIMBY concept, Maxana joins a growing community of activists, researchers, housing experts and community-based organizations that see growth as an opportunity to create housing for all the new people who want to live in cities, rather than a hostile invading force. These groups make up a loosely organized, informal coalition of organizations and individuals across the country and, indeed, the globe (groups using the YIMBY framework have sprung up from Melbourne to Helsinki to Iowa City), who believe that the root of housing affordability is a housing shortage, and that the solution to that shortage is simple: Build more housing.  

Image By: Maria Billorou
Zachary DeWolf at the 12th Avenue Arts Building: trying to make Capitol Hill a place for mansion owners and street people alike

Although they span the political spectrum, from far left social-justice activists to hard-core libertarian free marketeers, YIMBYs generally agree that cities should be accessible and affordable for everyone, whether they own a million-dollar mansion or rent a $900-a-month studio, and whether they work as a barista or just moved to Seattle for a new job at Amazon.

Seattle might not seem the most obvious axis for this pro-density revolution. For one thing, it’s a city where the single-family home, especially the iconic Craftsman bungalow, is sacrosanct. So thoroughly did Seattle embrace the postwar ideal of the detached single-family house with a yard that it’s written into our zoning code, which preserves a remarkable 57 percent of the city’s buildable land exclusively for single-family houses. (In Portland, the number is 3 percent.)

But as more and more people move to Seattle—the city’s long-range plans anticipate 120,000 new residents by 2035—tension between longtime homeowners and renters, many of them relative newcomers to the city, has mounted. Rents in Seattle increased more last year than those in any other big city in the country, and in the past five years, the median rent has increased from just over $1,500 to more than $2,000. Meanwhile, the median income of renters, $47,847, is less than half that of homeowners, $108,768.

Instead of merely complaining about the housing crisis, Maxana says, YIMBYs “see growth as something that can catalyze change and bring about good things for cities.”

“I don’t see YIMBYs as addressing a problem so much as addressing an opportunity,” Maxana says. “We’re not trying to stop things; we’re trying to say yes to change. I think it’s much more exciting to be pushing for a vision than against what’s happening.”

For Maxana, that vision includes more new neighbors, more interesting shops and coffeehouses, more places to walk and bike and ride—in other words, more of all the things that are coming to her Ballard neighborhood already. “In Ballard, we have all these new breweries, and they’re child-friendly and they’re dog-friendly, and there are places to sit outside with your kids,” Maxana says. “I see more people in the parks, on the streets, on the bus. In my neighborhood, I can walk to five bus lines that get me across town to everywhere I could possibly need to go in the city. And all of that activity lends itself to more vibrancy, and just a more interesting place to live.”

Maxana can rattle off the statistics that describe Seattle’s housing crisis—for example, 40 new people and 35 new jobs are added every day, yet only 12 new housing units a day. But she and other YIMBYs argue that statistics don’t change minds; values do. “We cannot convince anybody with the data alone. We have to be speaking about our values and we have to be speaking from our heart—not ‘I feel this way and so should you,’ but ‘I’m a mom in Ballard and I want my kids to be able to live here when they grow up, and ultimately, this is why I support [density].’”

YIMBYs are starting to make waves at city hall. In July, under pressure from YIMBYs and other urbanists who argued that the city needed to do more to include marginalized groups such as renters, immigrants and people of color, Murray announced the city was cutting formal ties with the 13 neighborhood councils that advise the city on growth and development, eliminating their funding and creating a new advisory group to come up with a more inclusive neighborhood outreach strategy. (The neighborhood councils, Murray noted, are dominated by older, white, wealthy homeowners, and are not representative of an increasingly diverse city.)

While the YIMBYs didn’t make this change happen on their own, their support helped provide political cover for Murray and his neighborhood department director, Kathy Nyland (a former Georgetown neighborhood activist who is openly sympathetic to the YIMBY cause), for what turned out to be a controversial move. Many neighborhood activists liked the neighborhood councils as they were.

Some neighborhood groups are starting to move in a YIMBY direction. A Capitol Hill renter and self-identified YIMBY, Zachary DeWolf stepped into a leadership vacuum on the Capitol Hill Community Council in 2014. He was first elected vice president in 2014, and then president in 2015. As president, he restructured a traditional neighborhood group dominated by older homeowners into an organization run almost entirely by young renters.

His goal: to make the group that represents Capitol Hill more welcoming and inclusive. He has encouraged young renters to run for leadership positions; changed the style of the meetings from a traditional format with leaders sitting at a table facing the audience, to a circular roundtable where everyone can participate; and instituted more after-work hours/evening “community conversations” and “socials” to give a wider range of people a chance to get to know each other and discuss neighborhood issues.

The group’s policy emphasis has been different, too. Instead of advocating for anti-urbanist causes, such as banning corner stores in residential areas and placing a moratorium on new micro apartments as it did in the past, the council is discussing how to accommodate a supervised drug-consumption site in the neighborhood. As DeWolf puts it, “Instead of pushing [drug users] out to neighborhoods that are farther out, where there’s less resources and community, why not just keep them here and take care of them ourselves?” He adds, “At the end of the day, every person that’s in our neighborhood—whether it’s someone living in North Capitol Hill in a gajillion-dollar mansion or someone sleeping in the doorway on 15th in front of someone’s business, every type of person is our neighbor. To me, that is very YIMBY.”

Dennis Saxman, a longtime Capitol Hill activist and renter who opposes what he sees as out-of-control development and gentrification in his neighborhood, believes YIMBYs are well-meaning, but that they misunderstand the root causes of Seattle’s affordability crisis. “I don’t think they understand that Seattle was once notable for the strength of its neighborhoods and their differing characters, and that at one time, that was seen as something important to preserve and desirable,” Saxman says. “Now it’s seen as a way to market neighborhoods while at the same time destroying what makes a neighborhood a neighborhood.”

Saxman says he admires a lot of what DeWolf has done to bring new people into the council, but argues that “they’re falling short” when it comes to including more racial minorities, longtime residents and low-income people. “I don’t think they’re authentically community-based,” he says.

Will Seattle’s future look more like DeWolf and Maxana’s vision—an ever denser city, where newcomers and their ideas are welcome—or more like the city of the past, where conversations were dominated by residents resistant to change? That may depend on whether YIMBYs can make the leap from a vocal group of contrarians who provide a counterpoint to conventional wisdom at city hall to a force that helps guide city policy while bringing new allies, including more single-family homeowners, on board.

One sign that yimbys in Seattle are having an impact came last June from 1,300 miles away in Boulder, Colorado. A group of 150 YIMBYs from all over the country convened at an inaugural conference, YIMBY 2016, to talk about their challenges and successes. The Seattle contingent, which included Maxana, Sightline Institute staffer and Capitol Hill renter Serena Larkin, and University District renter and YIMBY activist Laura Bernstein (who tweets at @YIMBYSea), showed up feeling a bit discouraged by local rancor over HALA. But they left energized after delegations from other cities expressed enthusiasm for what they see as an inclusive coalition of Seattle groups that support HALA, which include urban activists, developers, environmentalists and social justice organizations.

“All these other groups and cities kept telling us, ‘We need to do that work—how did you get all of those people at the table together?’” says Larkin. “It wasn’t the policies [the details of HALA] we came up with, but the relationships that they saw had been built through HALA.”

When you’re in the thick of things in Seattle, it’s hard to see what’s being accomplished here, notes Bernstein. “But when you compare Seattle to other cities, then all of a sudden we look like the success story. I think that there are battles that we’re losing, but we’re winning the war.”

Maxana points to the success of the housing levy, which funds low-income housing and which Seattle voters approved by more than 70 percent in August, as a sign that many Seattleites support the idea of building more housing, including affordable housing. “I see that, and I just have to believe something is clicking,” says Maxana. “And even though you have such a volume of vitriol on [private social media site] Nextdoor and in some of these neighborhood meetings, I think, for the most part, when I look at the city, I see people who want a good place to live not just for themselves, but for their kids and their neighbors.”

Including neighbors they don’t even know yet.

What The Hala?
The proposed Housing Affordability and Livability Agenda (HALA), billed as an “action plan to address Seattle’s affordability crisis,” aims to build 50,000 new housing units in the next 20 years, 20,000 of those affordable to people making less than 60 percent of Seattle’s median income ($37,680 for an individual and $53,760 for a family of four*).

To help accomplish this, HALA will: 
Increase the maximum height of new multifamily buildings in multifamily areas and commercial buildings outside downtown, South Lake Union and the University District by 10–20 feet.

Require rental housing developers to make a percentage of the new housing they build affordable to people making less than 60 percent of median income, or pay a fee that will go toward affordable housing elsewhere in Seattle. (Commercial property developers will also have to pay a similar fee.)

Ease restrictions on backyard cottages and mother-in-law apartments in single-family areas, to allow as many as one of each on single-family lots.

Expand the boundaries of urban villages and rezone about 6 percent of Seattle’s single-family areas to allow low-rise multifamily housing in those areas.

Implement anti-displacement strategies in neighborhoods with low-income residents who are especially vulnerable to displacement, and promote homeownership, especially for vulnerable populations.

See a full list of HALA strategies at seattle.gov/hala.
* Source: City of Seattle