IBM to give most employees 100% primary care coverage

Unique plan aims to cut health costs

By Tim Mullaney
Bloomberg News / October 30, 2009

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NEW YORK -International Business Machines Corp., the world’s largest computer services company, will provide US employees with 100 percent coverage for primary care, a policy designed to curb health expenses.

Beginning next year, employees will no longer have to pay deductibles for visits to in-network doctors such as internists, general practitioners, and pediatricians, said the company, based in Armonk, N.Y. The company said it is one of the first US employers to adopt such a policy.

The decision is aimed at encouraging employees to visit the doctor more often, so illnesses are treated before they become serious. IBM said the policy will cover about 80 percent of its 115,000 US employees. The other 20 percent belong to health maintenance organizations.

“We believe in giving people incentives to get health care early and often,’’ said Marianne DeFazio, director of health care benefits and strategy at IBM. “When people have no barriers to getting primary care, you catch things early and you prevent things.’’

IBM said it has invested $79 million in nutrition and exercise programs between 2004 and 2007, saving more than twice that amount in health care costs.

DeFazio declined to say how much the move would cost IBM in the near term. More prevention will eventually cut health cost inflation, she said.

“We believe more efficient and individualized care will result in better outcomes and lower costs for everyone,’’ she said.

IBM will have to blend financial incentives for primary care with information to push costs down, said Lisa Suennen, a health care venture capitalist at Psilos Group in Corte Madera, Calif. Insurance plans at some companies give diabetics incentives to get primary care and add education programs to help patients understand how to care for chronic illness, she said.

What IBM is doing “is not common at all, and it’s a good start,’’ Suennen said. “But it needs to be coupled with information to coach the patients.’’

Previously, IBM required health plan participants to pay 20 percent of the cost of primary care, DeFazio said.

The company already covered preventive measures such as mammograms for women older than 40 and colonoscopies for employees over 50, DeFazio said.

IBM rose $1.37 to $122.87 on the New York Stock Exchange.