When Laura Smith grocery shops, it is almost as if someone is watching her. And there is some truth to that.
To make a bad choice -- say potato chips, or other fatty snacks -- will be reported as points against her. But if she buys healthy foods, like fresh produce and whole grains, she gains points. This is all automatically tallied at the register as her food is scanned.
It’s not that someone is spying, unbidden, on Smith. She has willingly joined an employer-sponsored program that pays her $20 a month to shop healthy -- “ an incentive to continue doing what I want to do in the first place,” she says.
Eventually, more than 1 million people across New England may have the same option.
The cash incentives are a new perk that Harvard Pilgrim launched for its 1,200 workers in April and plans to introduce to employer health plans later this year.
The company, which insures 1.2 million people through 20,000 employers, will be the first insurer in the state and among the first in the country to offer a benefit that links cash rewards with healthy grocery shopping.
“We believe health insurance can be used as a proactive and supportive tool to change culture, to change behavior,” Eric Schultz, Harvard Pilgrim’s chief executive.
Newton-based wellness firm NutriSavings runs the program for Harvard Pilgrim and developed a scoring system that ranks foods based on their nutritional value, on a 100-point scale. Foods rich in nutrients like fiber, protein, vitamins, and minerals get high scores; those loaded with fat, sugar, sodium, and saturated fats score low.
All fresh fruits and vegetables are good for the top score, 100 points. Sodium-packed hot dogs and sugary sodas are among the worst offenders -- 0 points, or close to it.
Participants’ scores are calculated by taking an average of their monthly grocery purchases. Harvard Pilgrim employees get $10 a month for enrolling in the program, and another $10 if their monthly score is 60 or higher.
The program doesn’t rely on the honor system; grocery purchases are tracked electronically when participants scan loyalty cards at the checkout counters at Shaw’s, Stop and Shop, Roche Brothers, Hannaford or Wegmans stores.
More than one-third of Harvard Pilgrim’s employees are participating, and more than 65 percent of their shopping trips have scored high enough to get the cash rewards.
The initiative is an expansion of so-called wellness programs that employers around the country are adopting as a strategy to control health care costs. Weight Watchers meetings, group workouts, and health screenings are offered with the idea that health insurance, absenteeism and other costs will decline if employees are healthier.
A 2010 Harvard analysis found medical costs fall $3.27 for every dollar spent on workplace wellness programs. Such programs have allowed John Hancock Financial to keep its employee health plan premium increases 1 to 3 percentage points lower than the overall market, according to spokeswoman Melissa Simon Berczuk. Storage company Iron Mountain is expecting premiums to stay flat in 2015 thanks to its wellness efforts, said Scott Kirschner, director of benefits strategy.
“The employers I speak to about this are very confident the time and money they put into their wellness programs are worth it,” said Kristen Lepore, vice president of government affairs for the employer group Associated Industries of Massachusetts.
Many companies offer incentives to encourage healthy behaviors -- for example, by discounting gym memberships. For Harvard Pilgrim, offering cash rewards for healthy eating was a logical next step.
Schultz, the chief executive, is among the participants. He admits that his regular grocery purchases include Cap’n Crunch cereal and pudding, which have dragged his overall score to below the 60-point threshhold. “These are items that I never used to think twice about putting in the grocery cart, but now I’m trying to bring up that score,” he said.
Sometimes a small tweak -- like switching to a less salty pasta sauce -- is enough to push up the score, said Scott Miller, a father of three teenagers who does the shopping for his family and, so far, has been buying food healthy enough to earn the $20 monthly reward.
“I try to look at the labels when I can, but it’s really difficult to track,” said Miller, a market researcher at Harvard Pilgrim. “I walk out of there with two carts full a lot of the time.”
The cash is a welcome motivator for Smith, a program specialist at the Harvard Pilgrim Health Care Foundation, the insurer’s charitable arm, who has been extra vigilant in eating healthy as she prepares to give birth to her first child at the end of June. Smith decided to save her rewards for something special.
“When we have our baby,” she said, “we’ll have some extra funds that we can put towards something like a vacation or a Disney trip.”