Switching to high deductible plans coupled with incentives for staff who get annual check-ups and health screenings is shaving thousands of dollars — and in one case, millions — off what local counties are paying for employee health care.

Assistant Montgomery County Administrator Amy Wiedeman said the changes are helping the county hold down the rising cost of health care — a $50 million a year expense — for its 3,200 employees by up to $4 million a year.

Lisa Hale, director of risk management in Greene County, said that after five years of offering wellness incentives to county employees, the cost for health care and the number of catastrophic illnesses both are on the decline.

“We know from talking with employees we have dodged serious health events,” said Hale, adding that the total cost of Greene County’s employee health care is about $11 million a year. “We did reduce our costs 2 percent, and we feel that the Wellness Incentive Plan helped with that result.”

In an attempt to control costs, employers increasingly are turning to wellness programs, although the payoff remains unclear, according to a 2011 study by the Center for Studying Health System Change. Tammy Whitaker, employee benefits/safety officer for Warren County, said it’s hard to quantify the cost saving of wellness programs. “It’s the cancer treatment we will not be paying in the future because of a health screening, or a diabetic with sugar levels under control who won’t have to deal with complications later on,” she said.

Hale and Wiedeman say the benefits are two-fold.

“We’re spending health care dollars much more wisely, and we’re getting a healthier workforce,” Wiedeman said “It’s a better deal for employees and it’s a better deal for taxpayers because it provides more money for direct services.”

Health care costs for Montgomery County’s employees had been increasing about 11 percent per year since 2005, faster than the 9 percent national average. Wiedeman said Montgomery County’s health care costs were higher because its workforce suffered from diseases such as diabetes at rates higher than the national average. “We were seeing costs go up every year while our revenue was decreasing,” she said.

Annual health care membership plans for Montgomery County employees were projected to leap from $15,089 per employee in 2011 to $22,355 by 2014. The county pulled together a health care benefits task force in November 2010 to address the rising costs. What they found, as a self-insured organization, the bulk of costs were from claims and the most prevalent illnesses were related to lifestyle choices, such as high blood pressure and diabetes.

“That’s when we decided to put in a health care plan with wellness incentives,” said Wiedeman, adding that the change to high-deductible plans was launched on July 1.

All county employees are eligible for up to $1,200 a year for a number of incentives such as being tobacco free. If they are in the high-deductible health plan, the funds are deposited in their health savings account. If they are on the traditional health plan, it is deducted from their monthly premium contribution.

“It’s made a difference,” Wiedeman said. “We’re saving $3 million to $4 million a year. We’ve been able to offset some state cuts through this.”

Much of the savings, Wiedeman said, comes from employees making wiser health care choices.

When you have a high-deductible health care plan, people are more likely to check prices, Wiedeman said. Montgomery County employees are challenged to stretch dollars spent on medical expenses by considering generic drugs or finding a family doctor instead of making regular trips to an emergency room.

Medical costs still are rising under the new plan, but at a slower pace, Wiedeman said.

About 30 percent of Montgomery County’s employees opted for a high-deductible plan.

Hale said wellness incentives have been offered to Greene County’s 850 full-time employees for five years. The county has 22 goals or incentives that employees may choose from that range from getting an annual check-up, keeping cholesterol under 200, maintaining a recommended body mass, getting a flu shot, meeting a physical fitness goal or getting certain health screenings.

“If you meet goals, you are rewarded,” Hale said.

Employees on family plans who meet eight goals and those on single plans who meet five goals get a one-month premium holiday, or a month free from their 20 percent medical plan contribution.

Miami County Commissioner Richard Cultice on Friday said the county, which is self-insured, is currently re-evaluating its employee health care plan.

Warren County spent about $16 million on health care benefits in 2011. Whitaker said the county is trying to reduce that figure by bringing health-related programs right to the office, like an annual blood draw.

In 2011, 671 Warren County employees (out of the 924 eligible) got an extra paid day off work because they participated in the blood screening program. The test results — for blood sugar and cholesterol levels — were sent to the employee’s home or directly to a personal physician.

“Employees are getting on board. They are thinking about longevity and quality of life,” Whitaker said.