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3 First Steps to the Employer’s Expanding Health Benefits Role

Mercer’s 2011 Workplace Survey has revealed several encouraging findings for those of us involved in managing healthcare plans.  Specifically, the survey found:

  1. Nearly 8 out of 10 employees say their benefits are one of the reasons they work where they do.
  2. 91% of employees said that getting health benefits through work is just as important as getting a salary.
  3. An increased level of participation in programs that encourage personal accountability, including wellness programs (33%) and disease management programs (26%).

“Employees seem to be turning their uncertainty about the future—both in terms of healthcare reform and their own job security—into a desire to become more involved in their healthcare decisions,” says Suzanne Nolan, partner and director of marketing and communications. “Employers can build on this momentum by providing the education and programs to encourage informed decision making and health-conscious behaviors.”

So this is where we are in 2011:  Employers providing health education and programs.

Maybe you’ve been actively engaged in employee health education over the past few years so this is welcomed news to you and further motivation to continue building your program.  If you haven’t been active in health education, or if you’re wondering where to go next with your program, I can suggest some ideas.

But before getting specific, consider these basic facts:  On average, 10% of healthplan members are responsible for 64% of total medical claims.  What’s more interesting (at least to me), is that 59% of next year’s top 10% will come from this year’s low cost group.  So where do these new high-cost claimants come from?  Well, nearly all of them come from two (2) categories we refer to as “Diseased but Undiagnosed” or “At Risk”.  Therefore, I’d like to submit three simple ideas for your consideration:

  1. Sponsor a Physical Promotion Program – Offer employees (and spouses) rewards and/or reduced contributions for getting an annual physical and all age-appropriate testing.  This is the best way for those “Diseased but Undiagnosed” employees to get diagnosed, into treatment and avoid some expensive and debilitating exacerbation in the coming months or years.
  2. Reward Members for Following Treatment Plans – It’s a “no-brainer” to reward healthplan members who score well on bio-metric testing, etc.  But it’s even more important to reward healthplan members who don’t score well but who make the effort to comply with their physician’s treatment plans.
  3. Track and Reward “Small Wins” – Being committed to long-term member health status improvements is essential to lowering healthcare costs.  Health is a lifelong proposition that requires members to consistently make daily decisions to eat better, exercise, get rest, stay hydrated and so much more.  For those members who have the added challenge of losing weight or changing unhealthy behaviors, rewarding their “small wins” is extremely effective in maintaining motivation.  I submit that a member who reduces their BMI from 30 (obese) to 28 (overweight) is as deserving of a reward as the member who maintains a BMI of 24 (normal).  So track reward progress over time even greater savings.

Developing a full-blown wellness strategy including health education and programs to encourage informed decision making and health-conscious behaviors is a serious undertaking requiring strategic clinical planning.  However, there is no more important activity to start with than preventing the migration of members into the top cost tiers in coming years.


Photo compliments of Erix on Flickr

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