Health Plan Design Options
For the next two weeks we will be highlighting Speakers from our upcoming 2012 SHRM-Atlanta and SEBC Benefits Conferencebeing held on Thursday, August 23. This will be a content filled day of both healthcare and retirement tracks — with takeaways you can immediately take back and apply in your workplace. Be sure to stay after for our SHRM-Atlanta August Chapter Meeting for more valuable learning and networking!!
Health Plan Design Options
How do you determine what is best for your company and your employees from both a coverage and cost perspective? Is consumer driven healthcare, ACOs or other structures viable options for you?
The benefit world as we know it is changing, and changing dramatically. For most of our long history, the simple truth about health benefit plan design is that our major motivation was to contain and control costs for the employer. We accomplished this in a variety of ways, from the traditional and historic measures of greater cost sharing in terms of deductibles and co-insurance and increased employee contributions, to the more “modern” approaches of increased consumerism and behavioral change (wellness and wellness incentives). Even now, as we hear the drumbeats of value based benefit design and Accountable Care Organizations, will these be enough to maintain a health plan for employees with Health Care Reform looming out there?
The answer to this question should be a resounding yes – unfortunately, in our haste to “control costs” we have become too limited in our world view. Instead of solely looking at what our plan costs were and what they will be, and then defining success as keeping this change near flat (but at least below what others report!) we need to look more broadly at our health plan to make sure it is viewed as a benefit – that our carriers and vendors are helping our employees access care and not as a barrier to care and also, for the more progressive employer, as an agent of productivity management.
Admittedly, negotiating care under the current crop of designs can be complex, but there are tools that can be layered in to ease this burden for employees and their families. Time spent trying to get a claim paid or obtaining a referral for service is time typically lost during the work day – both in terms of resolving the issue and then exacerbated in the countless retelling of the issue by the water cooler.
Further, our ability to quantify and measure productivity has reached new heights, but by failing to look at productivity gains in the workforce as an outgrowth of healthier employees, we are forcing the discussion back to a comparison of year over year gains. As reform looms ahead of us, the more progressive and higher performing companies will look to invest more dollars in care delivery when they can see greater returns in employee productivity. The data is out there, as are the benchmarks for measurement, we just need to do a better job in defining our objectives.
Bill Danish is a Senior Client Executive with Seacrest Partners. He is known in the benefit community for his direct, forward thinking approach towards employee benefits. Mr. Danish is frequent lecturer and guest speaker at industry conferences and has authored several articles on cost-control strategies for employee benefit plans. Come learn more at Bill’s session at the 2012 SHRM-Atlanta and SEBC Benefits Conference!















