Health Care Costs Rising

The cost of providing employees with health insurance coverage continues to increase at a double-digit rate. We’ve read a lot about cost drivers in health care – exorbitant hospital charges, rising prescription drug costs, expenses associated with developing new technologies and treatments, an aging population and litigation. Nurturing these factors is an environment in which the demand for health care seems to be increasing.

For the most part, there is little employers can do to control what is driving health care costs out of their reach. Health benefits companies can and do negotiate discounts, and while those help, the underlying costs continue to skyrocket. The increases created by these cost drivers flow through the health benefits companies and eventually trickle down to employers in the form of higher health insurance premiums.

In this soft economy, declining revenue is putting a squeeze on company expenses. It is likely that you will experience a 15 percent to 20 percent increase in your group health insurance when a renewal form lands on your desk.

Can you raise the cost of your company’s product or service as quickly as your health insurance premiums are increasing?
Probably not. However, there are steps you can take to gain some control over your health care costs.

Finding a solution

Employers can exercise some control over their costs by finding a health benefits company that provides the “best” value for their company’s premium dollars. The way in which you “shop” a health plan can impact the price. I’ll use an analogy. Your travel agent has a great deal for you – air, car, hotel and meals included. You tell your agent to book it.

Coincidently, your neighbors just booked that same trip for $1,000 less through their travel agent. One agent shopped for the best price, the other agent arranged the trip through his or her vendor of choice. Whether it’s a family vacation, buying a car or choosing a health benefits plan, how you shop can impact your cost. Make sure your insurance agent doesn’t “arrange” your health plan for you. How many providers are enough? The more participating providers a health plan has, the more you’re likely to pay in premiums. If you are considering a health plan that doesn’t include a few desired physicians, request that the carrier add them to its network.

Physicians participate in many different health plans and are usually willing to participate in one more. Don’t get caught in the trap of paying 10 percent to 15 percent more for your health insurance premiums because one or two doctors are notparticipating in the plan. It’s reasonable that an employee can find another physician out of the thousands on the plan.

The power of marketing

Living in the United States affords us exceptional opportunities and choices. Along with that privilege comes a barrage of communications designed to influence our decision-making. What we read in the papers, see on television, hear on the radio, see flashed across a billboard, get stuffed in our mailboxes or pops up on the Internet is designed to predispose us to a company or its product.

Marketing can be an effective tool, and depending on how much is spent, can be quite influential. What marketing cannot do, however, no matter how much is spent, is replace what it takes to come up with an affordable health benefits solution that works for you. Be sure to look for a health benefits company that is flexible, listens and is willing to roll up its sleeves to provide you with a package of health benefits that you can afford.

Worksite Wellness

Employers increasingly are realizing the value that worksite wellness programs deliver as an effective tool to improve employee health, increase productivity, reduce absenteeism and lower health care costs.

A 2003 report published by the U.S. Department of Health and Human Services (HHS) highlighted how important it is for employers to incorporate health promotion as part of their business strategy. The report asserts that preventable diseases place a heavy toll on business, including lower productivity and higher health insurance costs.

The HHS estimates that $1.66 trillion was spent on health care in 2003. and it attributes a majority of those costs to chronic diseases and conditions such as heart disease, diabetes, obesity and asthma. Sadly, the money allocated for preventing or controlling these conditions is negligible.

In a recent article, American Cancer Society CEO John Seffrin reported twothirds of cancer deaths in the United States could be prevented through lifestyle changes in diet, exercise, cancer screening and “especially” tobacco use. A well-designed worksite wellness program, provided by your health benefits company, serves the best interests of both employer and employee.

Bottom line return on investment
Ron Goetzel, a nationally recognized expert in the field of health management, data analysis and applied research, said in a recent interview that with an investment of $100 to $150 per employee per year in health promotion, an employer can expect an average return on investment of approximately $3 for every $1 invested ($300 to $450 savings per employee per year). Goetzel says, however, that these returns are not typically realized until two to three years into the wellness program.

Legislative incentives
Sen. Tom Harkin (D-Iowa) has been an outspoken proponent in seeking legislative solutions for a strained health care system. “As a nation, we have a ‘sick care’ system that is focused on helping people after they get sick, rather than a ‘health care’ system which focuses on keeping healthy people healthy,” he says. Harkin introduced the Healthy Lifestyle and Prevention (HeLP) America Act of 2004. One of the initiatives under Title II – Healthier Communities and Workplaces, provides tax credits to businesses that offer comprehensive programs to promote employee health and grants for small business.

Worksite wellness, getting started
Implementing a worksite wellness program with your health insurance carrier can be accomplished with simple, lowcost strategies.

Offer incentives for participation.
Create a wellness campaign.
Schedule seminars on nutrition, diabetes and cholesterol.
Establish programs such as fitness, sleep diary, smoking cessation and injury prevention.
Offer chair massages or simple stretching exercises to do at the desk.
Change vending machine options to offer healthier, low-fat snacks and drinks.
Work with a health insurance carrier that can implement, manage and maintain your program. Actively promote employee participation.

A successful worksite wellness program can boost company morale, enhance productivity, reduce organizational conflict, attract superior workers and lower the rate of employee turnover.

The case for establishing a worksite wellness program is well worth the effort.

Resolve to Get Involved

As you review your goals for the new year, include engaging employees in their Florida health care decisions on your list. Educating employees on their part in medical care can lead to increased quality of life and productivity, and decreased sick leave and health care expense. Consider the impact of employee health empowerment in these terms: When an employee chooses to see a primary care provider or visits an urgent care facility instead of taking an unnecessary trip to the emergency room, it can save thousands of dollars in medical expenses. And early detection and prevention bring the priceless benefit of longer, healthier lives.

Use information resources

Health plans work hard to offer quality health care, but employees still play an important part in the process. Excellent employee resources include access to online information, on-site health fairs and case managers who help with serious medical conditions. These trained professionals can help people make educated decisions about seeking treatment. Supplying employees with a book covering basic health problems and distributing health information brochures also educates them. Inviting local doctors, nurses and health insurance representatives to put on presentations can further enhance employees’ access to health knowledge.

Choose a doctor

Employees’ first step to becoming more involved entails finding doctors who will work with them in caring for their health or letting their current doctors know they desire to actively participate in their treatment. Encourage employees to look for the following qualities in a primary care physician.

An attentive listener who wants to work with the patient
A clear communicator who explains the diagnosis in a helpful manner
Solid medical training and experience, including board certification
Accessible in terms of office hours, appointment availability, response to messages and hospital locations
Supply a thorough list of questions employees should consider when choosing a physician. Also, make sure they understand how to locate a physician within their health plan.

Evaluate the condition

Thorough self-evaluation before calling or seeing a doctor can help employees determine when to see a medical provider and make their visits most productive. Consider providing copies of a form or placing a document online that lists the questions asked at the beginning of every doctor visit.
What are your symptoms and when did they begin?
Is this the first time you have experienced this problem?
Do you have any idea why you might have this condition, including life changes or people around you having these symptoms?
Are you taking any medications?
Before and after going into the doctor, employees should try to research their condition. Asking the doctor for reference material, searching the Internet for reputable information and referring to employee health guides can help them develop a sense of what might be wrong and what treatments are available.

In learning about their conditions, patients actively participate in their health care.

Ask questions

While employees are at a visit, they should always feel comfortable asking questions. Make sure employees know to ask:
What tests, medicines and treatments are you recommending?
Why are these actions necessary?
Are there risks involved in these procedures, and are there alternatives?
What procedures do I need to follow when taking tests or medicines?
Do I need to call for results or to schedule another appointment?
Should I look for certain warning signs?
Patients have a right to know and understand what a doctor recommends. They also have the responsibility to learn about the choices available to them.

Encourage employees to ask questions and to make a record of their doctors’ answers. Patients should never feel pressured to make a quick decision. Depending on people’s medical history, values and preferences, they may choose a different alternative than the first option the doctor suggests.
Partnering in their health care enhances employees’ medical care and also plays a significant role in containing health care costs. Make employee health education one of your top goals for 2006 and contribute to a healthy, happy new year.