Government, Health Care, and Human Resources

Insurance provider services may reduce employer costs

April 4, 2014
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With the recent consumer enrollment deadline past, and the extended option for consumers and employers alike to keep prior non-reformed plans, the Affordable Care Act is a frequent topic of discussion.

Amid the frustration and confusion, there are a couple of suggestions a local health care insurance provider is offering business owners to help reduce costs and headaches.

Marti Lolli, director of health care reform at Priority Health, said although employers may have fewer options and may be looking at increases in plans or taxes due to reform, she advises them to let the market settle before ceasing to offer benefits.

“They never had to (provide benefits) by law before, but they did (offer benefits) since they needed to attract and retain talent. It’s part of compensation consideration,” said Lolli. “In order for small employers and large employers to compete for talent, they are going to have to offer benefits for their employees, and I would continue to advise them to do that, until the market settles a little bit.”

Michigan-based Priority Health is a health plan provider headquartered in Grand Rapids. It serves more than 600,000 people and has more than 27,000 physicians and 110 acute-care hospitals in its network.

According to Lolli, finding a good partner to help reduce costs by managing employee health is important for employers. Priority offers wellness plans for employers with 51 employees or more in an effort to engage employees about their health and maximize the value of health care investment, according to its website.

In terms of health management, Lolli said reform has been a bit of a distraction in the industry in terms of maintaining a heavy focus on prevention and monitoring medical conditions, and advises employers to find partners to help reduce costs in the long-term through health management.

“They are going to have to look for a partner who is a health insurer who is really focused on that,” said Lolli. “So understanding and managing chronic disease … those with heart disease, but also getting your employees active and healthy through wellness programs. And look at innovative ways to get a hold of those costs because that will still be a problem.”

According to the Workplace Wellness Program Study released in 2013, more than 60 percent of employers responding to a national survey stated their wellness programs reduced health care costs, and approximately 80 percent reported the programs decreased absenteeism and increased productivity. In the report, an employer in a case study attributed cost savings to a reduction in emergency room visits for employees.

The study was published by RAND Corp., a nonprofit research and analysis institution, and was sponsored by the U.S. Department of Labor and the U.S. Department of Health and Human Services.

The three wellness plans featured by Priority Health include: the core plan, the plus plan and the premier plan. Each plan incorporates assessment, engagement and measurement as a way to improve the health of employees. Organization cultural assessment, employee interest surveys and health assessment are three services offered in all of the wellness programs. When upgrading to the plus plan or the premier plan, employees have access to in-depth biometric screenings.

For the second step in the wellness programs, there are multiple ways to engage employees to manage their health. Some of the specific tools and services used to motivate individuals include: member discounts for health clubs and fitness gear, access to an online health coaching service known as Digital Health Assistant, and health tips in e-newsletters.

The plus plan also offers wellness competitions or activities, while the premier plan provides health coaching and classes. Measurement services include population health wellness reports for all three plans; biometric participation lists, aggregate reports and compliance reports for the plus and premier plan; and a health coaching report for the premier plan.

The three plans are targeted for different audiences, with the core plan designed for those new to wellness, and the premier plan for those deeply committed to a healthier lifestyle. Tools and services included in the core plan are offered within all Priority Health medical plans, except for the population health wellness report in the measurement step.

Another way to reduce expenses for employers is encouraging employees to use cost shopping when seeking medical care. Healthcare Blue Book is an online tool available for Priority Health members to search prices for various health care services, such as X-rays, lab tests, surgeries, etc.

“We are trying to make sure people understand the costs of their services in their purchasing behavior and in their decisions,” said Lolli. “Employers are also looking for ways to incentivize their employees to use both of those programs — to use cost shopping and to use wellness. So we work with employers on products that will motivate their employees to rewards, to do both of those things.”

Other health care insurance providers are offering wellness programs, as well. Blue Cross Blue Shield of Michigan offers the Healthy Blue Incentives program, aimed at educating employees about workplace wellness to boost the health of the company and employees, according to its website. The insurance carrier also has a BlueHealthConnection service, which is an online health management program for employees.

With health assessment tools monitoring blood pressure, total cholesterol and immunizations, the health program provides employees with personalized plan recommendations. The online program also offers a digital health coaching program, health articles library and additional resources such as wellness classes.

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