|
If your inbox is like mine, it's full of Washington speculation on how and when healthcare reform will take shape. In the meantime, we have unsustainable renewal increases coming up here in the real world. What's to be done? Here are seven initiatives for 2009-2010.
First, shop every line of coverage every year. No one likes to change carriers, but networks today are copy cats and chances are good your doctor is in all the major ones. Small group rate leaders change constantly and larger group carriers respond to competitive challenges. Create leverage every year.
Scouting for a way to rein in health benefit costs, Florida Power & Light...decided to start using a more open, competitive bidding process for its health and benefit plans... FPL kicked off its new bidding system in late 2004 and promptly struck gold. By forcing providers of plans for vision, dental and other benefit components to openly compete for its business through an auction-style process where players can see one another's offers, FPL figures it has saved $1.1 million annually in benefit costs.
Prices for employee health insurance have increased significantly over the past few years, with the total premiums rising by 87% since 2000, according to the Kaiser Family Foundation...Employers have been raising rates for dependents a lot more than for employees, so also compare prices for staying on the policy yourself while buying a separate (individual) policy for your family...If you are looking at individual plans, also make sure you're getting all the coverage you need; these plans may have exclusions and coverage limits that are different from your employer's plan.
Forth, Don't pay for ineligible dependents. We have a fiduciary responsibility to the financial integrity of our plans to see that they only benefit those actually eligible. Look in to amnesty periods or audits.
Typically, each dependent of an employee has benefit costs of $3,000-$5,000 annually. However, 2%-8% of these dependents may be ineligible to receive this coverage for a number of reasons - they are beyond the age limit, there's a change in marital status (an ex-wife or ex-husband was not removed from the plan), death, or they are in fact not a legal dependent (i.e. nephew or grandchild) as defined by IRS guidelines.
Fifth, let's finally get through to employees about the cost and benefits of generics.
The use of generic drugs has saved the health care system $734 billion over the past decade ...(yet) nearly one-third don't know or believe generics have same active ingredients and effectiveness as brand-name drugs...two-thirds don't understand cost differences...(and)71 percent remain concerned about drug costs with one in four having recently delayed filling, not filled, or not taken a prescription as instructed to save money ...
Sixth, let's help our employees understand that there is good, cost effective prevention and other prevention that is neither.
It is true that if the prevention strategies we are talking about are behavioral things-eat better, lose weight, exercise more, smoke less, wear a seat belt-then they cost very little and they do save money by keeping people healthy...But if your preventive strategy is medical... if it consists of screening, finding medical conditions early, shaking the bushes for high cholesterols... then more often than not you don't save anything and you might generate more medical costs ...
Seventh, engage employees. Create a healthcare partnership. Explain that when it comes to healthcare and cost, employers and employees are in this together.
Today, Safeway has accomplished what Washington claims is the goal: The company's per-capita health-care expenses have remained flat, compared to the near 40% increase experienced by the rest of corporate America over the past four years.... employees have skin in the game. The company deposits $1,000 each year into a "health reimbursement account," which workers can use to pay for care...Safeway workers these days treat that first $1,000 carefully, since anything beyond it comes out of their pockets. The company is alive with stories of people who no longer visit the emergency room for routine care but instead call around to doctors to ask prices, and swap information with colleagues...Employees are tested for smoking, weight, blood pressure and cholesterol. Every area they "pass" results in a reduction in their premium, of as much as $1,560 for a family, a year. Those who fail but prove progress can get refunds...
|
BSGToday, July 2009
