High-deductible health plans were intended to make workers more responsible healthcare consumers by switching more of the costs to them, but getting accurate pricing information to consumers — or even agreeing on what “price” means — has been difficult. When it is available, roughly one in 10 patients take advantage of it, the New England Journal of Medicine found, and usually after they received care.
With these two challenges in mind — getting accurate information to plan members and then getting them to use it — how can advisors help their clients reduce the cost of their health plans by engaging employees in the process?
Alternative Reimbursement: You Can’t Pay Less For Healthcare Unless You Pay Less For Healthcare
Thursday, June 10, 2021, 2:00 PM ET / 11:00 AM ET
The only way to pay LESS for healthcare is to pay LESS for healthcare. This simple statement sounds obvious but is ignored by most employers as reflected in their health benefits. For years, we have depended on the carriers to negotiate the price we pay for healthcare, having a more direct and transparent reimbursement (provider compensation model) is the key to immediately lowering your health benefits cost.
In a post-COVID world, even zero change in employees’ healthcare costs will likely still result in them spending a greater percentage of their income on healthcare. Why? Most household incomes are down so the focus shouldn’t be on maintaining the status quo, but on fighting to reduce overall costs and expenditures.
Teach employees what questions to ask. NJEM found the complexity of the billing system can undermine any price shopping that patients might do. They don’t know if the prices they’re looking at are for the same services, or if they cover the total cost to the plan or just the out-of-pocket cost to the employee. Without this information, employees’ decisions are only slightly better than picking a provider at random. Teaching plan members what to ask, and even providing scripts for them to start the conversation, can make it easier for them to be proactive about price shopping.
Create layers of educational interventions based on how and when plan members will access them. A simple price list may suffice for a plan member who’s just scheduling a routine appointment, but judgement and decision making can be impaired by stress; someone facing a catastrophic diagnosis will take the easiest route unless they have more interactive or personalized guidance showing them the way to better quality or less expensive care. Willis Towers Watson found that almost half of employers were considering introducing care advocacy or navigation services to help their employees make better choices.
Design communication strategies for your current workforce. Many employers are relying on old-fashioned methods of communicating benefits to their members like benefits booklets and presentations, a study by HealthJoy found. That’s a problem, as 80% of employers surveyed by the International Foundation for Employee Benefit Plans said their workers don’t read the benefit materials they provide them. Employers should revisit their education strategies whenever they have turnover to keep up with their changing workforce’s evolving needs.
Look for gamification opportunities. There’s a lot of hype around gamification, and behavioral research shows that it can have some impact on users. Be careful, though — poorly designed games may not create long-term changes in behavior, and may even annoy users.
Communicating the importance of smart healthcare shopping is clearly a challenge for employers. Advisors have a valuable opportunity to serve employers and HR professionals. Almost 90% of benefits leaders said they place a high level of trust in their benefits brokers and consultants, and 20% say their broker or consultant is the resource they rely on most when it comes to making major decisions about their benefits programs, according to Artemis Health.
Artemis also found that although controlling costs is important, benefits leaders’ top priorities center on employees’ experiences, and finding ways to make them more productive, more satisfied, and generally healthier and better off. By developing enhanced communication and education strategies that help employees navigate the complex and often overwhelming world of healthcare, they can do just that.