How long do people typically spend
choosing a health plan, hospital and
doctor during their company’s open enrollment period? Two hours? A day?
The average is just 16 minutes. By minimizing time spent making selections, people
hope to make the process less painful. But
without careful selection, they may lack the
choices they need later on.
Open enrollment is like putting together a
complex puzzle. The more employees try to
make sense of the insurance options offered,
the more they may end up confused.
With open enrollment season approaching
for many Southern California businesses,
Smart Business spoke to Barry Arbuckle,
Ph.D., president and CEO of MemorialCare
Medical Centers and chair of the California
Hospital Association, to learn more.
Why is open enrollment so important?
During this period — typically about 30
days — employees select benefits for themselves and their families. Choices determine
cost, access and quality of their health care
for the following year. Whether adding
dependents, enrolling in a new plan, increasing or decreasing out-of-pocket expenses or
changing other options, consumers should
know the facts before making decisions.
What many don’t realize is that by selecting
a doctor they determine the entire course of
their health care. This includes the hospital
they’ll go to for inpatient and outpatient care.
What’s the best approach?
Shop for health care benefits like you
would for other major purchases. A wrong
decision can be costly in terms of health and
financial results. Don’t just sign up for the
same plan. Instead, examine benefit options
for your current needs.
With HMOs, doctor (or network) selection
determines the specialists one can see. For
these reasons, it’s important to have a big
picture perspective before signing on with a
health plan. Are you satisfied with your medical, dental, vision and drug plans? Are you
comfortable with your current primary care
physicians acting as your gatekeeper or do
you want increased flexibility? Review these
and other issues before making a change.
Where do I start?
Start by ensuring your chosen hospital is
part of a larger system of care. A health care
system with multiple locations and thousands of physicians and employees offers
more comprehensive care for everyone in
the family. Also, a health care system is more
likely to have access to the latest equipment
and procedures. By planning ahead, you’ll
have access to the health care services you
consider important — and hospitalization in
a facility that meets your standards, when
needed. Inquire about a facility’s clinical
outcomes, its reputation and patient care
philosophy before making a decision.
Why does the choice of hospital matter?
By selecting a first-rate hospital, you’ll have
access to physician experts who work with
the hospital. Does the hospital employ a ‘best
practice’ approach where multidisciplinary
teams continually study and implement cutting-edge treatments and techniques in many
specialties? Large, highly regarded health
systems, like MemorialCare Medical Centers, are associated with scores of medical groups
and have physician referral call centers and
Web sites describing the backgrounds, specialties and services offered by their doctors.
What’s the next step?
After you’ve selected your hospital and
physician, check the details. Do you understand the benefits covered by your health
plan? Are you comfortable with the medical
group your physician belongs to? Can you
continue to see your favorite specialists?
Don’t just select the plan with the best price.
Examine your medical needs. Do you need
regular prescriptions or doctor visits? Do you
have contacts or glasses? These questions
play a part in how much coverage is adequate
without paying too much. And price out the
unpredictable — medical emergencies
occur, and payment varies from plan to plan.
How can employers improve their open
enrollment programs?
Ensure your plans are competitive.
Selection of health plans and medical groups
to include in your offerings is critical to
recruitment and retention.
Next, improve the process. The MetLife
2008 Open Enrollment Survey offers suggestions to enhance the open enrollment experience for the increasingly engaged employee.
Improvements include designing benefit plan
options and communications strategies
around employee demographics, surveying
employees about which benefits and tools
they’d prefer most, considering additional
voluntary benefit offerings to round out existing coverage, providing educational tools and
considering off-cycle enrollment of a new
benefit to help boost participation.
Ask local hospitals and physician groups
for help. MemorialCare Medical Centers, for
example, offer employers assistance through
benefits, health fairs and information, data
and education on how to select the best plan,
lower plan costs and access the best health
care possible.
BARRY ARBUCKLE, Ph.D., is president and CEO of MemorialCare Medical Centers (www.memorialcare.org) and chair of the California
Hospital Association. Reach him at [email protected] or (562) 933-9708. MemorialCare Medical Centers include Saddleback
Memorial Medical Center in Laguna Hills and San Clemente, Orange Coast Memorial Medical Center in Fountain Valley, Anaheim
Memorial Medical Center, Long Beach Memorial Medical Center and Miller Children’s Hospital in Long Beach.
