Business leaders, grappling with trying to provide a comprehensive health care benefit for employees while facing increasing medical costs are looking for innovative solutions.
Forward-thinking health care benefits companies are helping employers get the most value out of their benefits plan by pioneering technologies that control costs, engage employees in understanding and appreciating their benefits, and ease administration.
Using data to improve health
One of the best ways to leverage technology is to translate the massive databases of medical and pharmacy data into meaningful information and easy-to-use reports. Carriers can provide company managers with customized employer reports showing their significant health care expenditures and what is driving those costs.
The medical experiences of only a few employees can greatly distort the employer's overall claim experience. By looking more closely at where costs are highest and pinpointing which conditions are driving those costs, employers can provide targeted health care interventions for employees to offset more serious health care conditions that may occur if left untreated.
For example, experts agree that most youths with asthma can avoid serious complications or hospitalizations by following certain guidelines and taking medications prescribed. An employer that knows asthma-related claims are a key driver of medical expenses may add a disease management program that focuses on just that disease. This program may include targeted communications such as home mailings or reminders for check-ups.
Interactive employee engagement
Technology is alleviating time-consuming benefits administration for many companies. Through Internet-based solutions aimed at employees, many companies have simplified processes in a variety of ways, saving them valuable time and money.
New online features to help employees enroll and make benefits changes are easing the administrative burden from company human resources personnel. Easy access to personalized benefits Web sites and easy-to-use Web tools are revolutionizing the way employees interact with their personal health information.
E-connectivity options are empowering employees to manage their health benefits, enroll online in health and wellness programs, and provide access to credible sources of health information.
Carriers also are using sophisticated telephone self-service systems that provide employees with a wealth of personalized information. This system helps provide immediate assistance to callers with simple transactions, such as checking a claims status, and routes them to a customer service professional for more complex issues.
Increasingly, companies looking to simplify benefits administration are using Internet-based tools. Online eligibility and enrollment reduces errors and eliminates cumbersome paperwork that can complicate billing and payment transactions.
According to industry research, using Web-based benefits enrollment systems can save 60 percent to 80 percent of the cost associated with manual processing and benefits administration.
Companies can also feel confident about transferring their eligibility and enrollment files through safe and reliable electronic systems. With the speed of the Internet and advanced software programs, data is transferred immediately and includes security features to ensure the privacy of benefits information.
Technology is playing a key role in giving companies the tools and support they need to manage their benefits plans. New technologies using health benefits databases and Web capabilities are helping employers of all sizes to deliver a quality employee benefits package that keeps employees healthy and productive while making it more cost-effective and easy to administer.
Robert Mendonsa is general manager for Aetna's North Central Region, covering 16 states. He has responsibility for the customer segment representing employers with 300 to 3,000 employees. He is a past president of the board of the Illinois Association of Health Plans and is a member of Chicago's Economic Club. He also serves as president of the board of trustees of CommunityHealth, a free clinic staffed with volunteers, which provides more than 10,000 free patient visits each year to Chicago's uninsured. Reach him at (312) 928-3035 or (MendonsaRK@aetna.com).