Healthy returns Featured

8:00pm EDT May 26, 2009

Revenue is down, the budget has been hacked away and now you’re edging toward reducing employee health care coverage — or even eliminating it outright. Before taking action, take into account the short-term benefits and long-term effects of your options.

A knee-jerk reaction may be to shift the benefit burden to employees. But those who have been down that road, say there are ways to take a strategic approach to generate value from a shrunken budget and employee pool. The most successful organizations over the long-term will be the ones that cut costs now, while improving the health of their employee populations.

Utilize existing resources to find out how you can save money, starting with your health insurance provider.

“All wellness programs aren’t created equal,” says Michele L. Hunnicutt, manager of employee wellness and corporate on-site services for Methodist Wellness Services. “To produce an economic return on wellness efforts, you must develop a comprehensive wellness program working with your insurance provider and employees.”

Awareness of the claims filed by your employees will allow you to determine the best health plan move that will work for their needs and devise a health promotion program that will be most appealing to them. While moving to a lower-cost plan may be a necessity, it is a temporary fix and should be complemented with an emphasis on health that will have a more lasting impact.

A 2009 Watson Wyatt report shows that 67 percent of employer respondents to an Annual National Business Group on Health survey say the top challenge to maintaining affordable benefits coverage is employees’ poor health habits. Only by managing these habits can you truly get your costs under control.

Work with your provider

Work with your health insurance provider to decide what the best options to your budget will be. Negotiating rates with insurers isn’t usually effective, as insurers aren’t offering massive discounts because of the economic downturn. The option you usually have is a different plan with reduced coverage.

One option is cost shifting to save the company money while increasing the cost to employees. But altering plans and shifting costs to employees isn’t solving the problem of high premiums. A Hewitt Associates LLC executives’ survey shows that participants found cost shifting didn’t bring out desired behavior changes in employees and that an emphasis on health at the workplace is needed.

Another money-saving health care option is risk sharing.

“Dallas is the fattest county in the state,” says David Toomey, president and general manager, CIGNA HealthCare of Texas. “Get with your employees and discuss how you can solve the problem of being so unhealthy. See how you can help them manage what health concern or stress is most important to them.”

A third option is a health savings account, which takes money out of an employee’s check pretax and the employer has the option of adding money to the account, as well. If the employee switches jobs, he or she will take this health savings plan to the new position and the employer will retract its contribution from the fund.

“You have to look at your health plan and wellness programs as a business opportunity,” Toomey says. “Someone will be paying a higher rate for health care with an unhealthy population, and you don’t want to be that person. If your employees and budget can’t afford it, you have to try to fix it. Tell employees the plan options and what you are up against.”

While health promotion — or wellness — programs aren’t usually at the top of the list when contemplating short-term health insurance savings, a program will have positive results in the short term with the best outcomes in one to three years. Companies that effectively promote health see immediate savings in premiums of 10 to 13 percent with the potential of reducing future medical costs. The investment has a $3 to $6 payback on the dollar.

Your best bet to cut costs will be a two-prong approach. Change your health plan for instant budget relief and initiate a health promotion plan.

“Wellness programs and the information gathered from health risk assessments don’t matter if you don’t use the information correctly,” Toomey says. “You can expect a 25 percent reduction in absenteeism if you have used the right recruitment tools in your program — so find out what your employees want to do first.”

Design your health awareness plan with consideration of the number of employees that will be participating. A smaller company of 50 employees or less shouldn’t invest more than $25 per employee initially, but should focus on raising awareness by providing educational material that emphasizes preventive care, proper nutrition and health-related Web sites.

A midsized company of 300 or more employees should invest about $90 per person. Providing educational tools, focusing on the population’s main areas of concern and taking a competitive, fun approach is effective. A large company with a willingness to invest about $240 per employee can have a comprehensive program that includes education, financial incentives, inclusion of spouses and perks like gym memberships.

Your insurance provider may have free online health risk assessment surveys. By surveying your employees you can determine ways to meet the company’s and employees’ financial needs. Ask questions about physical activity, stress management, tobacco use and general disease risk factors.

“Measure employees’ current health status and risk factors,” Hunnicutt says. “See ways employees can modify their unhealthy lifestyle behaviors and ways you can maintain the health of healthy employees.”

Discussing what your insurance company provides to you at no cost or at reduced rates is a great first step. Many employers are unaware of fringe benefits included in their plans. If the insurance provider doesn’t offer what you need for free, it should be able to direct you to an organization or local hospital program that does.

The process

After you’ve determined a health awareness focus for your employee population, you can create a plan of action.

“You must get involved in the process,” says Thomas R. Beauregard, CEO, United Essentials, a UnitedHealthcare business. “Think of tangible ways you can connect with your employees, give them individual scorecards on status so they can see when they make optimal health conditions.”

You also need to make an assessment of your workplace wellness environment. Identify strengths and areas that need improvement. Enforce no smoking on the campus; provide healthy choices in vending machines and the cafeteria.

“Offer food that is healthy in the cafeteria,” says Gerald Cleveland, director of employee health promotion, University of Texas Medical Branch, Galveston. “Price healthier foods lower than ones that aren’t good choices. Employees tend to eat healthier when it’s cost-effective. ”

Provide health tips, programs, discounts to gyms and other information through multiple delivery sources. Some employees are more receptive to e-mails or newsletters — or they just need to hear the same message multiple times to get motivated into action.

“Cost shifting isn’t a long-term solution to health care costs,” Beauregard says. “Plan designs will continue to change over time, but you have to get started on a wellness program to change the behavior that helps get the [health insurance] costs hig h.”