Healthy returns Featured

8:00pm EDT May 26, 2009

You’re looking at your expenses, and that health care cost is just glaring at you. If only you could chop that number.

In fact, many employers are. The economic downturn has caused 60 percent of employers to change their health plan or strategy, according to a National Business Group on Health/Watson Wyatt Worldwide study. With the median health care cost per employee estimated to reach $7,400 this year, many employers are transferring costs to their employees.

That may be an idea of your own or a route you’ve already taken. But insurance providers and health care experts are cautioning you to think twice if you want true savings and you want to hang on to your employee base.

“There’s a great temptation I think to short term save dollars, but long term, it’s not a good trade-off,” says David Joyner, senior vice president, large group and specialty benefits for Blue Shield of California. “In the long term, I think employers and employees will save money if we’re able to influence lifestyles because a tremendous amount of life care costs are linked ultimately to lifestyle and diseases that are connected to lifestyle choices other than genetics.”

More than 75 percent of employers’ health care costs and productivity losses are linked to employee lifestyle choices, according to the Centers for Disease Control and Prevention.

Cutting or renegotiating your health benefits can save money. But until you understand what’s driving your costs — your employees’ bad habits — you’re not going to reach the root of the problem. The bottom line is, the more your employees use their insurance, the more you’re paying.

Understand what you’re paying for

To really control costs, you have to understand what they are.

Sit down with your broker or third-party administrator to discuss your claims. You need to understand the specifics of your population and how employees are using their insurance, meaning what services they’re seeking, what medications they’re on and perhaps discern the top illnesses they suffer from.

Larger companies dedicate time every week or once a month to go line item by line item and chart trends, but for smaller companies, it may take months to paint a clear picture. The overall goal is to carve out a specific area your employees are using a lot of and try to find a more efficient way of dealing with the health need. For example, finding out your employees use the emergency room as a physician’s office or pay three times the price of a generic drug for brand-name medication can empower you to seek cost-saving solutions for you and your employees.

“One of the realities of health care is there’s a huge difference in the cost of the health care depending on where it is provided,” Joyner says. “Employers can encourage their employees to make smart choices around health care purchasing. It saves the member money because their out-of-pocket will be lower; it saves the employer money because ultimately employer premiums are driven by, at the end of the day, what the health care costs are of their employees.”

Once you have a better understanding of where you’re spending money, don’t be afraid to look to your broker or health plan provider for advice on the next step. Much of your costs can be deterred by simply educating your employees, and most health insurance providers and local hospitals offer informative tools and programs as aids.

Understand what to educate your employees on

You don’t need to know the specifics, like the annual median cost increase for health care is estimated at 7 percent for 2009, to know costs are rising. And your employees probably notice the difference in their paychecks.

There’s no better time to proposition your employees with ideas that can better their health and save them money. Plus, emphasizing healthy living can quickly boost workplace morale and productivity, which can’t hurt in these uncertain times.

In order to provide your employees with pertinent information, you have to understand what risks they face. Many employers are opting to screen their employees, hiring a local clinic or hospital to come to the office and perform body mass index tests. The anonymous results are later given to you as a snapshot of your employees’ health.

Costs for the screenings vary dramatically. But another option is having your employees fill out a health assessment, which may cost nothing and take little time. Most insurance providers offer online health assessments, which may even be an incentive connected to your health plan. If you opt for an assessment, the provider then takes the information and directly contacts your employee with wellness information and advice.

Either route you go, the group you seek out can help you devise techniques that will speak to your employees’ needs and interests.

Step into action

Now you know the services your employees are using and the health risks that force them to seek care. However, you’re pinching pennies, and investing in a full-blown wellness program, which is estimated at the high end to cost $400 per employee, to support healthy living is the furthest thing on your mind.

But some food for thought: Wellness programs tend to see a 2-to-1 or sometimes even a 3-to-1 return on investment. And results usually can start to be seen in a year.

But wellness programs aren’t needed to see results.

“The big problem with much of the lifestyle change work is actually doing it,” says Dr. William B. Stewart, medical director of the Institute for Health & Healing at California Pacific Medical Center. “Most people have a pretty good idea of what to do, and there are lots of recipes out there for what to cook and how to exercise and how to do all these things, but the big challenge is to actually get off the couch or get your walking shoes on and initiate the actions that actually can benefit us.

“Educating people and making them aware of what the risk factors are and how those risk factors can be ameliorated by healthy choices.”

Some behaviors can be directly impacted at work with no added cost by changing vending machine options, starting a walking club or banning smoking. Ask your broker or a local health association to hold monthly seminars at your office. Ask your provider what free services it offers.

To really get employees to perform, the need for incentives still holds true. Companies have seen immediate savings in paying for employees’ medication if they buy generic.

Another idea is linking an employee’s program participation to his or her health plan. If employees reach lower targets in weight and cholesterol, consider paying for their insurance. Their healthier lifestyle means less risk for chronic diseases and probably fewer medications and doctor visits.

Research will tell you there’s room for creativity. But whichever route you take, you must see it as an investment in your employees and include them in the process.

“In different settings they want different things,” Stewart says. “The more employees are included in the decision-making around which activities are or aren’t provided gives them a sense of inclusion and will enhance participation.”