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On the Minds of Health Benefits Managers: Health Plan Design and Management Tips

Questions abound as health benefits managers rise to meet the challenges of changing health landscape, so we sat down with Joseph McCool, Principal of The McCool Group and moderator of the Employer Panel at Validation Institute’s Memphis Health Care Benefits Summit, to talk through some of the hot-button topics we’ve heard from employers while out on the road.

  1. Ensure employees have access to outcome-driven primary care physicians to reduce costs over time

Healthcare management is rapidly expanding, putting new tools in the hands of both HR professionals and employees. “At an enterprise level,” Mr. McCool explained, “it means instituting controls such as pre-authorization for medical procedures. At the individual employee level, it means offering biometrics services to help individuals understand their current risk factors for disease and illness.”

Awareness of these risk factors is only the first step, however. To reduce costs over time, individuals need to work with outcome-driven primary care physicians, and employers need to ensure that employees have access to those quality health care providers under their health plan.

  1. Communicate why changes in healthcare coverage are needed

According to Mr. McCool, transparency with employees is key: “You may not satisfy everyone, but you have to make a concerted effort to communicate why changes in healthcare coverage are needed and draw the line on change initiatives that would fundamentally alter the broader employer-employee relationship.” You can’t control what your company can afford, but you can control the way you explain it to those most affected, and do your best to ensure employees feel heard and appreciated.

  1. Engage with advisors, including business coalitions, to better understand the impact of cost-reduction strategies on the company and the employee

While benefits brokers, as Mr. McCool explains, can do much of the heavy lifting to piece together multiple options to manage spend and expand offerings that makes sense, working with local and national organizations like the Memphis Business Coalition on Health, rounds out your decision-making. These organizations are great sources for networking and also provide an opportunity to share ideas and lessons learned. Most importantly, they’re focused on helping its members take the flood of knowledge they receive from meetings, news articles, and other advisors and channel it all into meaningful, actionable steps.

  1. Demonstrate to employees that how they procure healthcare services impacts the cost of their insurance

Conversations about usage, preventive care, and outlining the benefits of the various services you offer, like telemedicine, are highly valuable but often overlooked. “If employees who don’t regularly go for physical exams continue using the local Emergency Room as a catch-all for every health issue, those costs will really stack up on the employer,” Mr. McCool advises. “Putting highly individualized health information into the hands of employees is a first-step toward managing costs and convincing employees that healthcare cost management can help preserve their jobs and the future of the company that employs them.”

The stress of benefits administration can be significantly reduced by understanding the resources available to you, finding trusted partners and colleagues to help guide you through the process, and empowering employees to take their healthcare by the reins to be an essential part of the solution.

To learn more about these topics, sign up for Validation Institute’s upcoming Memphis Health Care Benefits Summit. MBGH members, CEO Culture of Health participants, and Annual Supporters should contact ctravis@memphisbusinessgroup.org for the special registration link to receive your discount.

Posted by Cristie Travis at 12:10 PM

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