Employers and individuals are paying a majority of healthcare costs in the United States, with more than 178 million Americans having employer-sponsored health insurance.
For years, medical price increases have far outpaced inflation and the consumer price index (CPI), causing businesses to continually switch vendors to combat medical-related inflation.
Health Action Council offers action steps to develop a healthcare strategic plan.
FOCUS ON THE LEADING INDICATORS
The diagnosis and categorization of claims listed on reports from medical and pharmacy vendors (including diabetes, cancer, musculoskeletal (MSK) and obesity) are the health outcomes of the individuals in your benefits plan.
Determine the leading indicators of these diagnoses and claims and decide what can be done to mitigate them in the future. Work to build a plan on how to achieve change.
QUALITY MATTERS MORE THAN DISCOUNTS
Make certain to utilize quality healthcare to eliminate the risk by hiring quality providers to mitigate the risk of infection and other complications.
Ask your medical plan administrator how they evaluate the quality of providers in their managed care network and focus on net cost versus discounts.
LOCATION, LOCATION, LOCATION
Location and access healthcare services has a big impact on your healthcare spend.
Some communities have higher emergency department utilization rates. Plan sponsors should understand the differences in communities where they have operations and develop plans for each location to improve plan outcomes.
According the Academy of Urgent Care Medicine, nearly 40 percent of patients who visit the emergency room do not require true emergency care. Based on a study from the National Institute of Health (NIH), the median cost of the average emergency room ranges from $1,233 to $2,168 compared to an urgent care visit that costs just $50 to $150. Ensure your employee population understands the difference by using a web resource like findtherightcare.org.
FOCUS ON HEALTH LITERACY
According to the County Health Ranking, only 20 percent of an individual's health is related to the clinical care they access. The remaining 80 percent of health is based on behavior (such as diet and physical activity), social and economic factors, as well as the community in which your employees live.
Find fun and unique ways to improve health literacy so that plan participants can make better decisions about their health and ultimately their healthcare. Also, consider daily life challenges that your employees may be facing (such as transportation, multi-generational household, childcare, housing insecurity and food insecurity). These challenges can impact the capacity of employees to make better healthcare decisions, so try to determine how your organization can help.
ABOUT HEALTH ACTION COUNCIL
Health Action Council is a not-for-profit 501 (c)(6) organization representing mid and large-size employers that enhances human and economic health through thought leadership, innovative services and collaboration. It provides value to its members by facilitating projects that improve the quality and moderate the cost of healthcare purchased by its members for their employees, dependents, and retirees.
Health Action Council also collaborates with key stakeholders such as health plans, physicians, hospitals and the pharmaceutical industry to improve the quality and efficiency of healthcare in the community.
Enhancing Business. Enlightening Lives. Enriching Communities.
HealthActionCounci.org I 216.328.2200 I [email protected]