Collaboration between benefit consultants and health management providers is essential for any employer client. But if collaboration doesn't exist, or the integration between providers isn't seamless, it can influence the experience for participants and can ultimately affect program outcomes.

Getting to this level of collaboration and achieving seamless integration can be challenging unless each party is clear on what their role is and what they're expected to bring to the table.

But when all parties collaborate on behalf of the client and meaningful integration takes place, impressive results will follow - solidifying the client relationship across the board. It's a win-win.

 

Core competencies

The first step in understanding how health management providers can become an asset to a consulting business is to understand the core competencies and expertise of each organization and where there are gaps and overlaps. With this information, an organization can play an important role in selecting the right mix of vendors and facilitating the integration process.

In the end, the common goal is to meet the needs of the mutual client. Consider the chart of division of roles and responsibilities for benefits consultants and health management providers (located on p. 80).

 

Choosing the right provider

When the rubber hits the road and a recommendation is needed for a health management provider, aside from the specific product and service capabilities, how is this important decision made?

Paul Harris, senior vice president with Aon Hewitt, recommends finding a health management partner that can deliver a full spectrum of services. Employer purchasers are looking for health advocacy, wellness and condition management programs, he says.

"They also require detailed reporting at all phases of employee participation - from enrollment to engagement behavior change and flexibility in reporting, to both drill down on findings and to report at different levels within the client's organization," Harris adds.

"It requires a willingness and flexibility to integrate with other suppliers, such as the health plan case manager and programs from the pharmacy benefits manager to support effective and efficient therapies. And, of course, employers are looking for competitive fees."

Apart from the financial factor, which is always a key consideration, Amy O'Connor, principal with Mercer, describes three differentiators an employer will consider: "The ability to balance innovation along with the basic tactics for engaging and managing a population; honesty about limitations and expectations during the selling process; and a competent and dedicated account team to round out the entire offering."

 

Real-world collaboration

Dover Corporation, a worldwide, diversified manufacturer of industrial products based in Downers Grove, Ill., along with the company's health care benefits consultant, embarked on a massive overhaul of the Dover's health care strategy in 2009.

One of the main objectives was to bring unity to the diverse employee health programs that existed across Dover's 33 operating companies, more than 50 distinct business units and more than 100 U.S. locations.

The result was a 5-3-1 year strategy and the replacement of independent programs with a single, comprehensive program.

The latter includes integrated health benefit providers including a national health plan, pharmacy benefits manager, and supplier partners. These companies deliver lifestyle and disease management, health advocacy and nurse line, vision, dental, life insurance, disability and data warehousing.

Prior to launch, Dover and its consultant, Aon Hewitt, facilitated ongoing implementation meetings with the new partners. The key to success was the individual meetings and the group meetings to identify integration opportunities.

My firm, StayWell Health Management, has taken an active role in providing expertise on health management best practices and supporting the overall integration process.

In addition, these discussions are supported on a strategic level through an executive-level sponsor from StayWell that conducts monthly discussions with Dover management team members and the company's consultant.

Tactical support is ongoing through participation in vendor summits and ongoing integration activities as defined by the 5-3-1 strategy.

As a result of this strategic collaboration facilitated by Aon Hewitt, and alignment of core competencies between a variety of supplier partners, Dover was successful in launching its integrated program in 2010, consolidating employee benefits.

In the process, Dover secured volume-based pricing and performance standards not previously available to its individual operating companies.

 

Indicators of success

In addition, Dover is closely monitoring early indicators showing success from their consolidation and integration efforts. Early accomplishments include:

* Successful migration of more than 50 independent programs to a single benefit platform.

Operating companies and their respective populations leveraged the new, integrated resources that included full-service (health advocacy) and self-service (health portal) support to assess benefit plan options, enroll in the plan of choice and take the first step in participating in the new health management program.

* Establishing a baseline assessment of population health risks.

Half of the population completed the health assessment and/or the health screening identifying several key risk factors such as weight, nutrition, blood pressure, back care, and stress.

* Strong initial engagement in available programs.

More than one-third of the eligible population is engaged in personal health coaching to work on reducing health risks, or for those with chronic conditions, engaging in programs to help better manage conditions such as asthma, diabetes and heart disease.

* Introducing employees to the concept of personal responsibility for the quality of their own health.

 

Finding proven results

Employees and their spouses received a financial incentive in the form of a Visa gift card for completing the annual health assessment and a health screening that included their base-level biometric results. Nearly 9,300 eligible participants (approximately 7,000 employees and 2,300 spouses) have achieved the incentive thus far.

"We're very pleased with the implementation and early results from this culture-changing effort," says Amy Katzoff, health and wellness manager, Dover Corporation.

"This program requires all of our supplier partners to work together to deliver a high-quality experience for our employees and operating companies, many of whom had not participated in wellness or clinical programs before. Our programs, supplemented by the support from our onsite wellness manager, have generated a positive response from the OpCos and strong senior management support.

"By knowing our numbers and our health risks, we have focused the OpCo leadership on improving those risks and the health of the Dover population."

Willette is senior vice president and chief growth officer at StayWell Health Management. Prior to StayWell, Willette was a partner at a leading benefits consulting firm, where she served as national practice leader for health and productivity management. Reach StayWell at information@staywell.com.


 

COMPARING ROLES

Understanding the responsibilities of both parties allows each to work effectively toward their common goal: meeting client needs

The Health Care Benefit Consultant The Health Management Provider

* Establish stakeholder relationships at all levels of the organization, and help select third-party partners to deliver specific services. Provide leadership and guidance in anticipating provider integration opportunities or challenges. * Establish stakeholder relationships at all levels of the organization and with other client third-party providers that will integrate as part of a health management program.

* Consult with clients to help establish a long-term health care strategy that includes a solid health management component and is supported by short-term tactics to achieve overall objectives. * Understand the long-term health care strategy and specific health management component to determine responsibilities in delivering program elements to achieve both short-term objectives and the long-term strategy.

* Facilitate integration of services, sharing client health care data as a catalyst for discussion, via vendor-partner summits and/or ongoing, multi-provider meetings. * Understand the client's data and unique demographics to formulate recommendations and share knowledge of best practices during integration summits or multi-provider meetings.

* Advocate and monitor program best practices, leveraging partner expertise to assist in strategy planning and implementation. Lead the integration, analysis and reconciliation of data sets between providers. * Monitor and manage adoption of best practices, providing expertise, data and reports that inform strategic planning meetings (e.g., satisfaction and participation benchmarks, building a culture of health, incentive designs).

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