What to consider when redesigning a benefits program
The concept of design is matching people’s needs with what’s technologically feasible — and redesigning health plans is no different for employers looking to shake things up.
Creating a culture of health, rather than looking at plans as a way to curb costs, should be a priority for benefits executives when they redesign benefits programs, a panel of industry insiders said recently at the National Alliance of Healthcare Purchaser Coalitions conference in Arlington, Va.
Employers must have design standards and strive to make things better for employees, explained Marcia Peterson, manager of benefit design and strategy at Washington State Health Care Authority. That was her strategy when WSHCA redesigned its benefits program. She wanted to change the experience from start to finish and looked to the Bree Collaborative, an evidenced-based quality standard, as her blueprint for design, she said.
The goal of the collaborative is to identify and recommend evidence-based strategies in areas where there is unnecessary change in the way care is delivered and/or increased care that isn’t improving outcomes.
“What we focused on was the member experience and quality … not cost,” Peterson said, comparing healthcare purchasing to buying a cup of coffee.
“If we bought coffee the way we bought healthcare, it would be awful,” she said, noting consumers would need to get a cup from one vendor, some beans from another and then find someone to grind the beans.
But there is a disconnect in benefit plans between what employers say and what employees feel, added Ron Goetzel, vice president, consulting and applied research, at IBM Watson Health. He suggests employers find what the employee pulse is when designing benefit programs.
“We always look at the cost, but we never ask the consumer about the process,” he said. The secret sauce to getting employees engaged and on board, he said, is to create and promote a culture of health.
Goetzel said employers have the misconception that if they pay employees to quit smoking or eat healthy that they’ll do it. “Money alone won’t do it; it’s got to be an internal motivation,” he says. Employers need to exude health and wellness as a part of the organization. “[Employees] do it because they want to have a healthier family, money may be the wrong signal,” he adds.
In designing benefit plans, the goal should not to contain healthcare costs, said Ray Fabius, co-founder of HealthNEXT, a healthcare consulting group. “The real goal is to bend the healthcare cost curve, and it’s possible,” he said.
For the last 50 years, medical inflation has exceeded general inflation by about two to one, he explained. And that’s despite the fact that “we’ve come up with all these benefit designs — from HMOs to PPOs and now HDHPs and benefit exchanges.” Still, he said, one thing is absolutely certain: changing design by itself is not going to stem the march of higher costs or make a workforce more productive.
Echoing Goetzel, Fabius said that talking to and surveying employees about what they want from their benefits can be insightful and even therapeutic.
“You have to keep the well people well, reduce the risks of the high-risk and help people with chronic illness not succumb to the complication of their chronic conditions,” he said of designing benefit programs.