What are Your Benefit Strategies?

As I walk around the office and enter into our nursing areas, I sometimes hear one of our nurse coach case managers asking a member "In thinking about what you have just said, is there something standing out there that is important to what you are wanting?" It is part of the intrinsic coaching skills they utilize - helping members identify the intrinsic motivation within to help make healthy lifestyle changes. The basic question - What do you want? - is an excellent one for health plans. In really giving that thought, it will take the leaders of your health plan on a journey that is vital to the success of benefit strategies your company is developing. All of us are faced with a constantly shifting terrain of what appears to be, at first glance, obstacles - healthcare reform and the almost daily changes of what a health plan is required to do in plan design, plan notices, plan decisions; HIPAA regulations strengthening and how to abide by those regulations; the recession and the economic impact of that on business opportunities and operations; challenges of offering a competitive benefit package to attract and retain quality employees; difficulty drilling down to the core areas that need to be understood and taken into consideration before the health plan makes a decision on maintaining grandfather status or not; the list of obstacles is endless. Another variation of the "what do you want" question that is also worth asking: As a health plan, what is it in two to ten years from now that you will be glad you did? The reality is that health care planning strategies, in today's world, are a key to your business' success. For most companies, it is in the top three expenditures. So as we are hit with these seismic waves of healthcare changes, how do health plans not only stay in the game but also stay in the winner's circle when it comes to the health of their employees and the cost containment needs of the health plan? Healthcare reform is forcing every health plan to relook at their benefit plans. So forward thinking groups will take this opportunity to not just be reactive to the regulatory needs of healthcare reform, but move out of the reactive mode into the strategic mode. Turn this obstacle into an opportunity. What truly are your benefit strategies for improving the health of your employees and lowering health plan costs? The reality is that this is not a short term, annual project but a commitment to a long term perspective and plan for the impact of your health plan on your members' health and the plan's costs. Top leadership has to believe a solid benefit strategy is a key foundational piece to the success of meeting goals for the health plan and the company. A key component of a strategic plan is the ability to monitor, track impact and make appropriate strategic adjustments as conditions change. Our economy, our workforce, our business opportunities are all dynamic and ever changing - so our health plans have to be continually monitored to make strategic adjustments. Some ways to start gaining traction in having a formal strategy for your health plan: a. Cost Trends - everyone wants to understand them, and "bend" them. But to do that, you need to really understand what your drivers are in health care cost trends. How do they impact you now - and what are the future consequences of those drivers? Does your health plan population have unique circumstances that need addressing? b. Have you recently evaluated your strategic plan for improving the health of your employees and lowering health plan costs? Is your strategy solid for prevention and early intervention? Or is it just a cookie cutter approach? Is it specific, and truly individualized to target your population? c. Everyone agrees cost management for catastrophic and chronic illness will be a key for successful health plans. Integra Employer Health offers our clients a coordinated, interoperable framework for early identification and intervention with members, regardless of where they are on the health continuum. Our programs are constantly reviewed and adjusted to meet the changing needs of the health plan's population. We offer our clients consultative services in helping determine what medical management interventions would maximize the health of members as well as provide best utilization o f health plan dollars. Is it time for your health plan to re-evaluate what programming you want to offer in the future? d. Do you have a wellness program in place that mitigates risk? While offering health fairs or smoking cessation is helpful, a good program addresses areas like pre-diabetes, prehypertension, etc. Good programs evaluate all your employees with the goal of moving everyone towards health. Engaging patients with these early conditions to move their clinical status towards improved health is essential to producing a positive ROI in a wellness program. e. Determining what are the keys to having a competitive benefit package to attract quality recruits for positions in your industry is important. Also determining what are key regulatory requirements for a health plan - and how your health plan can efficiently and cost-effectively comply with these regulations. Integra Employer Health offers solutions to our partner health plans as health plan strategies for the future are developed. With our experience, nationally recognized staff and a sustained history of success, we can assist you build strategies that will help you achieve your health plan's strategic goals. Our Account Executives are already in the process of contacting our clients to discuss recommended strategies for the future. But please contact them at any time with your concerns and questions; we are ready to help!