Benefits

Keeping doctors out of the chair and part of the conversation

By Garrett Weldon, PT, DPT, Vice President of Provider Partnerships and Clinical Strategy, healtH2Business

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In 1891, an artist named Lukes Fildes completed a painting entitled, "The Doctor." It portrays a concerned physician watching over a gravely ill child. It is remarkably lifelike, perhaps because it is based on the artist’s own experience of losing a son before adolescence. Overlooking the sick child, the doctor is seated in a chair and appears deep in thought. Behind the little girl, with faces of fear and sadness, are the girl’s mother and father. Today, the painting begs the question: who is helping this little girl more? The doctor? The parents? Sure, both are present, but both are also an arm’s length away, immobile and frozen in their inability to intervene. There are no IV poles, cardiac monitors or tests to be run There is simply no active intervention being or to be done.

It wasn't until 1941 that penicillin was first prescribed and arguably changed the way we live and die. Now we have things like cortisone treatments, open heart surgeries, kidney transplants and rapid stroke interventions happening daily. If Sir Fildes were to paint this picture in 2019, I am confident the symbolic physician would no longer be simply sitting in a chair. He would be up on his feet, intervening.

However, having the doctor out of the chair comes with its own set of problems. Misdiagnosis, inappropriate interventions, over-treatment, under-treatment, human errors and debates about how, when, where and on whom to intervene. While these problems can be significant, I for one am still glad the doctor is out of the chair.  

It seems to be too often in the space of employee benefits that conversations turn to putting doctors back into their metaphoric chairs. From my perspective, many of the discussions happening are without consulting a large enough sample size of doctors or hospital systems to speak on their behalf. Often, anecdotal experiences are being used to frame the full provider experience. That is, simply, an error. Of course, doctors make mistakes, some of which even cause premature death, disability or financial hardship. But what if, instead of putting them back into the chair, we sought to give them a voice? What if we brought them to the table of creation? What if we gave them responsibility for a population? What if we worked with them to create and design plans in such a way the emphasis included responsibility and opportunity as opposed to just cost-containment. What if one of our top goals was to allow employers the flexibility they need to sit down with doctors and have meaningful conversations about their employee populations? What if our actions strongly suggested we view providers as a part of our community and in turn an integral part of the solution?

In the upcoming webinar, “Build the dream: Constructing a cost-containment ecosystem for your organization,” I’ll be exploring more of this topic. I will also be sharing my experience as a clinician and how the PPOs and ASO arrangements of today are not conducive to the vision of the healthcare delivery model I had and practiced, which ultimately led me to be a believer in reference-based pricing plans.

3 tips for driving employee engagement

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The way employers communicate benefits information has a tremendous impact on how well their benefits programs are understood, utilized and perceived by employees. Providing your employees with ample informative resources will help better convey your message. The better your benefits are communicated (and the better employees understand them) the more valuable they will become.

Many employers think that managers and supervisors are the best choice to share benefits information with employees. This makes sense, since direct managers are more approachable and accessible for questions. But as with all internal communications, there is a risk if done incorrectly. Take caution when communicating benefits information by taking the following best practices into consideration.

1 Avoid verbal communication hiccups.
Communicating inaccurate information to employees is always a major concern when using managers and supervisors to relay benefits information. Keep in mind that misinformation not only causes an employee relations problem, but also carries legal risks. Consider these tips to avoid problems:

  • Allow only Human Resources personnel to discuss benefits information with employees.

  • Remind supervisors and managers to review plan documents carefully in the case they do receive questions. Stress that they should refer employees to HR with any question they are unsure of how to address.

  • Communicate to managers and supervisors that they should never make any promises regarding any aspect of the benefits plan that the company is unable to keep, whether formal or informal.

2 Take caution with written communications.
All written materials (even informal documents) about benefits information prevails in court. As a precaution, make sure all written benefits communication is consistent with the official documents before distributing.

Employees often rely on summary plan descriptions to determine their rights under a specific plan. In the event of an issue due to discrepancies between plan documents and the summary plan document, the summary plan document can hold up in court. Because of this, it is crucial to make sure that the summary plan document is correct, current, clear and in agreement with the plan documents, handbooks and all other benefits information.

As a safety measure, be sure that these materials state clearly that the plan document has absolute authority over them. This information should appear in a separate paragraph in a prominent position. Consider using larger, italic or boldfaced type or a distinct border to make the information readily apparent.

Take further precautions by implementing the following processes:

  • Storing a copy of each communication or disclosure sent to employees, however informal.

  • Granting discretion to fiduciaries in the plan document.

  • Ensuring all documents relating to the plan do not include any misleading information before distribution. Requesting any additional information from the plan administrator regarding information that you believe may be misleading.

  • Reserving the right to amend the plan at any time, for any reason.

  • Developing a benefits guide that reflects your organization’s brand and includes all benefit information in one place.

  • State in the plan documents that plan amendments are to be made only in writing and approved by the business owner or plan administrator, if applicable.

3 Remember to keep your broker involved.
Your broker can help you customize your benefit plan communications and materials so you’re not relying on the generic information provided by the insurance companies. At the very least, they can add your logo to all communication pieces. Your broker can also help you create a communication plan to help you and your management team do the following:

  • Get the word out about how your benefits stand out in the job market by sharing your benchmark data.

  • Creating a multi-channel communication strategy to reach all generations of your employee base. For instance, younger employees might prefer on-demand resources (recorded videos or webinars, virtual avatars or decision-support tools, etc.), while other employees might prefer in-person meetings or one-on-one support.

To learn how to take employee engagement to the next step, join me next week for a webinar, “Employee Engagement + RBP: Employers’ secret to lowering healthcare costs,” on April 9th.  

4 Points to hit when talking benefits with your CFO

By Sheryl Simmons, Chief Human Resources Officer

As an HR leader, it’s essential to collaborate with all members of your C-Suite. Doing so is not only important to your organization’s success, but it also helps you share your unique insight and be seen as a key member of the C-Suite table. What better opportunity to display your value than by tackling the healthcare dilemma? After all, it’s imperative that your business crafts a strategy to tackle the skyrocketing costs and poor employee experiences with healthcare. Your CFO is already keenly aware of this. Partnering with them to strategize your organization’s approach can likely be a win-win for all, but it’s essential that you begin by learning to speak your CFO’s language for a successful partnership.

1 Treat benefits like an investment opportunity.
When speaking with your CFO, focus on demonstrating the investment opportunity a modern benefits approach can offer your organization. Let them know that your company is in the healthcare business. In fact, every U.S. company is in the healthcare business. Healthcare is the second or third largest expense for most employers. General Motors spends more on healthcare than steel. Starbucks spends more on healthcare than coffee beans. Once your CFO is on-board for a partnership, lay out the strategic, business-focused reasons for implementing a modern benefits approach.

2 Give them the 411 on cost-saving solutions.
Provide a high-level view of the variety of new, cost-saving healthcare solutions available in the market. Be prepared to answer why you selected the options for your company, as well as why you don’t see the others as a good fit.

Keep in mind, your CFO is not entirely fluent in HR speak and that’s okay. Share your knowledge. Get comfortable speaking from a financial viewpoint about the modern solutions organizations are using to combat rising costs like:

  • People-friendly reference-based pricing models that increase access to quality care AND lower healthcare costs
  • Pharmacy benefit management vendors that provide transparent contracting
  • Medical management that is integrating throughout the employee experience

3 Find the numbers. Know the data.
If you have access, dig into your claims data to show the breakdown of your current healthcare costs. It is highly probable that a small population of your employees are driving the majority of your healthcare costs. These are the numbers you need to bring to your CFO. If you don’t have this data available to you, hit your CFO with the fact that just 5 percent of Americans are driving over half of the cost of U.S. healthcare.

Use this information to forecast how new approaches to benefits can lower your healthcare costs. For example, implementing a self-funded solution that offers holistic care management can help improve the health conditions of employees who need it the most, while also offering wellness initiatives to maintain the health of your healthier employees.

4 Show them the money.
It’s fair to say that your company’s bottom line is top of mind for your CFO. In fact, 65 percent of CFOs claim “cost management” as their top priority. With that being said, you must be able to show them true numbers on how a new self-funded solution can provide real cost-savings for your company’s bottom line.

This can be done by showing a comparison of the cost trend of traditional benefit strategies. Fully-insured employers can expect to continue to see a 20 percent increase in their benefits, while self-insured employers that offer traditional PPO networks, can expect a 5.5 percent cost increase for the future. However, employers that are implementing creative healthcare solutions like a health plan management approach to self-funded benefits are experiencing an average decrease in healthcare costs of 20 percent in their first year.

If you’re already in the process of researching vendors that offer these modern approaches, be sure that you’re also making it a requirement for them to provide you with an ROI analysis. If they can’t provide this for you, do you truly trust them to partner with you?

You can find more tips and resources to help you grab a chair and collaborate with the entire C-Suite at YourHRSeat.com.

A CHRO's Perspective on #BrokerMinds: Part 1

By Sheryl Simmons, Chief Human Resources Officer

As a CHRO, it’s evident that the shift towards healthcare consumerism has led to a major reshaping of employee health and benefits – and brokers are more valuable than ever. Being on the employer-side of things, I’ve always really valued the role of brokers, but sometimes approach things differently. So I teamed up with our marketing team to commission a third-party study of benefits brokers, consultants and advisors to help all of us step into the mind of today’s brokers to learn about technology adoption preferences. The data uncovered three distinct broker personalities based on their technological mindset – Analog Consultants, Receptive Next Gen Brokers and Automation Leaders.

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Chances are you’ve done all the hard work to ensure you have the right broker for your organization and value all they have to offer. In this three-part blog series, I’ll be diving into the data and sharing my perspective on how HR professionals can get the most out of their broker relationship – no matter what type of broker you have. First up, Analog Consultants.

Step into the mind of Analog Consultants.
Analog Consultants tend to take more of a traditional approach to consulting when compared to the other two broker personalities. They have a wealth of experience and pride themselves on the service they provide to their clients. This service-minded approach is likely the reason they tend to have such long-standing relationships with their clients.

While they may be more traditional, they do have an interest in exploring new benefits technology on behalf of their clients – 25 percent stating an interest in learning more about online enrollment tools and 20 percent expressing the same interest in benefits administration tools.

A significant reason for this interest is their concern about staying relevant to their robust book of clients. In fact, 45 percent of Analog Consultants agreed that one of their concerns was staying relevant to the changing needs of technology.

Yet over a third of these consultants aren’t considering Ben Admin tools – meaning some of these same consultants are not adapting to the current industry trends and could be missing key solutions to solve their clients’ needs. The key to all Analog Consultants—no matter where they fall within this data—is identifying their tendencies and communicating your organizations’ needs to them clearly. 

Getting the most out of your relationship.
In my experience, HR professionals who work with an Analog Consultant have a long-vested relationship and rely heavily on them for their legal and compliance knowledge. In fact, 69 percent of Analog Consultants view remaining compliant as one of their clients’ top priorities. However, 69 percent of them also view maximizing benefits offerings as one of their clients’ top challenges.

If this rings true for your organization, then it’s essential to continue engaging in these discussions to ensure your strategy aligns. For instance, if maximizing benefit offerings is a true challenge for your organization, then be sure you are leveraging your broker’s service-minded attitude for assistance. Invite them into the office to host meetings with employees to discuss the benefit offerings available to them and provide the consultation they need. This will help your employees to have the same level of comfort with the benefits your broker is advising as you do.

However, if compliance and benefit offerings are not a top concern for your company, then perhaps it’s time to initiate discussions with your broker to ensure your strategy and goals are aligned. For instance, if HR technology like Ben Admin solutions is of interest to you, be sure you communicate that with your broker. While blue-chip service is a great asset for any broker to have, ensuring you have access to the technology you need to ease administrative burdens and ultimately lower employee health and benefit costs is essential. After all, your broker only knows what is communicated with them.

Take a deeper look into your broker’s mind.
Get the full data on Analog Consultants and other broker personalities by downloading the “2018 Broker Tech Trend Report.”

Stay tuned. Next I’ll be sharing my perspective on the minds of the Receptive Next Gen Brokers.