Are You Ready for Active Plan Management?

Author: Eric Swartley, LD&B Employee Benefits Consultant

Are You Ready for Active Plan Management?

My colleagues Trevor Parmer (https://myehrc.com/the-complex-world-of-prescription-drugs/) and Jonathan Crawford (https://myehrc.com/healthcareandyourbottomline/) have done a fantastic job in their recent blog posts of laying out some of the pitfalls and profit-taking of the modern healthcare industry.

Both have suggested that there is a “better way”, and that is absolutely true! Employers have a choice to actively manage their health plans through a self-funded platform like our Employers Health Risk Consortium (EHRC). Many of our EHRC clients have managed to effectively avoid costs they would have otherwise incurred in traditional plans, either directly (costing the plan less) or indirectly (costing less to Stop Loss and cooling future premium increases). Admittedly, it does not always FEEL like cost avoidance when claims are still running hot. Paying $300K for a course of treatment that might otherwise cost $1 million+ is still $300K, after all…but it sure helps a group’s experience to eliminate the difference!

You might be asking: “Would Active Plan Management be effective for my company?” I am glad you asked! Here are a few ingredients for success:

• Corporate Culture: When employees trust that management is truly looking out for them and not just the bottom line, they are much more open to consider alternative treatment options that can save money for themselves and the health plan. If employees do not trust that management has their best interests in mind, they will likely not be as willing to change behavior…even if they stand to benefit financially.
• Employee Communication/Engagement: This goes hand-in-hand with culture, but just having good culture is not quite enough. Employees need regular touchpoints (magnets on the break-room refrigerator, intentional promotion at scheduled safety meetings, sign boards, etc.) to remind them of the tools available to them. Otherwise, they will often just take a provider’s referral without considering that they might be able to access better care at a lower cost (or no cost!) if they engage. As I like to say… “If it sounds expensive, call somebody” – HR or your broker partner. Also, testimonials from your employees can be pure gold in promoting cost-saving initiatives.
• Good Old-Fashioned Luck: Even when the two bullet points above are satisfied, there is an element of luck. Creating a working environment that supports healthy habits for body, mind, and spirit will certainly increase your luck, but…stuff happens. Even then, the EHRC will often be more forgiving at renewal than a stand-alone plan because of the agreements in place with our vendor partners.

If you see this list and say “Hey, my company does a great job promoting positive culture and clear communication!”, perhaps your company is ready for active plan management. Start the conversation today by reaching out to an LD&B Consultant. You have invested in your employees, let us help you find return on that investment!