Employers are getting serious about data-driven health plan design. They understand that in the age of health care reform, they must actively manage their health plans in order to control costs. And their efforts are paying off.
A recent study of U.S. employer-based health plans shows health care inflation hit a 15-year low in 2012. Conducted annually by Mercer, the growth of the average total health benefit per employee slowed from 6.1 percent in 2011 to 4.1 percent in 2012.
Some of the successful plan design strategies that contribute to slowing the rising cost of health care include more employers offering consumer-directed health plans, greater investment in wellness programs, and more aggressive understanding of participant behavior. One key area gaining popularity and positive outcomes is pharmacy management.
Pharmacy benefit plans can play an important role in the health and well-being of plan participants when they’re designed properly. But, if not managed well, they can be a cost drain on health benefits. A well-designed plan includes providing quality drug therapy to those who need it, when they need it, as well as incentives to ensure that when participants fill a prescription, they actually take the medication as directed.
One of the challenges I’ve observed with clients who rule out programs like more sophisticated pharmacy benefit management or high-deductible health plans is a lack of attention and resources applied to managing the behavior changes being asked of plan participants. Instead, much planning and focus goes into plan design, data feeds and other technical administration. Communicating the behavior change is an afterthought. This is a huge mistake.
For less than one-tenth of 1 percent of the overall cost of benefits, most employers can invest in resources to communicate about plan design changes in ways that are fun and engaging and that avoid the frustration that can occur when employees misunderstand how their benefits work. There is nothing worse for an employee than to go to fill a prescription and be told he has to cover the full cost because he did not understand his plan design restrictions.
As employers continue to engage in more sophisticated health plan designs – designs that require the active understanding and participation of the people covered on their health plans – change management, training and consistent communication must not be overlooked. Today there are many resources, from mobile to traditional print, that can be leveraged to help plan participants better understand how to use their plans. There really is no excuse for employers to overlook this important step any longer.
That same Mercer study that showed health care inflation is slowing also predicts a low increase of 5 percent in 2013, provided employers continue to implement expected plan design changes. But the full result will only truly be realized if employers also invest in the communication needed to make those plan design changes successful.
Michelle Hicks, a senior professional in human resources, is a director in the communication practice of Buck Consultants, a Xerox company.