Maximizing Benefit Value

Shaping Behavior

A few employers are choosing to tie certain benefit availabilities to employees’ participation in surveys and wellness programs. “The spirit of our meeting yesterday with [a large health insurer] was that completing a health risk assessment would allow you to buy up to a more flexible plan, or a plan that might be of higher benefit,” Miller says. “There is an incentive to participate.”

The incentivized plan might include products and services specifically tailored to the demographics of the population, and it might also include the option of high-deductible catastrophic coverage coupled with a health savings account or a health reimbursement arrangement.

“Consumer-driven [initiatives] themselves won’t control health care costs, because all you are doing is shifting dollars from a health insurance plan back down to participant,” says Brian Owen, a senior consultant at the Stanton Group, a Plymouth-based provider of employee benefit and retirement plans. “You need to give participants the tools that they need in order to be more conscientious consumers of health care and to try to improve their quality of life”

Martin agrees. “When you start to make people responsible for their own health care dollars, it’s only fair that you provide them extra tools to help them maintain a healthier lifestyle and hopefully lower their claim incidence,” he says.

So how can employers begin to incorporate value-based health care into their own offerings? The first step is to identify the needs of your employee population. Miller suggests contacting your vendor to see what resources and metrics it can offer. Then ask an external independent consultant to help you sort through your claims data and identify the points that jump out.

If you do decide to make new benefits available, education is key to the success of your effort. Employees can be wary of change, and unless they’re a part of the planning and implementation process, they may perceive plan alterations in a negative light.

“I think we’re on the right track when it comes to value-based benefits,” Burrows says. “The simpler we make health care, the better. But to succeed, we need to extend the conversation to the consumer at every opportunity.”