As we barrel into open enrollment, healthcare cost-containment strategy is at the top of every HR leader’s mind. You might be considering a telemedicine benefit for your 2020 plan or wondering about onsite clinics. No matter what you’re thinking, you’ve probably noticed: cost-containment ideas don’t necessarily translate to savings.
In this post, we’ll examine some standard cost-containment techniques. We’ll also explore how HealthJoy’s benefits experience platform can accelerate your strategy by centralizing your benefits, communication, navigation, and automation.
Given a choice between two gas stations, can you imagine filling up at the more expensive one? We can’t, either. We know employees want to choose the most inexpensive option for their MRI, primary care visit, or annual physical. Unfortunately, medical procedure pricing isn’t as easy to compare as fuel. Even employees who want to find an inexpensive option might give up if the process isn’t simple. That can mean a higher copay for them and increased costs for your company.
At HealthJoy, we know that price transparency is key to accelerating your cost-containment strategy. That’s why we emphasize it in every member communication. Say an individual member needs to find an inexpensive MRI in their city. Our live concierges will research the highest quality provider at a fair price, then send members a simple breakdown of the cost at different providers.
To make it even simpler to encourage healthcare shopping, we recently debuted HealthJoy Rewards. Our solutions make it easier for employees to understand what they’ll save when they make smarter healthcare decisions.
We know that encouraging employees to shop for healthcare is an excellent cost-containment strategy—but only if they’re willing to put in the extra work. Onsite clinics let employers leap this hurdle altogether.
These all-in-one wellness centers typically offer a lower price for acute and primary care services and might also simplify access to weight loss programs, mental health services, and condition management. They keep preventive medicine top-of-mind for employees, making it easier to stay healthy, manage their chronic illnesses more effectively, and save time.
The investment for an onsite clinic can pay off in increased productivity and lower rates of absenteeism. A 2015 survey by the National Association of Worksite Health Centers polled 255 employers with onsite clinics and found that 64% reported a reduction in medical care costs. One-third of large U.S. employers with 5,000 or more employees now offer onsite clinics.
HealthJoy works alongside your onsite clinic to increase utilization. The benefits wallet integrates with clinic benefits to remind users of this option every time they open the app. Year-round education by JOY works even harder to keep your clinic top-of-mind. We can also send results from a HealthJoy telemedicine consultations to an onsite clinic for a seamless follow-up experience.
Telemedicine is an increasingly popular strategy for employers focused on cost-containment. Virtual healthcare solutions, like onsite clinics, allow employees to avoid expensive claims, spend fewer hours at the doctor, and sidestep an unnecessary trip to urgent care.
The average employee wastes 2-3 hours in wait and travel time when they go to see the doctor. Americans, on average, earn over $27 per hour, which means a productivity savings of $50-$75 per telemedicine visit. Wait times are one striking example of telemedicine’s potential savings. The average wait time to see a typical doctor is 24 days. HealthJoy’s telemedicine solution, in contrast, usually offers a screen-to-screen meeting with a medical professional in less than 10 minutes.
Most basic telemedicine vendors can help clients achieve a break-even ROI, but with higher utilization, you might see savings of 10-20x more. HealthJoy’s telemedicine benefit has the highest utilization rate in the industry. Our live concierges redirect members to telemedicine when appropriate, and communications from our virtual assistant, JOY, ensure they’re aware of their benefit. HealthJoy allows you to add the ease of automation to your cost-containment efforts.
Preferred Pharmacy Providers (PCP)
Prescription medicines are a significant driver of healthcare spending—especially when employees don’t know how to select the least expensive options. Negotiating a preferred pharmacy provider program (PCP) is one way employers can manage prescription costs.
It may be smart to build a PCP into your plan design if you see that prescription spending is high among employees. From there, teaching employees how to make the most of your pharmacy partnership is vital.
We know employers see more significant cost savings when benefits are top-of-mind. That’s why HealthJoy’s artificial intelligence-powered virtual assistant, JOY, creates custom notifications about prescription benefits, preventive care, and more.
Even if you don’t elect to go with a PCP, consider ways your company can lower prescription spending as a cost-containment strategy by working within your plan.
One of the built-in features within HealthJoy is Rx Savings Review. The doctor-created program uses nine different strategies to find your employees the lowest cost medication. We utilize everything from therapeutic alternatives to international mail-order on expensive tier five drugs to save companies money. If your company has a preferred pharmacy, we’ll always add this recommendation when applicable.
As our population ages and chronic illness rates increase, case-management services offer a way to bridge gaps in care. Case managers help patients navigate the healthcare system and get the care they need to be comfortable. When that navigation includes finding lower-cost medications, avoiding unnecessary procedures, and managing symptoms, it can also spell plan savings for employers.
Though case-management services might require an investment, they can also spell significant savings—especially when you consider that impaired performance from chronic illness costs employers an estimated $198 billion per year. Cancer, HIV, and cardiovascular disease, conditions that are commonly addressed by case-management services, are expected to continue as leading drivers of employer healthcare costs in 2020.
Untreated mental health conditions are a huge driver of healthcare costs.
For one thing, employees struggling with mental and emotional stress tend to miss work. When they are present, they’re distracted and less productive. One report estimates that depression and anxiety cause a loss of $1 trillion in productivity per year. That number doesn’t factor in employees experiencing marital stress, family issues, addiction, or grief.
Employee Assistance Programs, or EAP’s, offer cost-effective solutions to help workers proactively tackle life’s stressors. Resources are typically limited in scope, but in many cases can be just as effective as long-term or broader solutions.
A short-term counseling EAP solution, for example, might offer employees six targeted counseling sessions to help them cope after a divorce. Short-term counseling can improve presenteeism, absenteeism, and productivity markedly over a short period.
The ROI on an EAP depends on utilization. Since we know that employees often don’t use their EAP’s, generating awareness and centralizing the benefits experience is essential. HealthJoy makes this process simple, with communications that keep employees engaged and educated about their benefits year-round. We recently launched our EAP to make integration with HealthJoy even simpler.
Reference-based pricing (RBP)
Reference-based pricing (RBP) is slowly growing in popularity as a way to manage healthcare costs. But without proper education, it can create financial stress and confusion for employees and considerable headaches for HR.
In RBP, the employer sets a maximum amount they will reimburse for certain medical services. Whereas traditional network agreements rely on a discount off billed charges, RBP reprices claims based on fair market pricing (usually Medicare plus an additional profit margin).
Implementing an RBP strategy can be tricky guided to appropriate providers, and they can end up with a bill for the amount between the reimbursement maximum and the provider’s charge. This practice is known as “balance billing.” The financial stress of several thousands of dollars of unpaid medical bills can impact productivity—as well as the employees’ perception of their benefits and the company as a whole.
That’s why successfully incorporating RBP into your cost-containment efforts means consistently educating and engaging employees. HealthJoy makes this cost-containment strategy simpler. From the moment an employee logs into the HealthJoy app, our virtual assistant JOY can educate them on RBP. If employees have questions beyond what JOY can handle, one of our healthcare concierge team members joins the chat to explain more complex concepts.
HealthJoy stays top-of-mind with both a physical and digital presence, reducing the risk of surprise medical bills and helping ensure an RBP strategy works for employers and employees.
Accelerate your healthcare cost-containment strategy
As you finalize your company’s benefits package for the coming year, it’s worthwhile to consider where this cost-containment strategy list fits in. Once you know what you’d like to use to cut costs, it might be time to ask: is your benefits tech stack helping to accelerate your efforts?
Remember that centralizing the experience, making your cost-containment strategy more straightforward for employees, and even incentivizing smarter healthcare decisions can go a long way toward improving your 2020 healthcare spend.