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Are you considering a new health insurance partner?

While Washington continues to grapple with sweeping health insurance changes, employers are trying to control their health plan costs.

An annual challenge: cost versus value

Regardless of size or industry, employers annually review strategies and products as they seek new ways to control health care costs. If premiums for their current plan are rising, employers may be tempted to switch to a less costly plan for the coming year. This short-term view may help balance the budget, but may not effectively address the challenge of reducing health care costs. It may actually cost employers more in the long run.

Adopting a longer-term strategy, rather than a short-term, “year-to-year” approach, can more effectively control health care costs. My personal experience has shown that improving the overall health of an employee population is key to not only lowering employers’ health care spending, and having a more engaged and productive workforce. This can’t happen in one, short 12-month cycle.

Employers must be willing to take a multiyear approach to address the problem and make a long-term investment in their employee base. This investment can produce a sizable return. Here are some things to consider:

Chronic disease taking a heavy toll

According to the CDC, 86% percent of the nation’s $2.7 trillion annual health care spending is for those people with chronic and mental health conditions. This includes treating heart disease, stroke, cancer, type 2 diabetes, obesity and arthritis. Chronic disease costs take a heavy toll on health insurance premiums in this country.

What can be done?

At Aurora, we’re striving to improve the medical outcomes for chronic disease patients through consistent, impactful interventions, such as:

  • Follow-up phone calls and reminders to patients from their doctor’s office (rather than from an anonymous insurance company representative);
  • Ongoing patient education and monitoring to increase treatment plan compliance; and
  • Using nurse navigators, care coordinators and a team approach to keep patients with chronic conditions as healthy as possible.

These and other proven patient-centric approaches can keep chronic disease patients on the right track, but they require deploying additional resources upfront. It’s an investment that Aurora and our insurance company partners are willing to make. The goal is to improve the overall health status of these patients. Given time, these tactics can increase member engagement, improve patient compliance and close gaps in care. The end result can be improved health of plan members and reduced health care costs (but this doesn’t happen overnight).

Preventive care pays dividends, too

When health insurance covers preventive care, it removes financial barriers so members get the care they need and their health status will improve. While there could initially be an uptick in primary care visits and prescription costs, these costs will be offset by fewer expensive inpatient and emergency department admissions down the road (again, taking a longer-term approach). Think about the financial upside of providing preventive care for a valued employee who has high blood pressure. Proper medications, medical monitoring and lifestyle changes can significantly reduce that person’s risk of having a costly, debilitating stroke in the future.

Partners for improved health

To keep their workforce as healthy as possible, employers should consider a health insurance partner that works collaboratively with an integrated health care system to improve the overall health of its subscribers. Insurance plans with “in-network” access to the most efficient, cost-effective health care facilities and providers in the area (those producing better outcomes based on evidence-based practices) should be given top consideration.

As a final thought, with the increased movement of employers toward selecting narrow, high-performance networks, switching health care plans year-after-year can disrupt continuity of care. This may negate progress being made by longer-term care management plans aimed at helping employees improve their health and manage chronic conditions.

Making informed, value-based decisions

Adopting a multiyear approach and making investments in employees’ overall well-being can lay the foundation to help employers make solid, value-based decisions when choosing a health insurance plan.

If you would like to access a thought-provoking white paper written by Aurora’s Nick Turkal, MD, CEO, on the timely topic of health care reform, please click here.

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Scott Austin Senior Vice-President Commercial Growth
Scott Austin is Senior Vice President of Commercial Growth Strategy for Aurora Health Care. His oversight of Aurora’s long-term commercial growth strategy includes growing Aurora’s ACO solutions and enhancing Aurora’s employer products and services. Scott has more than 35 years of experience in the employee benefits field, including holding leadership positions for insurance companies and insurance agencies.

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