Health care costs and health insurance
premiums are continuing to rise at
alarming rates. And, unfortunately, this
is not a new phenomenon, as employers have
been struggling with unpredictable and
uncontrollable rate increases year after year.
Annual double-digit premium increases
have forced many employers to pass significant costs on to employees, in the form of
higher contribution, deductible, coinsurance
and/or co-pay amounts. Most employers still
take the responsibility of providing quality
benefits seriously, but employees need to be
involved more than ever before; they need to
think carefully about how they use their benefits and become smarter consumers.
“The way we purchase health care is unlike
any other purchases we make,” says Amy
Broadbent, the vice president of JRG
Advisors, the management company for
ChamberChoice. “Most of us will search a
newspaper for a coupon that saves us pennies at the supermarket. But when it comes
to health care — something far more expensive and complex — we rarely ask enough
questions or consider all of the options that
could save us money.”
Smart Business spoke with Broadbent
about health care and how to help employees
become better health care shoppers.
Why is it so important for employees to
understand health care?
Many employees do not understand the
role they play in managing health care costs
and do not spend health care dollars wisely.
How many employees actually realize that
each time they go to a medical provider or
receive medical services they generate a
claim that must be paid for through their
employer-sponsored medical plan? The costs
of their claims, their family members’ claims
and fellow employees’ claims determine, at
least to some extent, the price their employers pay for health benefits. In the end,
employees’ decisions directly affect annual
premium adjustments. It is time for employees to begin making more conscientious
health care decisions. The more knowledge
employees have about their personal health
and the treatments they receive, the more
they can control their out-of-pocket costs
and, ultimately, the employer’s costs.
How can employers educate employees to
become better health care consumers?
When someone is sick or injured, he or she
wants to feel better, fast. Most health plans
provide coverage for treatment that can be
received in a variety of settings: a doctor’s
office, a hospital, an urgent care center or an
emergency room. But, every setting is not
appropriate for every kind of care, and, too
often, we utilize the quickest means available
rather than the most cost-effective. For many,
the decision is based on convenience rather
than cost. Educating employees to choose
the most cost-effective option would go a
long way toward ensuring that an employer
can continue to provide quality benefits.
How can employees involve their medical
professionals?
You and your employees should take the
time to talk with your doctors. Surprisingly,
many patients do not ask their doctors basic
questions about treatment options and alternatives. Patients often accept their doctor’s
advice without taking the time to question
treatment alternatives. Having a dialogue with the physician helps the patient better
understand how their care and treatment
decisions affect their health plan costs. This
will also enable the doctor to get to know the
patient better and, ultimately, prescribe the
most effective treatment possible. Taking the
time to ask basic questions will enable the
patient to become a more educated consumer. Ask questions like: How much will my
treatment cost? Can I be treated another way
that is equally effective but less expensive?
What are the potential side effects? What are
the risks? The intent is not to forego care but
to receive the most appropriate level of care
at the most reasonable cost available.
How can employees become better educated
on their prescription medications?
Learn the prescription facts. Many people
incorrectly think there are significant differences between brand-name and generic
drugs when, in fact, there are not. The true
difference lies in the name of the drug and the
cost. It is no secret that generic drugs cost
less than brand-name drugs. Employees
should be encouraged to ask their doctor if a
generic equivalent is available any time they
are given a prescription. Not only does this
save the employee money but the use of
generic drugs also saves the employer money
in terms of health plan utilization. The greater
the overall use of generic prescriptions, the
better the impact on the health plan utilization and, ultimately, health care rates.
What else can I, as the employer, do?
As an employer, you are undoubtedly trying
to figure out how to prevent ever-increasing
health care costs from having any more of a
serious impact on your company. Health care
costs will continue to rise and the reasons
why are not within an employer’s control.
Therefore, employers need to encourage
employees to become better-educated consumers of health care services. Employers
and employees are in this together. It is time
for employees to understand just how much
of an impact their health care choices and
decisions make in the long run.
AMY BROADBENT is the vice president of JRG Advisors, the management company for ChamberChoice. Reach her at (412) 456-7250
or [email protected].