As medical care gets more expensive—and employees stay as unhealthy as ever—your organization probably is trying to cut costs wherever it can. One of the best ways: implement programs that prevent disease.
Preventive services such as immunizations, preventive medications, screenings and counseling are effective at keeping employees healthier, says the National Business Group on Health. The group offers nine recommendations for making prevention part of your organization’s business strategy:
1. Make prevention a priority for your organization, and come up with a strategy. Where to start:
- Define the organization’s expectations for all its disease prevention, health promotion and wellness initiatives.
- Outline priorities for disease-, health behavior- and population-specific prevention.
- Set goals for the number of employees you hope will use preventive services.
2. Base decisions on data. Examples:
- Use claims data to learn how many employees use the preventive services you offer and pinpoint where use falls short of your organization’s goals.
- Conduct a health risk appraisal to inform employees about their own health risks and help them adopt healthier behaviors. Common problems identified by the appraisal can help focus your organization’s priorities for preventive services.
3. Select a health plan that covers preventive services. If your existing one doesn’t, renegotiate to add them.
4. Write detailed summary plan descriptions that answer these questions:
- Which specific clinical preventive services are covered?
- Which recommendations are appropriate for which populations?
- What is the timing and frequency of the recommended service?
Then, distribute the clearly written materials to all employees.
5. Tailor your preventive services to the needs of your organization and its employees. Consider age, gender, risk and how common certain diseases are among your worker population.
6. Offer the same preventive care to all employees, regardless of the plan they’re enrolled in. This ensures coverage of more employees, reduces the administrative burden of having many plans with varying covered benefits and makes it easier to coordinate prevention services with the health promotion and wellness activities that your organization offers.
7. Don’t start from scratch when designing a preventive services benefit. Tap the wealth of resources already available. Some good ones include:
- U.S. Preventive Service Task Force (www.ahrq.gov/clinic/uspstfix.htm)
- Advisory Committee on Immunization Practice (www.cdc.gov/vaccines/recs/acip/default.htm)
- American Academy of Pediatricians (www.aap.org)
- American College of Obstetricians and Gynecologists (www.acog.org)
- American Medical Association (www.ama-assn.org)
8. Take advantage of everything the government entitles you to. For example, set up your plan to include reimbursement for the coverage of preventive services. To find out which services are 100% covered, visit www.irs.gov/publications/p502/ar02.html.
9. Integrate the disease prevention efforts of your health plan with your, and your wellness, disability and occupational health and safety staff. The health plan, after all, is just one corporate health care initiative.
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