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Moving your health care costs to health care assets

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in Leaders & Managers,Management Training

Contributor: Nancy Blough, J.D., MBA, executive vice president of the American Health Data Institute, Fort Mill, S.C.

Over the past five years, health care premiums have risen five times as fast as general inflation, four times as fast as workers' earnings and 2.3 times as fast as business income growth. Corporate America continues to register alarm over unrelenting health care cost growth. If not restrained, health care costs will significantly affect every firm's profitability and competitiveness.

Many employers choose to curb health care costs by actively managing worker's coverage through a variety of key ingredients. But they recognize that there is no single solution to contain ever-growing health care costs.

Disease management/wellness. One way employers curb health care costs is by keeping employees healthy. Those employers realize that 20 percent of their covered lives are driving 80 percent of the corporate costs due to chronic diseases.

By identifying the most at-risk employees through an effective chronic disease management program and predictive modeling, employers can target resources (such as nurse coaches) to those most in need of care, coordination and education.

Benchmarking. More employers are also benchmarking whether their employees receive standards of care for their defined chronic conditions. Those employers are also integrating their health risk appraisal tools to include more than the healthy well.

By using incentives suited for the company's culture, employers can reach participation levels of health-risk assessments and chronic disease-management programs in the 70 percent level and above.

Managing data. Employers also realize that they need actionable data to effectively manage their health plans. Executives are taking advantage of advanced analytics that measure standards of care for the chronically ill and for profiling physicians.

Employers are monitoring—and beginning to pay—health care providers based on the provider's quality and efficiency scores. They're also providing that information to their employees to empower them to become better health care consumers.

Independent and actionable analytic data allow employers to tread carefully before shifting more costs to employees. The data often show that higher costs for employees cause some employees to postpone care or not take medications, which ends up raising long-term costs.

Most employers would like their employees more engaged in health care decisions. For this to occur, employers need to provide employees and their spouses with decision-making tools. Increased and constant communication with employees regarding health care topics allow employers to create better health care consumers and to build a "culture of health" in their workplaces.

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