Your benefits package.
Stop wondering. Start comparing.

We provide fresh, relevant, local, and customized data for employers to benchmark their benefit plans using proprietary tools that are unique in the marketplace.  Try us today!

Back Button Menu Button

New Era in Iowa Healthcare (Needed)

May 15, 2013 By Leave a Comment

Value in Health Care DeliveryI’ve recently been visiting with healthcare providers around Iowa discussing how employers view health insurance and the value of healthcare delivered to their employees and family members. The discussion has been both open and honest. In fact, Iowa hospitals and physicians appear to be both interested and concerned with what they are learning.

My presentations evolve around four key observations that I have made over the past 29 years, both as a benefits consultant (my past life) and as a researcher. The intent of sharing these observations with the provider community is to convey the ‘pain points’ experienced by Iowa organizations regarding exorbitant health care costs and to begin a new dialogue of collaborating resources to find meaningful solutions in our health care world. After all, we are all in this mammoth problem together, right?

Here are my four observations:

  • Observation #1 – Health insurance premiums for Iowa employers have increased by 164 percent from 1999 to 2012. A great deal of uncertainty exists about the future of the health care ‘system.’

Year-after-year, employers continue to pay a handsome portion of the insurance premium. We know that take-home pay continues to erode for employees, as cost-sharing continues upward through increased payroll deductions and benefit plan alterations that include both higher deductibles and out-of-pocket maximums. This is clearly unsustainable for ALL of us. For communities to remain healthy and vibrant, employers must find solutions to this escalating problem.

  • Observation #2 – Iowa employers continue to embrace wellness initiatives, as they desire to have a healthier and more productive workforce.

Gradually we are morphing into a new social conscience of embracing healthier lifestyles – as more Iowa employers continue to assess and implement wellness efforts. We also have the Healthiest State Initiative and Blue Zones Projects™ in the news. The statewide Capital Crossroads Community Wellness Study reported that Iowa employers are open to partnering with community-wide wellness programs. For those employers currently without wellness programs in place, only three percent feel that wellness programs don’t work! This is encouraging.

  • Observation #3 – Lack of transparency in health care is a major concern and frustration to Iowa employers and their employees. Health insurance has become a major distraction to employers.

There is a growing belief that the ‘market’ approach does not work for ‘buyers’ of health care. In the next few years, will we see a gradual shift by employers to a more defined contribution approach by limiting financial support for employee premiums? Will value-based benefits begin to take hold that will nudge employees to use ‘higher value’ health providers and utilize approved medical procedures requiring less out-of-pocket exposure? Transparency of costs and outcomes are essential for the private market(s) to exist as health providers WILL definitely be held more accountable in the future.

The Accountable Care Act (ACA) will not solve the cost issue for employers and their employees. In fact, the ACA adds greater complexity in the insurance markets, forcing employers to search for opportunities that will relieve tensions and uncertainties. A ‘Provider Renaissance’ is sorely needed to deliver great value for the insurance premium being paid.

So what does all of this mean to the healthcare provider community?

Employers want to TRUST that hospitals and physicians will:

  1. UNDERSTAND the employer perspective, which is the need to be competitive by having a healthy workforce. Health providers must have the employers’ best interest in mind.
  2. CONSISTENTLY provide quality outcomes at reasonable costs – i.e. receive greater value for the dollar paid.
  3. COMMIT to do these critical things on an on-going basis – long term.

As mentioned in a prior blog, our fragmented delivery system is really not a “system,” but rather a concoction of multiple temporary or expedient remedies that attempt to solve our problems as we confront our health care needs. No one is at fault, yet we ALL are.

Now is the time for employers and the healthcare provider community to work together – starting with a meaningful and trusting dialogue that will result in concrete solutions.

To learn more, we invite you to subscribe to our blog.

Filed Under: David P. Lind, HHRI Tagged With: , , , , , ,

Expansion of Medicaid – What REALLY Matters?

May 8, 2013 By Leave a Comment

Quality care diceA new randomized and controlled clinical trial provides fascinating information for Iowa (and other states) to review while policymakers consider whether or not to expand Medicaid. I highly encourage you to read this study, as it helps frame the real issues we must focus on as a state and country.

Published in The New England Journal of Medicine, ‘The Oregon Experiment – Effects of Medicaid on Clinical Outcomes,’ study reviews the potential effects of expanding Medicaid to impact healthy outcomes when health coverage becomes available to low-income adults. As you have correctly guessed, the petri dish for this experiment was the state of Oregon.

When expanding Medicaid for the poor, the primary benefits can be lower depression rates, greater health-care utilization and the elimination of catastrophic medical expenses for those who acquire the insurance. According to the study’s primary author, Katherine Baicker, a Harvard health economics professor, “The purpose of insurance is not to just get you access to healthcare, it’s to protect you from financial ruin if you have an expensive condition.” Dr. Baicker was one of many speakers at Harvard’s “Forces of Change” series on healthcare that I attended in Boston a few years back…she is a wickedly smart and a concise researcher.

In Iowa, a great debate has erupted (mostly along partisan lines) about whether to expand Medicaid or pursue a new but untested plan offered by Governor Branstad. Both approaches have supporters and critics for a number of reasons – arguments founded on facts, emotion and, you guessed it, politics.

So what is the truth?

I don’t pretend to have the answer. However, the Oregon Experiment does give additional insight on the implications for any legislative activity enacted in this state. It is common knowledge that having insurance coverage allows us to seek medical care that will make us healthier and more productive…and we won’t go bankrupt. We also know that having insurance provides each of us a peace of mind, it certainly does for me. Finally, having insurance improves access to healthcare providers and services. Enough said, right?

Not so fast – after learning of this new study, we may need to reassess this logic and maybe qualify it a bit more. The study findings consistently support the importance of delivering QUALITY health care to our population. To borrow a quote from Dr. Ashish Jha, another wickedly smart physician and researcher at Harvard, “The explanation is simple. It’s not about access to healthcare; it’s about access to high quality healthcare.” Baicker’s recent study certainly supports Dr. Jha’s conclusions.

We cannot expect to have a healthier population by merely providing insurance to gain access to necessary care. In fact, there is evidence that shows doctors who spend a great deal of their time serving Medicaid recipients deliver lower-quality care. Insurance will unlock the door to gaining access to care, but having this access does not ensure we receive quality care that will improve our health.

The Affordable Care Act (ACA) attempts to improve access to care for those least fortunate in our society – and most everyone agrees that this is important. However, the ACA does little to control spiraling costs and improve the quality of care being delivered. By adding more insureds into an already dysfunctional, high-cost ‘system,’ will only make our health costs considerably greater and even more uncontrollable over time.

It’s like rearranging the chairs on the Titanic.

Improving the health of our population means that we must pursue logical steps to ensure that high-quality care is being delivered at a reasonable cost. Gaining access to care is not enough…we must commit to having high-quality care accompany this access. Dr. Jha articulated this point very well: “Quality is the link between healthcare services and better health outcomes.”

It is time to make sure this healthcare ship is traveling in the right direction. It’s what we all should demand…it’s what we all deserve!

To learn more, we invite you to subscribe to our blog.

Filed Under: HHRI Tagged With: , , , ,

Acts of Kindness – A New Company Holiday?

May 1, 2013 By Leave a Comment

Make A Difference in Your CommunityI’m always looking for emerging trends with employers regarding the benefits they offer. Just recently, I came across a commentary piece in the March edition of Employee Benefits News about an employer, Borislow Insurance, a benefits brokerage firm based in Massachusetts, who created a holiday tradition called The Random Act of Kindness. My interest was immediately peeked.

As described by Mark Gaunya, principal at Borislow, their program works as follows… For each of the last five years, Borislow gives each employee a $100 bill and asks them to go out into their community and ‘pay it forward.’ This ritual takes place about two weeks before the actual company ‘holiday’ celebration.

The rules are quite simple. Each employee must:

  • Use the money to make a difference in someone’s life.
  • During the holiday celebration, share with other employees how they spent the money.

As mentioned by Mr. Gaunya, “The stories are incredibly touching, and there usually isn’t a dry eye in the house by the time all is said and done.” Stories include an employee secretly following a senior citizen around a grocery store and paying for the groceries at the checkout counter. Another employee used the money to help pay some of the funeral expenses for a family that just lost a child to a sudden death.

Isn’t this perk really about a sense of belonging to an organization that desires to make a difference in small (and unique) ways within its’ own community? This particular employer-provided benefit allows for individual creativity. Employees provide thoughtful acts of kindness helping those who least expect it. Civility in our communities can certainly go a long way, especially given the many societal challenges we face.

Whether through volunteerism or asking employees to donate money to various causes, organizations can make this ‘benefit’ become an avenue of employee engagement. For some organizations, it may seem awkward to ask employees to donate to certain causes…or perhaps even volunteer their time. If the program is not communicated appropriately to employees, it may be negatively perceived as ‘intrusive’ or ‘forceful.’

It seems to me that corporate giving and employee volunteerism can represent an enjoyable way for employees to meet outside the workplace and experience a real source of pride by giving back to their community. Employees can derive a tremendous sense of joy when giving back to others in many different ways – through giving of their time, talent and money.

Employee engagement is extremely powerful for any organization. Finding meaningful ways to engage employees that will ultimately benefit their community is definitely a win-win-win for the employee, the community…and the employer. There is a great deal of information on the impact that corporate giving has on revenue, etc. One such resource can be found at Boston College’s Center for Corporate Citizenship.

So is this idea an emerging trend? I don’t know. But I do believe that Mr. Gaunya’s organization is on to something that creates a great deal of value to all who touch that $100 bill!

To learn more, we invite you to subscribe to our blog.

Filed Under: David P. Lind Tagged With: