Health Literacy – What having it, or not having it does to your business

 

October is healthcare literacy month. A lot of our articles focus around this topic on a daily basis anyways, but I thought it prudent to really hone in and explore it. I’m quite festive so I think it’s fitting. We can look at healthcare literacy, what it means and why it matters all day long. And we probably will. But right now I think its important to consider its impact on any given business. Just about every single one of us is given health insurance by our respective companies. So, it makes sense to look at how we use that insurance and what it means for our company at the end of the day (or plan year).

Let’s start by defining health literacy – Health literacy is “the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions” (CHCS).

It’s that last part that we’re really concerned about – “making appropriate health decisions”. And we’re not talking about eating vegetables or working out more. We’re talking about your ability to interact with your doctor, communicate what’s going on medically, and effectively pay your bills. Effective management of these things are really what drives the cost of your health plan up or down, regardless of what kinds of claims you have.

The part that most people struggle with is understanding what you do and do not have control over. You know that a certain percentage of your employee population is going to get sick or become diagnosed with a chronic condition. If we could prevent these things from happening then we’d be in a different business. What you can control is how people react when given these diagnoses. You can make sure that they are realistically equipped to handle whatever the healthcare system, doctors and insurance companies throw at them.

You may not be able to prevent diseases, but you can prevent poor handling of treating that disease. And your insurance plan will be much better off for it. I know it’s not fun to think of everything is purely financial. You want your employees to feel like their health is important, and talking about their health and money in the same conversation can be tough. But look at it this way – you want to have a health plan that the company can afford, and that its employees can afford.

1.       Health literacy keeps your health plan affordable for you – If your plan is running at a 12% increase each year, you’re in for some serious trouble. You can’t possibly afford to maintain a plan with healthy benefits and keep your doors open at the same time. Check out this link for info on different plan designs and keeping your insurance healthy.

2.       Health literacy keeps your plan affordable for your employees – If your employees can’t afford to pay their health insurance bills, they aren’t going to have a positive health outcome. This situation isn’t good for anybody, employer included. You want your employees to be able to pay their bills, and improving their health literacy is cornerstone to that goal. Click here to see more about how you can realistically improve your employee’s health literacy.

If you want to see more info on health literacy and keeping your plan affordable, subscribe to our blog.

3 Ways to Support Your Employee’s Healthcare

 

As we’ve looked at in the past, a lot of companies have transitioned to a high deductible health plan. We know that it’s a smart move if you want people to take control of their care and help to keep costs sustainable. But is it enough to let them figure it out for themselves? Is it enough to hand them the keys to your multi-million dollar plan and expect for them to arrive safely every time? You know where I’m going with this one – no, it’s not.

 

People need support -they want support. You’d be surprised by the sheer amount of employers that tell us that their people don’t want their help, only to realize after implementing a literacy program that people really, really do want help. Why wouldn’t they? Healthcare is expensive for the both of you, and most people are happy to take the support where they can get it.

Let’s look at a few ways that you can help your employees get the care they need and how you (the person in the leadership role) can help them to get there:

1.      Keep an open-door policy – I’m proud to say that this is probably the area where companies feel most comfortable. Whoever manages your benefits (be it the HR department, management or the finance guys) should encourage employees to ask questions. You may not always have the answers, in fact, you probably won’t have the answers. But you should point them to the direction where they can get the answers. This is really pretty easy typically as your carrier can help out with a lot of that stuff.

2.      Send employees guides – Ok, this isn’t necessarily so clear or obvious. But you should think about some of the bigger things that people have issues with. Things like getting to the doctor, knowing where to go when they need to get medical help (looking at the levels of care) or learning how to pay bills (or even that they can dispute them). Your population will have its own idiosyncrasies and needs, and based off this you can tailor the information that you give them. Trig has free guides and tipsheets that should get you most of the way there. Check out our blog for that, and you can start passing these things out or posting them around the office.

3.      Purchase a healthcare literacy platform – This isn’t a shameless plug for Trig, yes we are this, but you can look elsewhere as well. But we feel strongly about combining your benefits and information into one place because it actually works. Think about the way that technology progresses, it consolidates your problems into more digestible chunks. That’s exactly what these programs do, they break down your benefits, explain them and tell you where and how to get better care.

If you’re doing all 3 of these things, then you can sit back and relax. You’re doing your part. As a matter of fact, no, your work isn’t done. I ask you to go out and tell people about what you’re doing. The world needs more companies that care about their benefits. And the best way that we can help is to talk about it.

How Education And Outreach Can Beat The Odds

 

As we often discuss in this article series, the notion of healthcare education and outreach is very important to us and to our clients. We firmly believe that it is key to making an impact in your claims cost, and in getting an overall positive experience out of your care. But can we really expect to see an impact? You can. By targeting individual programs that solve specific issues that a company may be facing, and promoting the heck out of it, you can seriously make an impact. You see, people traditionally haven’t been in the driver’s seat of the claim management role. Until now. You can teach people how to ask the right questions at the right time, educate them on the process and give them your most effective tools and solutions.

Consider this statistic – about 90% of a groups claims come from 30% of that population. That means that there are a very small amount of high healthcare users. One might think that we should hone in on just that population and work with them. Unfortunately that’s not the case. You’re going to want to provide the same level of education to all plan members as someday a new group of people are going to comprise that 30%. Let’s take a look at one of our dearest clients, and what they’ve done to reduce their plan costs.

 

Our Client: How their belief in the theory of managing their health plan through the members improved their outcomes

Average Our Company
Number of Employees 51
Insured Members 96 92
Members eligible for Disease Management 28 31
Members Participating in Disease Management 2 28

 

Statistically speaking, this group is quite average in terms of population size. Where they excelled was in their utilization of the carrier’s disease management program. By using Trig’s outreach and education, we were able to boost engagement by a multiple of 14 times. It just goes to show, that even with a relatively small population, a huge difference can be made.

Plan members are not stupid, they just haven’t been given the tools to navigate this process on their own. With more education, you will get less medication and less cost and more productive lives. And this translates into a better overall care experience that costs less.

 

 

What’s the ROI of Understanding your Health Plan?

 

Health Literacy. It’s an oft discussed topic and its one that we mention pretty much all the time. Health literacy has been linked directly with patients care outcomes, and, unsurprisingly, poor health literacy translates to poor treatment outcomes. With the mass shift in health plans towards high deductible plans, there’s a lot of pressure on the consumer to pay attention to what they’re doing. And key to this strategy is understanding how to be successful in a “consumerist” environment. Simply put, without understanding how to use the care system (and identify simple terms like deductible and copay), it becomes hard to get cost effective healthcare.

What I’m curious about is the notion of ROI in healthcare. In a previous article, we discussed the idea that having a health program is often not subject to ROI. Why? Because you can’t quantify value. And you can’t put a number or a price on people’s health. So, what about when it comes to additional tools like literacy programs? Is it possible, or even logical, to apply an ROI to those programs? Under normal circumstances I would argue that an ROI can be applied to just about any business expense. But healthcare is not a normal expense. It doesn’t play by the same rules. The cost of a company’s health insurance pretty much changes at random (at least it feels that way), and because of that we don’t often hold it to the same standards as we would other expenses.

 

Now, let’s run with this idea. We don’t have to provide hard data to justify ROI, but we do have to see value out of our purchases. Otherwise why would we spend money on them? Perhaps if we take the example of “wellness” as a product to analyze. We know that you can’t put a number on someone going for a run each day, or eating more broccoli than last month. But can we expect to see value? Maybe. How about programs like telehealth? You know that the average cost of a telehealth appointment for one of your employees is exceptionally low. You can’t quantify the time they’d have had to take to go to the doctors and miss work, however. But I think that a reasonable person would conclude that it is a worthy expense. You save some money. You save some time. Everybody wins. No need for hard facts and figures.

 

Now, how about health literacy (back to our favorite topic)? Do you need to provide ROI for a health literacy program? Or does this fall into the “obviously beneficial but not quantifiable” camp? Like we mentioned before, health literacy is about attacking your current health costs by improving the quality of care. Let’s dig deeper into this example. If a health literacy program were to be effective, it would teach your employees to do things like shop around for cheaper prescriptions, or teach them to verify each diagnosis so that they don’t get the wrong treatment or surgery. It’s not something that you can necessarily put a hard figure on, because you can’t know how deep they would have gone down the rabbit hole of getting the wrong treatment.

 

What I can say is this: pursue programs that provide value to your firm. Find a program (like health literacy or telehealth etc.) that you believe in and think will make your employees care experience better. Unlike a lot of things, the best care (read “correct” care) you can get is also the cheapest, because you only have to do it once. Anything that brings you closer to getting the correct care should be deeply considered.

 

Does ROI Matter in Health Insurance?

Ok, time for some real talk. Over the last couple of years there’s been a lot of analysis, alterations and a reframing of the way that we look at healthcare from the employer perspective. Obamacare has forced us to step back and ask ourselves what level of benefits we should really be offering to employees. Do we go for the “Full Monty” and offer amazing benefits with the hopes that we can attract great people? Or do we pursue a more barebones approach and offer what Obamacare requires us to offer? What I’m getting at is this: What do we expect to get back from our investment? What is the “ROI” for offering benefits? And Most importantly, do we need ROI to justify having health insurance?

I’m going to pose this question: “When is the last time that your company has tried to measure the ROI of your health plan?” I’m not talking about all of your benefits, like 401K contributions, or a long term disability policy, but your healthcare offerings.

Now the last few years have increased pressure to offer a competitive plan. Costs have risen and people are looking at their budgets more closely than they were during the Bush and Obama administrations. But have people changed their perceptions of ROI in healthcare? I’d argue that they have not. Firms want to reduce their insurance costs, but they aren’t trying to “prove” that they are a worthwhile investment. This leaves us in a really odd place. Almost every single large purchase is analyzed and put through the ringer at your average company. Accountants and Finance Managers like to have a tight grasp on everything coming in and going out. So why do we not do the same with health insurance? I think it’s for 2 reasons:
1. Health insurance is viewed as “out of our control”, because getting sick happens, and you can’t tell your employees not to get sick
2. You have to offer health insurance. According to both social norms, and now the law, your company has to offer your employees health insurance, or risk huge fines

Whether or not you or I think that we “should” or “should not” be looking at health benefits from an ROI perspective is a relatively moot point, the majority of people simply don’t look at it that way. However, the majority of firms do look at external products from an ROI perspective. Products like “wellness” and employee intranet sites. Products like enrollment and other HR-based insurance offerings get put through the same ringer as your monthly coffee delivery guy.

I want to pose one more question to you: “What products are worth looking at from an ROI perspective?” Should we apply the ROI principle to every business maneuver, or do some things speak for themselves? When we’re talking about employee satisfaction and performance, not even the largest of Silicon Valley firms can provide us with the algorithms to answer these questions. We have to be able to rely on our judgement and put forth a consistent strategy.

3 Ways to Simplify Your Benefits

Having spent 30 years in the health benefits industry, I can honestly say that one of the most common and consistent complaints that I’ve heard from customers is that their employees find their benefits confusing. Pretty much across the board. Think about it, of course they find their benefits confusing, there are a myriad of forms thrown at them every year, they probably don’t understand why or how their premiums really change each year, and they aren’t really given the tools to figure it out. Up until now, our mantra has pretty much been “just figure it out”. Got a problem? Go to the same doctor that you’ve always seen. Need a new doctor? Try to get a recommendation or something. And if you’ve been given a bill that looks a bit hefty, just deal with it.

Well, I’m happy to report that the world is changing. More attention is being paid to making healthcare more seamless and easy to navigate and technology has stepped up to help guide people through the craziness. I thought it pertinent to give some guidance on what you can do to simplify your benefits, and also to help employees get better care. The two go hand in hand and really cannot be talked about independently. Why? Because most often the biggest reason that people don’t get the best possible care is because they don’t really know what they’re doing. And I’m not talking about people giving themselves a self-diagnosis. I’m talking about learning how to find a doctor, interact with them, and make sure that they get the correct diagnosis (to the best of their ability).

Without further adieu, I present 3 ways in which you can simplify your benefits for your employees:

  1. Keep an open door policy – I’m proud to say that this is probably the area where companies feel most comfortable. Whoever manages your benefits (be it the HR department, management or the finance guys) should encourage employees to ask questions. You may not always have the answers, in fact, you probably won’t have the answers. But you should point them to the direction where they can get the answers. This is really pretty easy typically as your carrier can help out with a lot of that stuff.
  2. Send employees guides – Ok, this isn’t necessarily so clear or obvious. But you should think about some of the bigger things that people have issues with. Things like getting to the doctor, knowing where to go when they need to get medical help (looking at the levels of care) or learning how to pay bills (or even that they can dispute them). Your population will have its own idiosyncrasies and needs, and based off this you can tailor the information that you give them. Trig has free guides and tipsheets that should get you most of the way there. Check out our blog for that, and you can start passing these things out or posting them around the office.
  3. Purchase a healthcare literacy platform – This isn’t a shameless plug for Trig, yes we are this, but you can look elsewhere as well. But we feel strongly about combining your benefits and information into one place because it actually works. Think about the way that technology progresses, it consolidates your problems into more digestible chunks. That’s exactly what these programs do, they break down your benefits, explain them and tell you where and how to get better care.

If you’re doing all 3 of these things, then you can sit back and relax. You’re doing your part. As a matter of fact, no, your work isn’t done. I ask you to go out and tell people about what you’re doing. The world needs more companies that care about their benefits. And the best way that we can help is to talk about it.

How to Incentivize your Medical Plan + Control Costs so that you can sleep at night

With all this talk about high deductible health plans and increased consumerism in healthcare, we are often left wondering if it all really works. Can we really do something about the rising care costs? Can we really expect people to shop for healthcare like they shop for cars and other consumer goods?

 

There are a lot of differing opinions on what we can really expect from people. Some are of the mindset that we should just reduce people’s coverage and let them fend for themselves. Others think that we need to provide people with the tools and resources to become successful. Most of these strategies fall under the category of “incentivization”, with varying degrees of being “hands on” from your firm’s perspective.  I’m of the mindset that we should definitely be providing people with some guidance. But more on that later.

 

Let’s take a look at a few ways that you can incentivize your benefits package:

  1. The Hands Off Approach – If you’re hoping to dip your toes into the world of incentivization, but don’t want to add anything to your workload, you should really consider a benefits redesign. Look at implementing an HRA (here’s a guide for that), and consider a high deductible plan. This isn’t the most impactful route, but it’s a start.
  2. The Half-Way-There Approach – If you want to up your game and start to incentivize your benefits in a more active way, think about looking at consumer literacy and training programs. There are a few out there (Trig being one of them) that operate as completely hands off, if you so choose. Where you start to see real change is when you tie HRA or HSA credits to completing some of the training. It’s easy and cost effective from the firm’s perspective and gets employees to learn how to be a consumer (often for the first time).
  3. The Fully Hands On Approach – If you’re set on making impactful change to your benefits plan, simply incentivizing a few training courses isn’t going to be enough. While you should still do it, you will also have to engage with a literacy and training program yourselves. As leadership of your company, you should understand a bit about healthcare literacy so that you can answer questions when your employees walk in the door. They need someone that can show them how to find answers and understand their role in the medical care process. All initiatives need a champion, and if you’re serious about seeing change, you are the best champion that your employees can get.

 

With this in mind, only you can decide how deep your firm wants to go to maximize your benefits. After all, your benefits are the most expensive item behind your payroll, so having some control over the spend is important. The good news is that once people begin to advocate for themselves and learn how to get better care, they will instinctively continue to grow. They just need a little help getting there, and that’s why incentivization is key.

3 Levels of Convenience Care, and Why it Matters

If you’re a follower of our stuff, you may have noticed that we talk about “convenience care” quite a lot. Its something that we believe in and can get pretty fired up about (don’t judge, some people like celebrities, some people like health-tech startups).  Its occurred to me that we should really do an article that focuses more squarely on convenience care and why you should care about it. But before we get to that, lets just look at providing a definition of convenience care so that we can get on the same page.

I’m going to define convenience care as this: Any service designed to offer fast medical care for common ailments, most often delivered at a greatly reduced cost. These are commonly staffed by physician assistants or nurse practitioners and should be relied upon for minor medical situations. Check out a breakdown of the different kinds of services here.

It starts to get a bit more confusing when you consider that there are different types of convenience care clinics that you can attend. Some virtual, some in person. But in order for you to understand the how (and why) these apply to you, let’s look at the different kinds:

  1. Tele-health – This is my personal favorite. My iphone apps mostly consist of music streaming, a good map application and a tele-health service. As with anything, these are going to vary based on your location and benefits provider/plan. But a good tele-health service can be your first line of defense for all things medical. You can often book an appointment in minutes and be video-chatting with someone in less time than it takes to drive to the store. They can also do a lot more than you think, like look at the odd rash or give you a medication refill.
  2. Walk in clinics – This is your best bet if you need something like a flu shot or a test for strep throat. They’re great for getting a more in-depth service than a tele-health call, but not so in depth that you need to go through the hassle of booking and attending a GP appointment.
  3. Urgent Care – ok, this is definitely not what we would normally consider “convenience care” because its certainly a level up in price and wait time (and you’ve got to physically go in and wait just like at the GP’s office). But a lot of people do see this type of doctor when they’re unsure so we’re including it for good measure. An urgent care clinic has a lot more capabilities than a walk-in clinic and can even set bones and help with most non-life-threatening issues. However, there is an increased cost associated with that.

This is just a snapshot of what we call the “levels of care”. It’s really important to understand their differences and what they should be used for. And convenience care is really the first level that should be considered. You wouldn’t want to see a brain surgeon for an allergy question, right? Less dramatically, you wouldn’t go to the emergency room for a cold. You could get treatment, but it would be an extreme hassle and you’d pay extortionate amounts for it. Just the same, helping your family or your employees to understand these levels of care (and what the more affordable options are) is really important for a happy workforce and a healthy insurance plan.

3 (Free) of the Most Important Preventive Services You Can Get

They say that the best things in life are free. And when it comes to healthcare, that’s no exception. If you haven’t heard, preventive care is free – as in, covered by your insurance. And since we’ve already used one adage, let’s use another: There’s no such thing as a free lunch. Well this time there is. Preventive care really is free, because your insurance company doesn’t want you to get sicker and have extortionately high claims. Makes sense, right? In terms of healthcare, what’s good for your insurance company is often good for you – not being sick. As always, it’s good to check with your insurance company before you get anything done to make sure that everything is within your network and is specifically covered.

With that in mind, we thought it pertinent to look at the most important preventive services that you can get. Even though we’d all love to take advantage of each free service, there’s only so much time in a day, and some services are more important than others. Very important, in fact. If you don’t get these things done, it could cost you much more than the extra cash.

  1. Flu Shot – your immune system isn’t always capable of handling the flu each year. Different flu strains change and you’ve got to get vaccinated for the right one. If you don’t you could be setting yourself up for a few weeks of feeling nasty (yes, stomach stuff). Last year the CDC (center for disease control) estimated that vaccines prevented over 5 million illnesses and over 71,000 hospitalizations. That’s crazy when you consider how much that would cost you, your company, and your insurance provider.
  2. Colonoscopy – this one isn’t so fun. The typical recommendation is that everybody goes in for a colonoscopy at about age 50. And while it’s not fun to prepare for or have a colonoscopy, the results are worthwhile. Colorectal cancer is now the second leading cause of cancer deaths in the US. Prevention and screening is pretty straight forward as well, as it usually takes about 10-15 years for the polyps (the abnormal growth) to turn into cancer.
  3. Mammogram – Unfortunately, we’re up for another screening that isn’t very fun. But mammograms are, simply put, the best way of detecting breast cancer early on. Just checking for lumps isn’t enough according to the American Cancer Society. The society also states that 1 in 8 women will develop breast cancer. Those are scary odds and well worth the checkup.

Even though you may not love dealing with your insurance company, they do offer some pretty nice freebies every now and again. And if you’re less concerned about the money, just think about how much you don’t want to get cancer. The tests are free, go out and get them.

 

 

 

Check out our list below of services made free by the Affordable Care Act:

COVERED SERVICES – FOR MEN AND WOMEN:

Abdominal aortic aneurysm screening for people who smoke or who have smoked

Alcohol abuse screenings and counseling

Aspirin use in men and women

Blood pressure screenings in adults

Cholesterol screenings for adults in certain age ranges or at high risk

Colorectal cancer screenings for men and women over 50

Depression screenings in adults

Diet counseling for those who are at high risk for chronic conditions

HIV screenings for adults at high risk

Immunizations for adults:

Hepatitis A

Hepatitis B

Herpes Zoster

Human Papillomavirus (HPV)

Influenza (Flu)

Measles, Mumps, Rubella (MMR)

Meningococcal

Pneumococcal

Tetanus, Diphtheria, Pertussis

Varicella

Obesity screenings and counseling

STI (sexually transmitted infections) prevention counseling

Syphilis screenings