Medical costs are expected to grow again in 2019 at a rate that will outpace inflation. As a result, many public entities are being pressured to consider new and innovative approaches to their health benefits. This type of change in strategy can help them achieve both quality and affordable care. However, organizations must also ensure that the value to employees will far outweigh any risk or disruption the change will bring. Here are three good reasons to consider such a change:
- Reducing total health plan costs. Today, many public entities have self-insured their health plans for greater control over costs and quality. They can further reduce healthcare spending by identifying plan members who incur high medical costs and offer them the types of services that will help them address their specific medical needs. For example, members who have diabetes often incur high-cost medical services, especially when they’re not properly managing their diet and exercise. Public entity health plans can monitor members who are diabetic and promote regular HbA1c testing. For diabetic members, the higher an HbA1c, the greater the risk of developing costly complications. Those who aren’t measuring HbA1c levels or those who have high readings could receive disease management coaching and case management services – this is an example of a sensible change that could be instituted.
- Improved experience for plan members. When public employees receive quality communications from their public entity health plan and they have access to concierge-level customer service, they don’t need to run to HR departments with questions and concerns. Public entities who self-insure their health benefits may consider switching administrators. They want a partner whose representatives are well trained in every aspect of their health plan and have the expertise to answer any and all questions from plan members.
- Improved transparency. Public entities are also looking for transparency into how their health plans are performing. There are many analytics and reporting tools available today, but not all of them have the same sophistication and capabilities. Public entities may want to make a change to ensure they have access to real-time data, as well as the ability to identify high-cost claimants, compare employee populations with national standards, and forecast outcomes. All of these functions can significantly improve how public entities manage their healthcare spending.
Savings opportunities, an improved employee experience, and improved transparency are all compelling reasons to introduce a change to your health benefits. In Part 2 of our Change Management series, we’ll review best practices to make sure the transition is as seamless as possible, so public entities and their employers can reap the rewards with minimal risk and disruption.
*The views and opinions expressed in the Public Risk Management Association (PRIMA) blogs are those of each respective author. The views and opinions do not necessarily reflect the official policy or position of PRIMA.*
By: Kelly Ferreira, CPA
Vice President, Implementation, HealthComp
Summary of Qualifications
Kelly has over 35 years of experience in health benefit administration. Her areas of expertise include implementation of project design, business process re-engineering and system development. Prior to working at HealthComp, Kelly held positions at Rudy Facciani Insurance Marketing Co., Saint Agnes Hospital and Deloitte & Touche.
As the vice president of implementation at HealthComp, a third-party administrator, Kelly oversees the implementation and administration of health benefits plans for self-insured employers, including public entities. She performs project management and business process optimization functions as part of this role.
California State University, Fresno
BS/Business Administration-Accountancy, Magna Cum Laude
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