6 Overused Buzzwords in Healthcare (and what they really mean)

There’s a lot of misinformation surrounding self-funded plans out there. Widen the category to healthcare in general, and it’s an endless struggle to weed through what’s fad, trend or fiction.

Are you hearing any of these this renewal season? If so, here’s what you need to know.

transparency

trans·par·en·cynoun : the condition of being easy to perceive or detect.

We think that transparency for employees and employers will help transform the existing system into one that actually works for employers and their employees.

Many people are claiming they provide it. We’ve mainly heard about “transparency” when discussing medical procedure prices and the variance that exists within networks.

But we also think it expands to employers who often don’t have access to the full data on their company’s health plan. Or even worse, employers who have yet to regain control over one of their highest spending categories.

Transparency, redefined

Questions to ask: 1. Are we accepting renewal quotes off of actual claim costs, or something we don’t have full insight into? 2. Are employees given the tools they need to accurately compare healthcare costs?

engagement

en·gage·mentnoun : to occupy the attention or efforts of (a person or persons)

We’re a culture that is quick to chase down the latest shiny new device, maximize things like mobile use and wearables, and then rejoice in single-digit adoption rates. But real, measurable engagement doesn’t look like that.

Creating a culture of engaged employees comes down to one powerful element: trust.

Successful engagement requires not only the technology that meets employees where they are, but a human element that helps them make sense of the confusing system.

Engagement, redefined

Questions to ask: 1. Are we investing in technology without addressing the core issues at hand?

consumerism

con·sum·er·ismnoun : the protection or promotion of the interests of consumers.

For the most part, employees don’t see healthcare as a consumer decision. They are told what they need and where to go and receive a bill in the mail.

With the rise of HDHPs and the trend of employers increasing employee share of costs, employees need the right tools to become smart consumers of healthcare.

Think about how you would go about buying a new car. You compare costs. You negotiate. You fully understand your financial responsibility before you sign on the dotted line. Why should healthcare be any different?

Consumerism, redefined

Questions to ask: 1. Are we simply passing along an increasing share of cost to employees, or actually providing them the

tools to be successful consumers?

big data

Big da·tanoun : data sets, typically consisting of billions or trillions of records, that are so vast and complex that they require new and powerful computational resources to process

Data is defined as “facts and statistics collected together for reference or analysis.” Having data on hand is great, which is why hospitals, brokers, providers and other care agents are rushing to collect as much as they can.

But it’s really what you do with it that matters. Data points like prices for surgeries are used to help employees make smarter decisions, and integrated lab results and claims data help identify who in your population needs timely attention.

When having conversations about your company’s healthcare data, make sure there’s an end goal in mind with measureable outcomes. It’s just information if it doesn’t make an impact.

Big data, redefined

Questions to ask: 1. What types of data are we collecting, and how are we using it to benefit our plan and employees?2. Do I own my company’s data, and the right to use it to make more informed business decisions?

wellness

well·nessnoun : the state or condition of being in good physical and mental health

Corporate wellness has made a big name for itself since its introduction in the 1980s. Employers have invested in yoga classes, screenings, health coaching and other programs promising ROI. But twenty years into the “wellness movement”, what do we really have to show for it?

A good deal of evidence raises serious doubt about the real-world efficacy of wellness and the ability of today's employer to implement it effectively. We’ve found many employers overlook the importance of two critical elements: integration and personalization.

Wellness, redefined

Integration First and foremost, wellness must be integrated with your benefits plan. HRAs, screenings, coaching encounters, claims and Rx data are always stronger together. Fragmentation lets meaningful opportunities slip through the cracks.

PersonalizationEach employee is at a different stage in their wellness journey. Success programs help all employees manage their health, whether it is managing chronic conditions, helping them quit smoking or reminding them of their annual physical.

Question to ask: 1. Are we relying on a one-size-fits-all wellness approach, or something more strategic?2. How is success being measured?

discount

dis·count noun : a deduction from the usual cost of something, typically given for prompt or advance payment or to a special category of buyers.

When it comes to controlling healthcare spend, it’s time to rethink the discount. Typically, carriers pass along annual increases while claiming the most competitive discounts with providers. In reality, these discounts range by only a few percentage points between carriers, all hovering around 50%. Meanwhile, opportunities exist within the network to lower base cost. Let’s look at the price range for a total hip replacement as an example. All providers are in-network, within the same ZIP code and include discounts.

Discounts, redefined

Savings opportunity: $37,844

A discount is not a strategy against prices that range by over 1000% depending on provider. The real opportunity lies in educating employees about fair-priced, high-quality providers

Question to ask: 1. Are we relying on a discount to control costs, or addressing base costs?2. What’s being done to manage our variable healthcare costs?

Managing employee healthcare requires more employer understanding than ever before.

Let us help you regain control.

Visit us at www.healthgram.com