Considerations When Implementing a High-Deductible Health Plan

How could lower premiums and high deductibles effect your healthcare

population?

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High-deductible Health Plans

In recent years, employers and brokers have explored numerous ways to lower healthcare costs—from implementing wellness programs to changing the structure of their plans.  

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High-deductible Health Plans

Many companies have successfully lowered their share of the healthcare spend by offering employees high-deductible health plans (HDHPs).  In order to receive optimal results, proper groundwork needs to be laid before the HDHP is launched.

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How HDHPs work

HDHPs- Health insurance plans that offer lower premiums with higher deductibles.  

These plans in many cases result in, employees having to pay a higher rate for each medical service rendered until they reach a deductible set by the employer.  

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How HDHPs work

After the deductible is met, the plan pays a designated percentage of covered charges.  These plans often are linked to health savings accounts (HSAs), which assist employees with the additional cost sharing associated with HDHPs.  

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How HDHPs work

Consumer-driven plan to increase employee awareness about healthcare costs and encourage them to shop around for the best value care. 

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A recent study showed an employee population that was offered a HDHP for the

first time saw a 19% decrease in overall healthcare spending the first year.

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The Missed Opportunity

This drop in spending largely resulted not from members selecting higher value providers, but from members refraining from obtaining medical care.  

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The Missed Opportunity

This outcome could increase employees’ risk of developing:

• More Serious Conditions

• Discourages Preventive Care

• A Sicker Employee Population

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The Missed Opportunity

The example from the study illustrates a missed opportunity to direct care to higher value facilities and to ensure members are getting the appropriate level of care. © Healthgram, Inc. 2015

The Missed Opportunity

The low utilization during the first year of the HDHP may show that members misperceived their health risks and did not understand medical costs or how their benefit design worked. © Healthgram, Inc. 2015

What can we learn from this study?

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Lessons Learned

The decision to move to a HDHP should be based on an analysis of past data and consumer behavior and include an examination of:

• Claims

• Services Rendered

• Facilities used most frequently

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Lessons Learned

A health plan administrator or broker should be able to help the employer identify whether there are high-price variances for common services in your area, presenting an opportunity for savings.

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Lessons Learned

Prior to launching the HDHP these key components should be in place to help support members:

• An Educational Communication Strategy

• Self-service Tools (Example- 

Healthcare Bluebook)

• A Proactive Outreach Plan© Healthgram, Inc. 2015

Lessons Learned

The plan administrator should provide one easy point of contact who can:

• Answer members' questions

• Help them to understand their benefits

• Be an ally in their pursuit of the best value

care© Healthgram, Inc. 2015

Lessons Learned

These resources, in conjunction with an incentive strategy to encourage engagement, can help to steer employees toward more responsible utilization of the healthcare system and discourage them from avoiding it entirely. © Healthgram, Inc. 2015

LEARN MORE

To learn more about HDHPs and the proper preparations to support them, contact us here.

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