Summary of The Alliance Employer Benefits Roundtable Alliance Employer Benefits Roundtable. ... The...
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Summary of The Alliance Employer Benefits Roundtable December 13, 2016
Transcript of Summary of The Alliance Employer Benefits Roundtable Alliance Employer Benefits Roundtable. ... The...
Summary of The Alliance Employer Benefits RoundtableDecember 13, 2016
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| Introduction
| Employee Cost Sharing and HDHPs
| Seeking High-Value Health Care
| Changing the Site of Care
| Finding Savings in Pharmacy
| Your Membership in The Alliance
| Request Your Customized Claims Data Analysis
2016 Summary of The Alliance Benefits Roundtable
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Introduction
On Dec. 13, 2016, approximately 30 employers, agents and industry
professionals gathered at Monona Terrace to discuss hot topics in benefit
plan design.
Staff members from The Alliance facilitated four small group discussions and
attendees shared their best practices, concerns and questions. Following the
small group discussions, highlights were shared with the larger group.
This event was the second annual roundtable discussion facilitated by The
Alliance. The report is a synopsis of the notes gathered from this event.
Four topics were discussed: employee cost sharing & HDHPs, seeking high-
value health care, changing the site of care and finding savings in pharmacy.
Each of the four topics discussed has been given a section, as noted in the
table of contents.
Highlights of the discussion are listed as bullet points. Notes and quotes heard
during the discussion are spotlighted at the bottom of each page.
2016 Summary of The Alliance Benefits Roundtable
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Employee Cost Sharing and HDHPs
2016 Summary of The Alliance Benefits Roundtable
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Employee Cost Sharing and HDHPs
Which employee cost-sharing methods do you currently use?• Wellness premium differentials• Wellness outcomes• Health Risk Assessments (HRAs)• High-deductible health plans (HDHPs) are gaining popularity• Employer contributes to employee health savings accounts (HSAs) • Out-of-pocket costs are increasing• Onsite clinic option• Steerage to high-value providers
2016 Summary of The Alliance Benefits Roundtable
Notes and Quotes
The majority of employers represented at the roundtable event reported that they currently have HDHP plans available to employees.
Shifting to higher deductibles and HDHPs is challenging.
Employees are more receptive to HDHP plans when their employer partially funds the plan through a HSA account.
“Use the term, “Consumer-Driven Health Plan, not High Deductible Health Plan.”
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Employee Cost Sharing and HDHPs
How do you educate your workforce about self-funded insurance?
• Education at annual employee enrollment meetings is key.• Offer incentives to encourage the employees to act like owners.• Stress the impact of the bottom line.• Introduce and encourage shared decision-making during health
care appointments.• Need more employee education on self-funded health plans,
employee cost sharing and HDHPs.
2016 Summary of The Alliance Benefits Roundtable
Notes and Quotes
Employer-members are educating their employees about how to more effectively use a self-funded health plan.
Health education inroads have been made, but employer-members asked for more materials to educate their employees.
There’s a learning curve to educating employees about how HDHP plans and HSAs work. And when it may be the right choice for the employee (and family.)
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Employee Cost Sharing and HDHPs
What lessons have you learned from HDHPs?• The “Cadillac Tax” will push consumers to
consider switching to a HDHP plan, unless the Affordable Care Act (ACA) is repealed.
• An employee who is enrolled in a HDHP plan can often be your best advocate for switching to a HDHP plan.
• Peers trust the opinion of peers more than flashy marketing materials.
• Some employees on HDHP plans need encouragement to seek care when needed and not delay due to high deductible.
2016 Summary of The Alliance Benefits Roundtable
Notes and Quotes
HDHPs work for some. But a HDHP may have too high of a deductible for others, particularly lower wage earners. It’s a balancing act.
Employer-members would like more videos and interactive options to educate their employees about health care. Example: “Meet Alex” Virtual Benefits Counselor.
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Seeking High-Value Health Care
2016 Summary of The Alliance Benefits Roundtable
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Seeking High-Value Health Care
What steps have your company used to encourage your employees to seek high-value health care?
• Encourage use of onsite clinic• The Alliance’s Find a Doctor tool• The Alliance’s QualityPath® program• Referral coordinators for care management• Preferred pharmacies through Pharmacy
Benefit Manager (PBM)• Education creates empowered consumers
2016 Summary of The Alliance Benefits Roundtable
Notes and Quotes
It’s a challenge to educate employees to ask their doctor questions about treatment options. It may be viewed as challenging authority.
Employers fear pushback if an employee does not have an optimal result after using a steerage program.
Putting cost and quality together becomes a POWERFUL message.
It’s tricky to explain that the cost of procedures can vary wildly.
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Changing the Site of Care
2016 Summary of The Alliance Benefits Roundtable
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Changing the Site of Care
How do you educate your employees to use appropriate care?
• Onsite clinic at no out-of-pocket cost.• Convenience sometimes creates over-use
of care; need additional education.• Condition management.• Educate on the importance of having a
primary care provider.• Encourage preventive care appointments.
2016 Summary of The Alliance Benefits Roundtable
Notes and Quotes
The impact of health coaching depends on how it is done. Does it add value to the employee’s health or is it viewed as just a “hoop” to jump through?
Physical health and mental health are related. Destigmatizing mental health may encourage others to seek care when needed.
Telemedicine use may grow as consumers become more familiar with it.
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Changing the Site of Care
What lessons have you learned?• Potential new employees view an onsite
clinic as a perk.• It can be difficult to incentivize Millennials
to go to preventive care appointments.• Communication about steerage is important
as employees value transparency.
2016 Summary of The Alliance Benefits Roundtable
Notes and Quotes
Some employees welcome the convenience of an onsite clinic, while others prefer an appointment away from the workplace.
Not all employees have selected a primary care provider; need to educate them as to why it is important to have a primary care provider.
Telemedicine is a viable health care option. Especially for minor late night or weekend concerns or mental health appointments.
On-site clinics work. It’s not for everybody, but even smaller employers can join together to fund a near-site clinic.
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Finding Savings in Pharmacy
2016 Summary of The Alliance Benefits Roundtable
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Finding Savings in PharmacyWhat do you do to mitigate drug spend?
• Use claims data to modify benefit plan• Tiered pharmaceutical formulary• Preferred pharmacies• Common prescriptions available for free at
onsite clinic (for high blood pressure, diabetes, antibiotics, etc.)
• Pharmacy Benefit Manager (PBM) looks for rebates• Mail order prescriptions (domestic or overseas)
• Incentivize the use of generic prescriptions• Communicate costs with employees
2016 Summary of The Alliance Benefits Roundtable
Notes and Quotes
Employers have concerns about the PBM industry and the impact of consolidation, especially level of service and savings as they get bigger.
Employers want to preserve local “mom and pop” pharmacies as an option.
Employers have found that if they show a large price difference between a brick-and-mortar pharmacy and a mail order pharmacy, employees will quickly switch to mail-ordered prescriptions. This has worked for both domestic
and overseas mail order programs. The magic phrase is “no cost.”
Some plans pay the full cost of condition management prescriptions.
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Finding Savings in Pharmacy
What kinds of specialty pharmaceutical plans or support are a part of your benefits?
• Fourth tier for specialty prescriptions• Step therapy• Precertification of opioid prescriptions• PBM does analysis of pharmaceutical claims
for each household and does a customized annual mailing to show less expensive pharmaceutical options (such as mail order)
2016 Summary of The Alliance Benefits Roundtable
Notes and Quotes
Some plans include counseling options when an opioid prescription is filled.
Mail order can sometimes be available for specialty prescriptions.
PBMs help employers save money on prescription costs. But how can an employer accurately compare potential savings between PBMs?
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We Are The AllianceWe Are A Cooperative
We transform health care. We are we, not I
or they. We are members. We are owners. We
are employers moving health care forward.
We see the opportunity in supporting one
another. We learn from the past. We keep
our eye on the future. We are adaptable.
Mission Statement
To move health care forward by controlling costs,
improving quality and engaging individuals in
their health.
Reserve Your Spot At The Next Alliance Learning Circle EventThe Alliance offers educational events to
keep you abreast of emerging health care
topics, benefit trends and changes in health
care laws. Learn more and register for our
next event at: www.the-alliance.org/events/
2016 Summary of The Alliance Benefits Roundtable
Member Services Is Here For You
We’re ready to discuss your health care claims data and assist you in optimizing your benefits plan.
Mike RocheMember Services
Paul RoelkeMember Services
Amanda GallmanMember Services Representative
800.223.4139www.the-alliance.org
