To keep rising group medical premiums as low as possible, employers have, for years, aggressively promoted preventive medical care. This strategy has been and continues to be one of the best cost containment strategies for taming the alarming and seemingly never-ending increases in health care premiums.
Not only does the early detection of health issues result in better patient outcomes, but it also helps prevent a medical claim from becoming catastrophic in terms of cost. High-cost claims not only create a financial burden for the patient but also contribute to year-over-year increases in medical premiums for the employer, which inevitably trickles down to the entire workforce enrolled in the health plan.
The pandemic, however, changed how individuals accessed health care. According to the Centers for Disease Control and Prevention, approximately 41% of people deferred care during 2020 and 2021 due to concerns related to the pandemic.
Many individuals who postponed elective or in-person care to reduce the risk of contracting COVID-19 are now starting to address their deferred care. Accordingly, employers are struggling to respond to this surge in employee health care usage in a cost-effective manner.
Furthermore this deferred care is contributing to an already tight labor market since absences from work for medical appointments and recovery is on the rise.
By implementing strategies to address deferred medical care, employers can better prepare for increased future health care costs and workforce absences. Here are strategies to help employers with these issues.
GUIDE EMPLOYEES TO COST-EFFECTIVE CARE
As employees start to prioritize their deferred medical needs, employers can help minimize costs by guiding employees to cost-effective care options. For instance, approximately 10% of an employer’s total medical costs are the result of avoidable out-of-network medical expenses, according to Amino. By helping employees stay in-network, employers can aid employees in avoiding unnecessary out-of-network care, thereby reducing overall medical expenses for both groups.
Employers can also direct employees to cost-effective outpatient care facilities or inpatient care options for procedures and imaging. For example, pointing employees to imaging clinics instead of hospitals for CT scans, MRIs and X-rays can be more affordable. Employer efforts, however, should not dissuade employees from seeking preventive care; doing so could lead to worse future health outcomes and costs.
IMPROVE EMPLOYEE HEALTH LITERACY
Through education, employers can help employees become better health care consumers and avoid unnecessary treatments or expensive procedures. Better educated employees are more likely to reduce health care costs by making better choices.
Employers can educate employees by creating user-friendly benefits portals that provide employees with easy-to-comprehend information, such as health plan options, forms, enrollment calendars, and links to health resources. In addition, employers’ efforts to educate employees must occur year-round instead of only during open enrollment. Employers can do this by providing employees with educational resources in emails, flyers, webinars, videos, and workshops.
Employers can also fight the costs of postponed medical care by encouraging employees to stay healthy. By incentivizing employees to exercise daily, eat better, reduce stress, and regularly visit the doctor, employers can help employees decrease their medical needs and improve their overall well-being.
Back in March of 2021 we discussed how employers were adjusting their fitness-oriented benefit options in a post-pandemic work environment. And while gym memberships are once again on the rebound, it would still be wise for employers to explore new possibilities for the post-pandemic world.
Leveraging technology can also help employers reduce the costs of deferred medical care. Technology enables employees to easily access and review their benefits, helping them become more educated on their employers’ benefits offerings and make better, cost-saving choices.
Advances in technology have even allowed individuals to stay healthy when they forgo in-person medical visits. Telemedicine, for example, has become a more accessible and affordable way to treat more individuals by offering flexible and cost-effective care.
It can also provide faster and more frequent care, which can help employees stay at work, stay healthy and reduce overall costs. In addition to telemedicine, individuals can utilize chronic condition management apps, virtual health programs and digital physical therapy solutions to stay healthy and reduce health care costs.
EXPAND ACCESS TO SECOND OPINIONS
Obtaining a second medical opinion can improve an individual’s care and health outcomes, especially in cases of rare health conditions requiring specialized treatment. Employers may assume second opinions will only increase health care expenses and absenteeism. However, primarily when provided by top doctors and specialists, second opinions may decrease overall medical expenses by reducing overtreatment and misdiagnosis.
Although a second opinion can effectively reduce health care costs, employees rarely seek them out. By providing access to a large network of top medical experts and specialists, employers can incentivize employees to get second opinions, drastically improving health outcomes and, in some instances, saving lives.
Advances in telemedicine allow employees greater and more affordable access to leading medical experts for second opinions. Employees with access to a large network of the best available care may be healthier and happier and more loyal to an employer.
FINAL THOUGHTSIncreased costs due to deferred care will likely continue to impact employers for the foreseeable future. However, savvy employers will implement effective strategies now to prepare for and address employees’ delayed care. Doing so may allow employers to reign in rising health care costs and productivity expenses, all while keeping employees healthy and safe.
Employers who proactively implement strategies to address the costs of deferred medical care will likely be better positioned to meet employee needs and prepare for unforeseen challenges.
For more information on mitigating group health plan costs, as well as workforce absence management strategies, contact JP Griffin Group, a division of HUB International, today.