医疗费用和员工健康计划

医疗费用, 因此，员工的健康福利成本, 已经以惊人的速度增长了近十年. 避免医疗费用上涨几乎是不可能的, but you 可以 learn about why they continue to rise and what you 可以 do to manage costs for your organization and your employees.

协助您, 这篇文章解释了导致利率持续上升的因素, the latest health care cost figures and strategies that businesses around the United States are implementing to help manage costs.

导致医疗保健费用增加的因素

你为什么.S. 医疗费用飞涨? 几个市场条件导致了十年来的无情上涨. 在过去十年中，导致医疗保健费用攀升的因素包括:

• 人口统计资料
• 扩大保健服务提供者
• 管理式医疗公司的整合
• 政治环境与政府监管
• 提高利用率和消费者需求
• 新医疗技术
• 管理式医疗体系弱化
• 医疗保健支出和医疗费用通胀
• 处方药成本增加

The following are two factors that are also contributing to current and projected health care costs.

人口老龄化

因为年长的员工更容易出现健康问题, 企业发现慢性病患者在增加, 昂贵的医疗问题和处方药的使用, 以及灾难性索赔的数量和频率的增加.

整体健康欠佳

美国人健康状况的恶化也导致了医疗费用的增加. Preventable risk factors such as obesity and high blood pressure have led to increases in chronic health conditions such as diabetes and heart disease—illnesses that are long term and extremely costly. Unhealthy lifestyles 可以 be addressed through wellness programs to improve employee health and reduce costs, 但大多数节省都是长期的. 对抗持续的短期增长, 雇主正通过更高的免赔额将越来越多的成本转嫁给雇员, 自付和自付最高金额.

Understanding why your annual health plan renewal rates may be signifi可以tly higher than in the previous year is the key to forming alternatives and solutions to your particular plan’s challenges. It is also important for educating your employees about the reasons behind any plan or contribution changes you may decide to introduce.

雇主能做些什么?

雇主们正在努力控制不断增长的医疗计划成本. 因为招聘和留住员工的问题，我们试图承担大部分成本, 许多公司都在用持续的方法来解决成本上升的根本原因, 系统性变化. With the growing epidemic of poor health and the uncertain overall impact of health care reform, 许多雇主都在考虑短期和长期战略来管理成本.

使用医疗保健数据驱动战略

A Hewitt Associates survey found that employers cite using health care data to make strategic health plan decisions as their top cost-cutting strategy. 然而, 调查还讨论了超越访问数据的重要性, 并了解如何在决策和实施战略变革时应用它.

更加重视消费者驱动的计划

An increasingly popular option in the health care industry is the adoption of consumer driven health plans, 通常涉及健康报销账户(HRA)或健康储蓄账户(HSA)。. 这些计划为雇主节省了成本，但也使员工受益. 接受适当的教育, 员工可以成为更聪明的医疗保健消费者, 这样可以为双方省钱.

促进员工健康

Health and wellness initiatives have become another popular health care cost management strategy, 并且仍然是雇主们最重要的成本控制策略之一. As more employers are realizing that improving employee health and wellness 可以 lower health care costs and increase productivity, 许多国家正在创建更全面的项目, 针对特定疾病，并将家属纳入倡议.

Incentives for participation are growing in popularity as well (including incentives for dependents), 但重要的是要使用有效的激励措施. Rewarding employees for participating in a program or meeting a health goal is much more effective than incentivizing things like the completion of a health risk assessment. 许多雇主还对不参与或不健康行为进行处罚, 通常是以更高的保费或额外的员工成本分担的形式. It is important to note that successful wellness and disease management initiatives are dependent on quality employee education and communication techniques.

增加员工成本分担

Many employers are choosing to pass more costs to employees or restructure their health plans to incentivize lower-cost options. 以下是一些雇主正在使用的策略:

• Moving from fixed-dollar copayments to a coinsurance model (employee pays a percentage of costs for each health care service)
• 增加免赔额和自付额最高限额
• 增加网络外供应商的员工成本分担
• Increasing employee cost sharing for brand name prescription drugs to incentivize use of generics
• 提供消费者驱动的计划, 要么作为传统计划的一个选项，要么作为完全替代

依赖管理策略

雇主们通过改变管理家属的方式，发现了巨大的节省成本的机会. 受抚养人资格审核 可以 为公司节省大量资金. 研究表明, 平均, 5%到15%的家属实际上没有资格参加医疗计划. 许多公司也在转向按会员收费的结构, 而不仅仅是“个人”和“家庭”.” Another emerging trend is requiring spouses to pay more in premiums or assessing a surcharge to encourage spouses to enroll in their own employers’ plans.

策略性供应商管理

A recent movement involves companies aggressively evaluating their vendor relationships and replacing or eliminating those vendors that do not produce measurable results. Employers are also looking for opportunities to consolidate vendor relationships to get the most for their money.

长期解决方案vs. 短期修复

由于财政压力，许多雇主都承受着压力, 像员工成本分担这样的短期策略仍然很普遍. 然而, employers are exploring multi-year plans and longer-term initiatives to improve overall employee health and strategically manage costs in the future. 特别是在医疗改革之后, many employers are becoming more concerned with developing strategies that are sustainable in keeping costs down.

哪种解决方案适合您?

你应该把成本转嫁给员工吗? 或者您应该尝试使用本文中讨论的其他方法来管理成本? 最终, it is a decision that you need to come to through thoughtful and detailed analysis of your plans and with the advice of your broker or consultant.

Below are some questions you 可以 address in order to begin developing an effective strategy that is right for your organization.

• 我们的项目结构、计划设计和定价是否合适?
• 我们是否有合适的供应商、服务、合同和资金?
• 我们的员工沟通工作是否恰当和有效, 尤其是在员工健康和/或消费主义方面?
• 我们是否为员工制定了有效的疾病管理和健康计划?
• Do our pricing and plan design features encourage cost-conscious behavior on the part of our employees?
• 我们是否在考虑长期的解决方案，而不是今年的权宜之计?

我应该告诉我的员工什么?

卫生保健费用每年继续以异常高的速度增长. 你希望继续为现有员工提供有价值的健康福利, 你希望这些福利能帮助你吸引和留住优秀的员工. 然而, you also need to consider the cost-effectiveness of those benefits at a time when hefty rate hikes are the norm. 

  The information contained in this article is designed to help you understand why your renewal rates may have increased, and to help you educate your employees about the reasons for any plan or contribution changes you may have to make. 如果你的员工了解医疗保健行业的当前趋势, they will be more supportive of changes and will appreciate the resources necessary to provide them with their health care benefits.

有关如何向员工传达健康计划变更的更多信息，请联系桑福德 & Tatum, a Alera集团公司.

This Benefits Insights is not intended to be exhaustive nor should any discussion or opinions be construed as professional advice.  ©2015,2018 Zywave, Inc. 版权所有.