It’s imperative to choose health plans that work best for those employees who need coverage the most, including people who suffer from a chronic condition such as heart disease or hypertension, cancer sufferers, and people affected by autoimmune or other chronic conditions.
Compared to average plan members, even a small percentage of high-risk employees in your company take a sizable slice of your company’s health expenses. Costs aside, you want to make sure your employees are getting the care they need to be their healthiest and productive. Here’s how to choose a plan that works for them.
Balancing Confidentiality and Transparency
First knowing that you have an employee(s) with high-cost medical conditions makes it easier for you to offer relevant strategies to help them better cope with costs. Often an employee won’t disclose this information, nor have to, for personal reasons. They have the right to keep certain information confidential, so you shouldlook into the reporting that your insurance carrier provides.
Once you have a high level knowledge of some of the conditions, a great step to take is to educate your employees on how to use their health benefits more effectively, such as ensuring they stay compliant on maintenance medications, using home delivery, making sure they go for regular check-ups, etc.
What Makes a Health Plan the Right One?
It is imperative to provide high-cost insurance members with health plans that offer care coordination services and appropriate access to providers and pharmacies with expertise in specific medical conditions. It’s also ideal that your health policy offers opportunities to implement a cost-effective purchasing strategy on quality drugs and health care through close partnerships with providers. Take advantage of insurers whose health plans offer ongoing reviews of specialty drug use by clinical professionals; this will help give you an overview of coverage for appropriate medications and their effectiveness for individual at-risk enrollees.
Encourage Savings on Medication Expenses
Specialty drugs used to treat certain medical conditions are one of the most costly expenses because they are complex to manufacture. According to a 2014 report by EMD Serono Specialty Digest, spending on specialty drugs is expected to more than quadruple by 2020.
To cut the cost of drug spending, keep education in the forefront. Your employees can gain significant savings by ordering prescription drugs by phone or mail or purchasing generic instead of brand-name medication, make sure they know this. Both employer and employee benefit from this type of knowledge.
Make it a point to review your health care costs and collaborate with your insurer to better manage costs for enrollees through disease management, prescriptive drug savings programs and collabroative treatment options. On top of this, determine the effectiveness of your health plan, and switch plans or coverage if need be. If you’re proactive in vetting your plan and taking advantage of what health coverage has to offer, you’ll achieve long-term benefits for both you and your high-cost insurance enrollees in terms of reducing health care expenses.
Emmie Sahlan has a graduate degree in English and has been writing professionally for the past five years. Her niche areas are insurance, credit cards, personal finance and education.