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Business Group in the NewsBusiness group supports mandatory flu vaccination for health care workers
The National Business Group on Health today recommended that hospitals and other health care facilities require employees to receive an annual flu vaccine to protect patients and other employees from the flu, unless they have a documented medical excuse or religious objections. The AHA Board of Trustees last year approved a policy supporting mandatory patient safety policies that require either flu vaccination of hospital employees or wearing a mask in the presence of patients across health care settings during flu season. At an NBGH briefing today, former AHA Trustee Jeanette Clough, president and CEO of Mount Auburn Hospital in Cambridge, MA, said her hospital last year increased employee vaccination rates to 92% from 70% through a robust vaccination campaign. According to the Centers for Disease Control and Prevention, an estimated 63% of health care workers had been vaccinated this flu season as of November, up from about half in previous years. NBGH represents more than 340 U.S. employers.
Health Care Facilities Urged to Require Flu Shots for All Workers
Taking Another Shot At The Flu Vaccine
Despite nearly 20 years of recommendations that health workers get flu shots, the most recent data from the Centers for Disease Control and Prevention show that less than 64 percent of them do. Consumer and business groups met in Washington Thursday to show their support for a recommendation from the National Business Group on Health (NBGH) that hospitals require all health care workers to be vaccinated annually against the flu. "We believe that patients have the right to assume that health care personnel, themselves, will take all reasonable measures to reduce and avoid transmission of preventable diseases including the flu," said Helen Darling, president and CEO of the NBGH. "I think we, as people, assume that after all, they're our caretakers and we look to them for care and treatment." The NBGH is a non-profit organization representing more than 300 large employers, including 68 of the Fortune 100 companies. Its statement urged hospitals to "require annual flu vaccination of all employees as a condition of employment unless employees can demonstrate medical contraindications (with physician documentation) or religious objections." If that is the case, the NHBG says those employees "should not engage in direct patient care if they have flu-like symptoms." At the press briefing, Darling said a mandate is an effective means to ensure health care providers are safe from the influenza infection. "We know that mandates work." Among other groups supporting the proposal there were Consumer Reports and the American Hospital Association.
Group pushes health worker flu vaccinations
Hospital Staff Should Get the Flu Shot
You might think that doctors, nurses, and other hospital staff would be among the first to get vaccinated against the flu. But too many don't, even though hospitals can be breeding grounds for the virus and patients there are especially vulnerable to it, according to a report released today by the nonprofit National Business Group on Health. To counter that problem, a coalition of groups led by the NBGH, including the American Hospital Association and supported by Consumers Union, have started an initiative to increase flu-vaccination rates among hospital staff.
Health Reform, Preventive Services, and Religious Institutions
Contraception coverage reduces costs: While the monthly cost of contraception for women ranges from $30 to $50, insurers and experts agree that savings more than offset the cost. The National Business Group on Health estimated that it would cost employers 15 to 17 percent more not to provide contraceptive coverage than to provide such coverage, after accounting for both the direct medical costs of potentially unintended and unhealthy pregnancy and indirect costs such as employee absence and reduced productivity.
LTC measure to get vote on repeal in House
Health insurance incentives: Is carrot or stick better?
With employer-sponsored health plans, is the carrot or stick more effective? Some companies offer incentives -- gas cards, cash, discount rates -- to get employees to live more healthfully and curb costs. But, increasingly, firms are punishing employees financially if they don't take their own health more seriously. The National Business Group on Health surveyed large employers and found 80 percent plan to offer financial rewards to employees who participate in certain health initiatives this year, up from 54 percent in 2011. Its survey shows the share of companies "penalizing workers over health measures or lack of participation in wellness plans" is expected to double this year, to 38 percent, the survey shows. Most penalties involve a higher insurance premium. In other cases, employers are refusing to hire nicotine users as a way to create a healthier workplace.
CDHPs expected to remain strong in 2012
HSAs, in particular, could see growth throughout the year, says Steve Wojcik, vice president of public policy at National Business Group on Health, a nonprofit dedicated to representing large employers' perspective on national health policy issues. FSAs have become a standard benefit and are commonly offered, especially among larger employers, while HSAs are starting to attract more attention not only because of their tax benefits but also in light of the provision that allows a participant to roll over unused funds year to year, which isn't allowed with FSAs. "The advantage of an HSA over an FSA is you can build up the account over time and invest in it," Wojcik says. "HSAs aren't like FSAs where you have to spend it during the current year or lose the money. A lot of people now that have had HSAs are building up significant balances on a tax-free basis, and that word of mouth spreading. It's getting other people interested in HSAs."
HR and Finance: Working Together
Helen Darling, chief executive officer of the National Business Group on Health in Washington, says HR executives are in the best position to know how their employees may feel about different benefits programs and compensation packages, because they are supposed to be closer to them. However, finance executives are going to hold the "purse strings," she says, so they can't just be a pass-through, because the costs are too substantial -- particularly if the changes are operational. "Some employers might decide to get out of the business of providing health benefits and just use the new exchanges," Darling says. "HR people most likely will want to keep their employees happy and engaged, so they might be more likely to say, 'Let's continue to provide the benefits.' Whereas finance is going to be more focused on what's this going to cost us, what are the trade-offs. It may be great, but something's got to give -- we can't afford it all," she says.
Early induced pregnancies are costing your health plan
Recent studies have shown that as many as 36% of elective deliveries now occur before 39 weeks, and many of these early deliveries are contributing to costly and avoidable complications. In the United States, one in eight babies is born prematurely, according to the March of Dimes. Premature birth costs society more than $26 billion a year and takes a high toll on families, though exact costs for a health plan are unknown. When asked about the cost, President of the National Business Group on Health Helen Darling says "we don't need to [know what the costs are], it's true that early deliveries are very costly, but for trying to get people to basically not have a delivery before 39 weeks, the case has to be made on the impact on the baby." Darling even referred to her own pregnancy many years ago while living in the South, "I was miserable and gained a lot of weight because this was before physicians told you about the importance of exercise, if a doctor had asked me if I wanted to induce early, I would've said yes because I didn't know any better." Now, she says, she would make a different decision. And women and their employers are in a position to make informed decisions.
Ernst & Young steps up for same-sex partners
NEW YORK (Reuters) - Ernst & Young employees who opt for same-sex domestic partners' medical benefits will get something of a delayed bonus this year when they file their 2011 federal and state tax returns. And the most recent survey by the National Business Group on Health found that just 8 percent of 51 employers questioned gross up for federal tax purposes, with 6 percent doing so for state taxes -- translating to four employers offering federal reimbursement, and three on the state level. For Ernst & Young to step forward, "it certainly should be considered a very generous benefit because it's additional cash," said Helen Darling, president and CEO of the National Business Group on Health, which includes more than 330 large U.S. employers. "That's probably why too many companies aren't doing it: It means paying out more cash. And it's big especially during hard times when everybody has to pay more for their benefits."
Taxes: Prepare for higher childcare, commuting costs in 2012
Paycheck a little lighter this month? Despite the extension of the payroll tax cut, taxes are still taking a bigger slice of many workers' pay in 2012. And 2013 could be even worse. Thanks to little-known factors such as lower transit and childcare benefits, some workers can expect to have their net pay decrease by several hundred dollars this year as new federal regulations rolled out January 1. "Unless a company is willing to bump up salaries to offset it, taking away a tax advantage or [fringe] benefit will always impact employees at the margins," says Steve Wojcik, vice president for public policy at the National Business Group on Health, a coalition of 325 large employers. "That's probably what many workers are feeling right now." Of course, it is still possible that Congress could act to restore many, if not all, of these expiring tax breaks. Whether that will happen remains unclear, but as Wojcik puts it, "You'd hope in this economic climate, Congress would be doing everything in its power to help workers and their families, not make things more difficult."
The High Cost Of A Good Night's Sleep
Helen Darling, president of the National Business Group on Health, which represents large employers offering health insurance to their workers, says the tests are driving up the cost of premiums. This is a good example of something where we have technology, we have financial incentives to use more of it then we have historically done, you have enough problems including a growing obesity epidemic, and you sort of put together the so-called perfect storm for driving up overuse and health care cost. She says doctors should focus instead on common-sense approaches to sleep apnea, like losing weight, before turning to expensive testing and medical devices.
Creating an Employee Benefits Framework
In a back-and-forth conversation, Harvard Medical School's Ron Kessler and Carol Harnett discuss some healthcare-plan design and ROI strategies for HR leaders, including the impact of recurring or chronic health conditions on accident and injury prevention. CH: There are many little decisions that HR leaders have to make regarding employee benefits. What's the best way for them to sort through the information? RK: I think HR executives can use one or several approaches to making decision about employee benefits. First, they can play it by ear and follow their gut instincts. Some companies may want to offer bare-bones benefits and others may want a rich benefits package. Second, benefits leaders can hire a management consultant who can share the experience of other employers in similar industries. Third, HR leaders can systemize their decision-making beyond a consultant's experience by joining an employer-based membership organization like the National Business Group on Health or the Integrated Benefits Institute. Employers gain access to benchmark information based upon different cuts of the data, including industry, benefit-plan design and outcomes that are important to them, such as healthcare costs and absence rates. Finally, the highest level of what's available now is to work with a company that provides services that directly focus on individual corporations and their distinct challenges. The service provider uses outcome measurements that are important to the employer. This last approach is only useful if the company is large and has a generous benefits package. We don't know if this approach is cost-effective yet, but it's promising.
You Can Afford a Trainer
Promoting exercise is part of employers' broader attempt to control long-term health-care costs, says Helen Darling, president of the National Business Group on Health, a coalition of 369 large employers based in Washington, D.C. "Despite the recession," she says, "the interest in providing services, benefits and, in many instances, financial incentives to improve health has continued to climb." Nearly three out of four employers had an on-site fitness center in at least one location, according to a 2010 survey of 62 large employers from the National Business Group on Health. One-third of those employers offer personal training at all their fitness centers, and 44% offer it at some facilities.
Mental Health Stigma Recedes
"It's good to make sure they seek [employee assistance] services because it affects lots of other things," said Steve Wojcik, vice president for public policy for the National Business Group on Health in Washington, D.C. "A lot of times people have some sort of underlying medical condition."
Be Healthy, Win A Bonus From The Boss
Lose a few pounds, pocket a few dollars. Thats the approach a growing number of Colorado employers are taking to improve the health of their workers. Dangling premium discounts, credits, rebates and even cold hard cash as tempting carrots, employers are enticing their staffs to quit smoking, shed weight, lower their blood pressure and achieve a slew of other positive health outcomes. Benefits consulting firm Towers Watson and the National Business Group on Health found even higher numbers, with 4 out of 5 companies surveyed planning to join the trend by 2013.
Smokers, forced to pay more for health insurance, can get help with quitting
Smoking is such a familiar health hazard that some experts say it doesn't get the attention it deserves; the focus is often on other lifestyle-related conditions, especially obesity. But smoking is still the No. 1 cause of preventable death in this country. Nearly half a million people die prematurely because of smoking-related illnesses, including lung cancer, heart disease and chronic obstructive pulmonary disease, according to the Centers for Disease Control and Prevention. Most smokers need some sort of assistance to quit, whether it's counseling, support groups or medication to help reduce nicotine cravings. But getting that help can be difficult. While public funding falters, a growing number of companies offer smoking-cessation programs to their workers. Last year, two-thirds of companies with 200 or more workers offered such programs, while 31 percent of smaller companies did so, according to the Kaiser Family Foundation's annual survey of employer-sponsored health benefits. (Kaiser Health News is an editorially independent program of the foundation.) At the same time that they offer a helping hand to quit, more companies are also penalizing employees who don't kick the habit by hitting them with higher health insurance premiums. At firms with more than 20,000 employees, 24 percent vary premiums based on whether someone smokes, as do 12 percent of companies with 500 or more workers, according to the 2011 survey of employer-sponsored health plans by human resources consultant Mercer. But employers argue that charging smokers more is fair. "The cost of medical care for smokers is considerably higher," says Helen Darling, chief executive of the National Business Group on Health, an employer group. "Employers are increasingly saying that if someone costs the pool more, they should pay more." Darling points out that companies that go this route typically offer free smoking-cessation services and give employees plenty of notice before implementing the change.
Insurers should reward wellness
As The Denver Post's Michael Booth reported last Sunday, a national survey of large employers by the National Business Group on Health found that 80 percent plan to offer financial rewards for health in 2012, up from 54 percent this year (the number who will penalize workers will double this year to 38 percent, the survey found).
Inspiring employee healthy lifestyles with employer incentives
The use of penalties to force employee lifestyle changes is expected to increase to almost 40 percent next year among large and mid-size companies, up from 19 percent this year, and 8 percent in 2009, according to an October survey by consultant Towers Watson and the National Business Group on Health. The penalties include higher premiums and deductibles for employees who refuse to participate in health management activities and those who smoke and participate in other risky health behavior.
Employee benefit plan regulations face pivotal new year
Rules for a New Year
Several requirements of the health overhaul go into effect in 2012. Companies will have to provide a short summary of their health benefits to all employees, showing employees' share of the cost in common medical situations. Final rules are pending on the exact information that might have to be included. Beginning next year, companies also will have to report the value of their health-care plans on employees' W-2 forms. Those figures eventually could be used to determine whether companies could be fined for not providing health care or might have to pay tax on so-called Cadillac health plans, says Marie Hollein, president of Financial Executives International, a professional group for CFOs and controllers. Companies also will begin having to pay $1 per plan participant next year to fund an independent research group that will study the effectiveness of medical treatments. The administrative costs could add up, but the research ultimately could cut health expenses, says Steve Wojcik, vice president of public policy for the National Business Group on Health. In January, new rules for employer-sponsored 401(k) retirement plans take effect, requiring companies to disclose in plain English how much plan administrators are charging participants.
High-deductible health plans on rise
Nearly three in four employers will offer at least one of these plans next year, according to a survey by the National Business Group on Health, a nonprofit association that represents large employers. Helen Darling, its president, predicts that by 2016 the majority of all health plans will have high deductibles. High-deductible plans are the only ones many small businesses and nonprofits can afford. Seventeen percent of employers in the survey conducted by the National Business Group on Health will offer only high-deductible plans. But the problem with traditional health insurance plans is that workers are often too quick to use the benefits, Darling said. She gave the example of a worker choosing between a brand name and a generic drug. With a high deductible, a worker might also be less apt to schedule an appointment with a dermatologist for an issue related to physical appearance. Regardless of the type of benefit plan, Darling said, all deductibles are on the rise. "It is now true that the median deductible in the country, I think almost two years ago, hit over $1,000," Darling said. "A high-deductible plan, under the law, has to be at least $1,200. That's not much higher than the average or the median right now. We are increasingly living in a high-deductible world."
Sending out 2011 with a rush on flexible spending
Until recently, flex dollars could purchase over-the-counter medications, but that no longer applies, says Steve Wojcik, vice president of public policy for the National Business Group on Health in Washington, D.C. "You can't just run out and get Tylenol or antacids the way you used to do," Wojcik says. "That's a big change from last year, and part of the federal healthcare law." The law also produced another change taking effect in 2013, when annual FSA contributions will be limited to $2,500. Meanwhile, it might baffle some taxpayers to learn that "you can use flex money for Bactine and other first-aid items - and you can use it for sunscreen, so you may want to stock up for next year," Wojcik says.
Flexible spending account deadline near
If you've signed up for a concierge service, get an itemized list of costs. A small but growing number of primary care physicians are charging patients annual fees ranging from $1,500 to $10,000 for personal services, such as private waiting rooms and longer appointments. The portion of the fees that cover actual health care services, such as a comprehensive wellness exam, is a qualified flex account expense, says Steve Wojcik, vice president of public policy for the National Business Group on Health. However, you can't use flex account money to pay for services that give you preferred access to your doctor, such as same-day appointments and after-hours consultations.
A Piecemeal Approach to Health Law in States
The attention of legions of lobbyists for employers and insurance companies is likely to shift now from Washington to state capitals. "The decisions about what is covered will be fought out state by state between highly organized, narrow, special-interest groups" and state officials, said Helen Darling, chief executive of the National Business Group on Health.
What Lies Ahead
Controlling Costs Here in the United States, not to mention the rest of the world, employers will continue efforts to contain healthcare costs. Such efforts will include attempts to reduce the number of unnecessary tests and procedures done by medical providers, says Helen Darling, president of the National Business Group on Health in Washington. "Screenings such as MRIs often find things that may not need to be acted upon, yet they generate more tests and more procedures that put patients at greater and greater risk," she says. "It drives up costs and generates more problems, and our members are going to be working very aggressively to tackle this over the next five years."
Despite Some Legal Risk, More Employers
LuAnn Heinen, vice president of the National Business Group on Health (NBGH), said that incentives are "a great way to get employees' attention." "It has an impact if I have to tell my spouse I left [hundreds of dollars] on the table," she said. It takes more than employer incentives to get people to maintain complex health behavior changes, Heinen said, but incentives can get the ball rolling. Employers Use Both Carrots and Sticks In spite of the legal considerations, employers are moving ahead with incentives because they work, Heinen told BNA. "This year companies are increasing the use of both carrots and sticks," Heinen said. By 2012, four in five companies will be offering some type of financial incentive to those who participate in their wellness programs "and 20 percent expect to have penalties in place"according to the 2011/2012 Staying at Work survey by Towers Watson and NBGH. According to Heinen, "Penalizing employees sends a different message to employees than incentives." She added, "What works for one company and culture may not work for another." Sometimes a penalty may be the next step for an employer, she said. For example, a company that has been covering smoking cessation medication and coaches for years, and has already instituted a smoke-free environment may decide to up the ante. "After you do all that, some companies are saying, Maybe we need to ramp up the message,'" she said. One way an employer might hold smoking employees' feet to the fire, Heinen said, is to announce a premium increase for the next year unless employees have signed statements saying they are not smokers. Heinen commented that while incentives are important, they are not everything when it comes to wellness. "To keep new healthy behaviors from being lost in the crush of the busyness of our lives, employers must embed healthy lifestyles into the culture," she said.
The Future of US Health Care
A survey this year by consulting firm Towers Watson and the National Business Group on Health found that 13% of U.S. employers are tying financial incentives to health outcomes like cholesterol-test results, and another 33% plan to do so.
PepsiCo to pay for employee surgeries at Hopkins
PepsiCo has signed a deal that allows employees and dependents across the nation to get certain surgeries at Johns Hopkins Hospital a cutting-edge arrangement that could grow in popularity as companies look to provide better health care and contain costs. The world's second-largest soda company will pay for workers and their dependents about 250,000 people to travel to Baltimore for cardiac or complex joint surgeries, such as correcting problems in a previous knee replacement. PepsiCo will also cover the deductible and coinsurance for the procedures. "This is really leading edge in a good way," said Helen Darling, president and CEO of the National Group on Health, a Washington, D.C., nonprofit that advises large companies on health issues. "I think the more these leading companies do this, the more it will grow in popularity." Darling said it is mostly large, sophisticated companies moving to such collaborations with hospitals. Lowe's Companies Inc., the home improvement retailer, entered into a similar arrangement last year to send workers to Cleveland Clinic for heart surgery. PepsiCo, which has a self-funded medical plan, said cost savings weren't the main driver behind the agreement with Hopkins. Instead, the company was hoping to get better care for employees. "The folks at Hopkins can focus on the best medical care for our employees and their families without worrying about if a meter is running, or about the financial impact of the care they are providing," said Bruce Monte, senior director of PepsiCo Health & Welfare Benefits. PepsiCo's arrangement is part of a broader approach by the company to promote preventive care and help employees lead healthier lifestyles. The company has clinics at some of its facilities, including 38 managed by Hopkins. The company also offers routine medical care at work sites, education programs on health, nutrition and exercise, on-site fitness centers and organized programs to encourage exercise.
Analysts forecast higher health costs for 2012
More than half of U.S. companies plan to charge employees more for their health insurance in 2012, a recent National Business Group on Health survey found. Nearly four in 10 said theyll increase employee deductibles.
Challenging Spousal HRA Incentives
Legal and benefits experts are all abuzz about a reported U.S. Equal Employment Opportunity Commission interpretation of the Genetic Information Nondiscrimination Act as it affects employee incentives for spousal health-risk assessments. Just how far employers really need to take this remains to be seen, with no federal guidance forthcoming. Some experts are hoping the issue dissolves before it becomes any more confusing. "It seems a stretch that providing medical information of one's spouse would violate GINA," says Steve Wojcik, vice president of public policy for the Washington-based National Business Group on Health. "If the EEOC were to make this a national policy, it would make them look ridiculous. "To throw up obstacles that lawyers have to worry about to offer up programs that get employees and families involved in wellness," he says, "seems very counterproductive to the real intent of the wellness movement altogether. Let's just hope this fades away into the woodwork." The NBGH, Wojcik adds, is telling its clients that "as long as they make it clear to their employees that they're still getting their incentives whether they answer [family medical questions] or not, then it's voluntary and that's OK."
A Rarity: Earn More, Pay More For Health Coverage
One-size-fits-all health insurance premiums that don't take into account how much an employee earns strike many people as unfair. Some raise questions about whether an employee's wages are actually a good measure of how much he can afford to pay in premiums, particularly if there's a working spouse in the picture who earns a good salary. "Maybe it's not adopted more because it looks fairer than it is," says Helen Darling, president of the National Business Group on Health.
Take an integrated approach to workplace mental health
Depression is associated with a number of common medical conditions such as heart disease, and, according to the National Business Group on Health, "two decades of research show that persons with depression are at a greater risk for developing heart disease than healthy persons."
Taking care of caregivers
"We know that people who are caregivers have higher health care costs," says Pam Kalen, vice president of membership at the National Business Group on Health. "Recent data show that the average additional costs are 8%, which is a result of them having additional medical conditions, such as hypertension and diabetes, which can be caused by the caregiving lifestyle." However, if support is given to sustain them in their work roles, caregivers don't necessarily sustain those poor levels of health. Flexible work schedules and telecommuting are other ways employers can help accommodate caregiving employees. Though 24% of companies offer telecommuting and flexible work hours as a benefit, according to staffing agency Accountemps, not all organizations are able to provide that "across every industry. If you need people staffed at all times, it'll be harder," says Debbie L. Harrison, senior regulatory analyst at the National Business Group on Health.
More firms using incentives to prod employees to fitness
In the past two years, many employers already have adopted financial incentives to encourage people to lose weight, join a fitness program or get a physical exam, according to a survey last month by the National Business Group on Health. "There was a long time when employers felt this was a personal issue," said Helen Darling, president of the organization, "but in the last five years, the dramatically increasing health care costs because of obesity have changed their minds." The survey of 335 employers found that the share of companies that used financial rewards in health management programs increased to 54% in 2011 from 36% in 2009. In 2012, about 80% of companies plan to offer financial rewards. The survey also revealed that the percentage using penalties, such as for smoking, more than doubled -- from 8% in 2009 to 19% in 2011. Nearly 40% of the companies surveyed plan to use penalties next year.
Retiree Reinsurance Runs Out
Created as part of the new health-reform law, the Early Retiree Reinsurance Program was designed to function as "a bridge" to help employers finance healthcare benefits for early retirees until the insurance exchanges became reality in 2014. Steve Wojcik, vice president of public policy at the Washington-based National Business Group on Health, agrees that lack of ERRP funding will not change much for employers in the long run. "For our members, it was not looked upon as something to rely upon to change their commitment to stay with or decision to scale back early retiree health benefits," he says. "Whatever the employer plans were for coverage for early retirees, they knew going in this was a temporary program," Wojcik says. "While $5 billion is a lot of money, the overall impact for our members has been minimal." The initial beliefs that the program would result in a funding shortfall "were confirmed when there was a rush to apply," he says. "The early applications were mainly municipal and state governments, possibly because they were encouraged to apply early. What most people would think of as for-profit employers were second or third in line." Wojcik says several members contacted NBGH to find out what to do and the organization helped as much as it could. One of the tricky aspects of applying was that even a single small mistake on the application form put an employer at the end of the line. On the other hand, he says, a publicly traded company eligible for the ERRP reimbursement that didn't apply might be neglecting its fiduciary duty.
Health care reforms face key court test
Is your job causing you to put on the pounds?
Several companies, including General Mills, Florida Power and Light and Pitney Bowes, are helping employees stay fit, LuAnn Heinen said, director of the Institute on Innovation in Workplace Well-Being (formerly the Institute on the Costs and Health Effects of Obesity) at the National Business Group on Health. Efforts include encouraging employee fitness; including adding walking paths to corporate campuses, making sure lunch meetings include salads and low-fat items, and giving discounts on salads and healthy items at the company cafeteria. "These are employers who are consciously improving the environment to make it a downhill slide to stay healthy," Heinen said. "It's really about supporting the people who already have tried to be healthier."
Health 411: Answers on healthcare and Medicare open enrollment
The cost of my employer's plan went up again this year. Can I find less expensive coverage someplace else? One potential option for saving money is to consider a consumer-directed health plan, which more employers are offering. These are high-deductible plans that "usually cost the employee less but they require them to pay more out of pocket," says Helen Darling, chief executive of the National Business Group on Health, a nonprofit that represents large employers on health policy issues. My employer keeps bugging me about taking a health risk assessment and joining a walking club. Does this have anything to do with my health insurance? "Most large employers are giving employees the chance to earn back some of their increased cost-sharing by participating in health improvement programs," Darling says. Lower insurance premiums, cash and gift cards are going to employees who agree to take a health risk assessment or participate in smoking cessation classes, for example. I missed my open enrollment period, but I'm not happy with the plan I have. Is there anything I can do? If open enrollment has closed and you've defaulted into a plan you don't want, talk with your company's human resources department, Darling says. "My experience is unless [the excuse] is completely ridiculous or flaky, they want to be helpful," Darling says. If nothing else, she says, "It can't hurt to try."
Managing a deductible
Get healthy and plan ahead. A growing number of employers are tying significant financial incentives to wellness efforts, and sometimes to concrete results on biometric tests such as cholesterol screenings. You should check if you have such opportunities. A recent survey by Towers Watson and the National Business Group on Health found that by next year, around 80% of companies will offer some kind of financial reward for workers who participate in wellness programs, while 38% plan to have penalties. Around 12% said they link the incentives to biometric results now, but an additional 16% said they will do so next year.
New York autism mandate follows national trend
New York insurance companies that were not covering the screening, diagnosis and treatment for autism spectrum disorders will now be mandated to do so effective Nov. 1, 2012. Though the legislation will not apply to employers with self-funded plans, "all of the interests and concern about autism and the pressure on parents still applies to them," says Ronnie Goff, vice president at the National Business Group on Health. A year ago, they conducted a survey of members and found that most members covered screening and diagnosis, but treatment varied widely. "Typically there is coverage for specific treatments, and many times they will cover certain treatments with certain specified conditions," she says. One employer had an autism care advocate to help families with diagnosis and only then is the treatment covered, but even that is few and far between. She says the big problem is employers are uncertain about what actually works.
Think before you leap (into your old benefits plan)
A recent survey of large employers by the National Business Group on Health, a corporate health benefits association, found that 53 percent of those polled plan to increase employee premium contributions, while 39 percent plan to increase in-network deductibles. About 25 percent plan to increase out-of-network deductibles and out-of-pocket maximums.
Workers can expect higher premiums, deductibles
Wellness programs: Companies continue to prod workers to live more-healthful lifestyles. "Employers are saying, 'If we are going to control health-care costs, we really have to work on the most- serious problem: employees' poor health habits," said Helen Darling, president of the National Business Group on Health, a nonprofit that advocates for employers.
Want healthier employees? Try offering prizes
Among the 62% of big companies offering wellness incentives, the dollar amount has risen to $430 per employee, up 65% from $260 in 2009, says a recent study by Fidelity and a nonprofit called the National Business Group on Health. The payoff is real: J&J says wellness efforts have saved the company $250 million in health care costs over the past decade. From 2002 to 2008, that worked out to a return of $2.71 for every dollar spent.
Engaging the Invincibles
By 2014, the under-30 population will become the majority of the workforce, a title once held by baby boomers. During this transition, employers must revisit their strategies for engaging younger populations in health care decision-making and lifestyle improvement.
Insight: Firms to charge smokers, obese more for healthcare
Overall, the use of penalties is expected to climb in 2012 to almost 40 percent of large and mid-sized companies, up from 19 percent this year and only 8 percent in 2009, according to an October survey by consulting firm Towers Watson and the National Business Group on Health. The penalties include higher premiums and deductibles for individuals who failed to participate in health management activities as well as those who engaged in risky health behaviors such as smoking. "Nothing else has worked to control health trends," says LuAnn Heinen, vice president of the National Business Group on Health, which represents large employers on health and benefits issues. "A financial incentive reduces that procrastination."
Open enrollment: Higher pay could mean higher premiums
A survey of about 600 employers by the National Business Group on Health (NBGH) and Towers Watson shows that 23 percent of large- and mid-sized companies structure health benefit premiums based on employee pay levels. About one in five employers (22 percent) that kept healthcare costs at or below national averages the last four years used this approach. By contrast, only 10 percent of employers with the highest healthcare increases structure premiums based on pay. Linking premiums to pay isn't commonplace -- yet. "Creeping up is the right phrase; it's not moving up quickly," says NBGH president and CEO Helen Darling, whose association includes more than 330 large U.S. employers. "It's directly related to the extent healthcare costs are rising. There's no way to get out of charging low-wage employees more as prices increase, but you can't ask them to pay too much." And paying more seems a given for almost everyone in the workforce. Darling cites figures that show healthcare costs rising by 7.6 percent in 2011. While the increase should only hit 5.9 percent in 2012, benefit offerings will begin to shrink, according to a Towers Watson survey of 368 midsize to large companies. What to do, then? Darling says some companies give workers chances to "buy back" what they lose in higher premiums and deductibles by participating in wellness programs. "If costs go up $300, you can take some tests, or work with a [wellness] coach, and earn back some of that money," she says.
Open Enrollment 101: What You Need to Know
How much are they raising those costs? The National Business Group on Health says insurance costs are expected to rise by 7.2% in 2012, and according to Towers Watson, an HR consulting firm, two-thirds of all midsize and large companies will be raising their employees' health insurance premiums next year.
Wellness: Use of incentives (and penalties) climbing because they work
Between 2009 and 2011, the use of financial rewards in health management programs increased by 50%. Meanwhile, the use of penalties increased by more than 100%, according to a new study. The numbers show employers are starting to quickly warm up to the idea of penalizing workers for not participating in wellness programs -- or not meeting certain health goals. The findings are from The Towers Watson/National Business Group on Health Staying@Work study of 248 U.S. companies.
Heightened Awareness of Benefits Plays Pivotal Role in Employee Experience
Employers spend a great deal of time and money trying to educate employees about their benefit options, but do employees most understand and use them effectively? Here are some of the do's and don'ts of benefits communications. "Most employees don't look at their benefits material until they have an issue, and employers need to overcome that inertia," says Helen Darling, president and CEO of the National Business Group on Health, a Washington, D.C.-based not-for-profit organization of mostly large employers. "Employers need to make dramatic statements to get attention, and requiring an active enrollment can help as well." Darling believes statements such as, "costs are going up" or "you will lose coverage if you don't enroll" are ways to gain attention, and making the communications as simple as possible is essential. "Information always needs to be sent home to the spouse, and with online communications, never underestimate a person's impatience with technology, you need to have as few clicks as possible or you lose them," she says.
More companies investing in employee fitness
Studies have shown that for every $1 a company puts into corporate wellness programs, $3 is saved through decreased sick days, increased worker productivity and employee retention, according to the National Business Group on Health in Washington, D.C. "The goal of a wellness program isn't just to lower insurance claims and pharmacy costs but to better manage absences and have fewer illnesses and injuries," said LuAnn Heinen, vice president of the business health group and director of its Institute on Innovation in Workforce Well-being. "The goal is to get a more effective employee." "Active, healthy employees are going to lead better lives. That means they're going to be better employees,"Heinen said. "The ripple effect of healthy lifestyle choices goes far beyond the workplace."
Insurers, employers offer incentives to promote healthful habits
Growing numbers of employers and insurance companies, stung by continued hikes in healthcare costs, are offering employees money and merchandise to lead healthier lives. Advocates of the approach are betting that preventive action will keep workers productive and hold down healthcare bills for expensive diseases like cancer and diabetes. One study by benefits consultant Towers Watson and the National Business Group on Health found that 58% of large employers are offering money, insurance discounts or other inducements this year to workers who manage their weight or engage in other activities to improve their health. That's up from 52% in 2010 and 49% in 2009.
Health care reform: Time for a checkup?
While the law continues to be debated, one issue is clear. The reform law has not curtailed the steady rise in health care costs for employers. In fact, it appears to have exacerbated it, at least in the short term. Employers expect the average cost of health care benefits to increase 7.2% this year, according to a survey by the National Business Group on Health (NBGH) and Towers Watson. That is up from an average of 6% in 2010, and both figures are well above current inflation rates. About 1% of the rise this year can be attributed to the health care reform law and requirements it has imposed for coverage, says Helen Darling, president and CEO of the National Business Group on Health. Though these changes are years off, employers should be taking action now to adjust their health plans, says Darling. She noted that the so-called "Cadillac plan" provisions of the law scheduled to go into effect in 2018 are already causing large employers to make changes to their benefit plans to control costs and try to avoid the tax. "The richer the benefits now, the more you need to hurry," says Darling. Though these changes are years off, employers should be taking action now to adjust their health plans, says Darling. She noted that the so-called "Cadillac plan" provisions of the law scheduled to go into effect in 2018 are already causing large employers to make changes to their benefit plans to control costs and try to avoid the tax. "The richer the benefits now, the more you need to hurry," says Darling.
Rising Health Costs Get Harder to Escape
Good health is the gift that keeps on giving. Not only do you feel better, you probably paid less for health insurance than some of your co-workers. In recent years, many large employers have passed on the rising cost of health insurance in the form of higher deductibles and co-payments -- costs borne primarily by those who use health care. This year, though, the pain will be shared, according to an analysis by Towers Watson, a human resources consultant. Employers will pass on cost increases primarily through higher employee premium contributions. Towers Watson projects that 66% of companies will increase employees' share of premiums for single-only coverage in 2012, and 73% will increase the share of premiums for dependent coverage. Another survey by the National Business Group on Health found that 53% of employers plan to increase employees' share of premiums, while 39% plan to increase in-network deductibles. --More spousal surcharges. It's not uncommon for working couples to compare their employers' health insurance options and sign on to the one with the most generous plan. However, this is a practice many employers want to discourage, since covering more family members increases their costs. Spouses are even more expensive to cover than adult children because they're older and more likely to get sick, says Helen Darling, chief executive of the National Business Group on Health. In 2012, nearly three-quarters of employers will offer a consumer-directed plan, according to a survey by the NBGH. At 17% of employers, a consumer-directed plan will be the only option. "Overall, these are less-expensive plans" for employers, Darling says.
The Steep Price of Insomnia
The new research carried out by scientists at Harvard Medical School and the University of Michigan used a questionnaire to gather information on sleep and insomnia from more than 7,000 adults. After crunching the numbers, the researchers came to some startling conclusions. Every year: --The average U.S. worker with insomnia causes his or her employer 11.3 days and about $2,280 in lost productivity. --Insomnia costs the U.S. workforce $63 billion in total. 23.2 of employees suffer from insomnia, according to the findings, and the problem is more common among women than men and less common among those over 65. So what are the underlying causes of such a high prevalence of insomnia? Speaking to HRE Online, Helen Darling, CEO of the National Business Group on Health, a nonprofit that represents large employers on health-policy issues, cited the tough economy: "People have a lot of things to keep them awake at night. Not only are the majority of employees worried about their finances now more than ever, but today everybody is so leanly staffed; non-revenue functions are about as lean as they can be. I don't think we're talking enough about the impact of insomnia on both employees' and employers' well-being." What can individuals do about this problem? Darling suggests bosses should be on the look out for exhausted looking employees and when they spot one, not simply ignore the circles under their eyes. "They should really say something like, 'You look like you're really tired today; we have an EAP [employee assistance] program; I had to call them recently; they helped me so much,'" Darling said.
Health law's hit on premium: 1.8%
Effective in 2014 Some of the law's largest coverage expansions, however, don't take effect until 2014, when tax credits are offered to low- and middle-income families to help pay for health coverage. Medicaid, the joint federal-state program for the poor and disabled, will also be expanded. Gabel attributed most of the 2011 premium increases to what he called "catch-up pricing" -- insurers' effort to recover claims costs that have outpaced revenue from premiums for the last four years. He cited a 7.6 percent increase in medical claims expenses in 2011, and increases of 5.9 percent to 7.4 percent in each year since 2007, according to data from the Towers Watson/National Business Group on Health survey of employers.
Advisory Panel Says Essential Health Benefits Package Must Be Affordable
The government moved a step closer Friday toward defining what "essential benefits" would be offered by companies selling coverage to millions of Americans in new insurance exchanges. In a 297-page report, the Institute of Medicine, a federal advisory panel, laid out criteria and methods the Department of Health and Human Services should use in developing the package. But, as expected, the report left to HHS the job of deciding specific benefits. Larger employers could also be affected by the list of essential benefits. "Whatever the government deems to be essential benefits could be seen by employees and others as a benefit floor for all plans, including employer plans, over time," said Steve Wojcik, vice president of public policy at the National Business Group on Health.
HR Plays Key Role in Spreading the Word That No. 1 Way to Stop the Flu Is Vaccination
With flu season once again upon us, health and wellness experts interviewed by BNA agreed that vaccinations are the No. 1 way to avoid the flu and that HR can play a key role in getting that message out to employees. According to an issue brief from the National Business Group on Health, the indirect costs of the flu for businesses in absenteeism, presenteeism, and other expenses run $76.7 million annually, while the direct medical costs of the flu average $10.4 billion a year. Influenza can occur at any time, but most of it happens from October through May, according to the Centers for Disease Control and Prevention.
Health care cost hikes increasing, expected to continue
Workers paying more for health insurance as costs rise
In the coming year, Fronstin said, employers are also likely to ask workers to pay even higher premiums. Helen Darling, president and chief executive of the National Business Group on Health, agreed. Darling's group found that more than half the employers they surveyed said they planned to increase the premiums workers pay and 39 percent planned to increase deductibles. "When times get tight, employers are suffering too," Darling said. "They have less money to spend and they pass on slightly higher cost to employees." Towers Watson, a global professional services company, surveyed 368 employers in July and found that roughly two-thirds said they will increase the employee's share of premium contribution for single coverage, and 73 percent will increase them for employees with dependent coverage. Towers Watson's survey and the National Business Group on Health found that employers were concerned about potential increases in their costs due to health care reform. However, Kaiser's Altman said that only 1 to 2 percent of 2011 cost increases were because of impending federal health reform regulations, such as requiring insurers to cover all wellness checks. Fifty-six percent of the employers Tower's Watson surveyed feared they would trigger the so-called luxury plan, or excise tax, by 2018. Darling said that she believed some employers were already passing on more costs to employers because they feared being penalized for offering health coverage that was too rich.
Health Insurance Premiuns Top $15K for Family of 4
Health insurance premiums for employer-sponsored health insurance posted an unexpected increase in 2011 according to the Kaiser Family Foundation/Health Research & Educational Trust 2011 Employer Health Benefits Survey released Tuesday. The average annual premium for family coverage increased by 9% to $15,073 in 2011. The growth rate was 3% in 2010. Premiums increased significantly faster than workers' wages (2.1%) and general inflation (3.2%). Since 2001, family premiums have increased 113%, compared with 34% for workers' wages and 27% for inflation. Helen Darling, president and CEO of the National Business Group on Health, a nonprofit that represents large employers on healthcare issues, cautioned against assigning responsibility for the premium increases to any single component of the healthcare industry. "Everything contributes," she said noting that Americans pay about $20 billion annually for unnecessary services. "At NBGH we talk to stakeholders all the time and everyone has their own ideas about what drives healthcare costs," Darling stated. Darling said hospitals often point to labor and imaging as cost drivers while physicians say the insurance payment system itself drives up their costs of doing business. "They say they can't make a living talking to their patients or taking their histories because health insurers won't pay for that. They are paid by insurers to order and run tests."
Health Insurance Costs Rising Sharply This Year, Study Shows
But employers and others say much more still needs to be done to control overall costs, especially when workers' wages are essentially flat. Of the $15,073 in average premiums paid for family coverage, Kaiser found that employees paid $4,129 towards the cost, in addition to whatever out-of-pocket costs they shouldered. "We're going to continue to have this yawning gap," said Helen Darling, the chief executive of the National Business Group on Health, which represents employers that provide health coverage to their workers. Health care costs continue to climb much faster than overall inflation, she noted. "The health economy acts as if it's a boom economy," she said.
Survey: Health insurance costs surge in 2011
The cost of employer-sponsored health insurance surged this year, snapping a trend toward moderate growth, but experts say these increases may slow again in 2012. Annual premiums for family coverage climbed 9 percent and surpassed $15,000 for the first time, according to a report released Tuesday by the Kaiser Family Foundation and the Health Research and Educational Trust. Premiums for single coverage rose 8 percent compared to 2010. Businesses likely reacted to these cost increases by freezing retirement account contributions or giving a flat wage or smaller increase to their workers, said Helen Darling, CEO of the National Business Group on Health, a nonprofit organization that represents large employers on health care issues. "(Workers) basically are giving their pay raise to the health system," said Darling, who was not involved with the Kaiser study. "It's really bad news."
The High Cost of Sleeplessness
A recent study by researchers at several schools, including Harvard Medical School and the University of Michigan, determined insomnia is costing U.S. businesses $63 billion in lost productivity annually. Broken down, each worker with insomnia costs his or her employer $2,280 to $3,274 per year. "People have a lot of things to keep them awake at night," says Helen Darling, president and CEO of the National Business Group on Health, a Washington-based nonprofit that represents large employers on national health-policy issues. Not only are the majority of employees worried about their finances now more than ever, she says, but "today, everybody is so leanly staffed; non-revenue functions are about as lean as they can be. I don't think we're talking enough about the impact of insomnia on both employees' and employers' well-being." So often, says Darling, the National Transportation Safety Board finds causes of automobile accidents to be "someone falling asleep or losing control." In cases where sleepy employees make others unsafe or themselves unsafe -- be they salespeople on calls; drivers of buses, trains or subways; pilots on long overseas flights; surgeons and medical residents; workers dealing with heavy machinery or safety equipment; the list goes on -- "companies will be at risk and could pay a very steep price," she says. "You have a wreck where a van crashes and 22 die because the driver fell asleep," she says, "and the company and the people involved will probably go bankrupt because of the fines and court decisions." Whatever the underlying cause -- whether they're lying awake at night worrying about their finances, or working three jobs just to pay the mortgage, "or pacing the house due to a troubled child or a pending divorce or a horrible spouse," Darling says -- HR leaders need to train their own staff, as well as all managers, to be on the lookout for signs of insomnia and be able "to communicate the availability of the help that is offered -- namely employee-assistance programs." Darling suggests managers and supervisors be encouraged to share their own stories when recommending a visit to the EAP. "They should really say something like, 'You look like you're really tired today; we have an EAP program; I had to call them recently; they helped me so much,' " Darling suggests. Darling agrees. "I think sleeplessness has a much bigger impact on companies than it's ever been fully appreciated in the business community," she says. "It used to be laughed at, treated humorously," she adds. "But there's not that feeling that it's something to laugh at among HR leaders anymore. Many already see this as a big problem that needs to be dealt with."
Making Workers Pay as the Cadillac Tax Looms
Companies seeking to rein in medical spending and worried about the "Cadillac tax" on expensive health insurance expected in 2018 are turning to coverage that shifts more costs to workers. As an alternative to traditional insurance, businesses are offering health-savings accounts, or HSAs, which let workers set aside funds to pay medical bills. These are paired with insurance coverage with a high deductible -- at least $2,400 per year for a family -- that typically must be spent before insurance kicks in to pay claims. Employers see HSAs as a way to hold down costs and prepare for changes in health-care law, says Helen Darling, president of the National Business Group on Health, an association of big companies. The health reform bill signed by President Obama last year will apply a 40 percent levy on health benefits above $27,500 for families. The only way to avoid "the Cadillac tax is if they control costs starting now," Darling says. The number of people with such coverage has risen 87 percent since 2008, to more than 11.4 million in January, according to America's Health Insurance Plans (AHIP), a trade group representing insurers. The National Business Group on Health found in an August survey that almost three quarters of companies plan to offer an HSA-type plan next year, up from 61 percent this year. In 2012, 17 percent will make such plans the only coverage available.
Employee incentives drive lower-cost health care
The idea of having employees pay the difference for higher-cost services is not new. About 39% of large employers surveyed in an August National Business Group on Health report said they use the technique in their prescription-drug programs, often by requiring workers who want a brand-name drug when a generic is available to pay the difference. Some employers encourage workers to use "high-performance" networks of doctors or hospitals by lowering their co-payments if they seek care there. But only about 1% of employers in the August survey use reference pricing like Prodigy, for lab tests, radiology exams or other medical services.
Preventing Sickness, With Plenty of Red Tape
Insurance plans in effect before March 23, 2010, that have not undergone significant changes in cost-sharing and other design changes are considered grandfathered and do not have to comply with the new fully covered preventive care rules. But the number of grandfathered plans is decreasing, as employers continue to make benefit changes that pass on more health care costs to employees. Less than half of the large employers surveyed by the National Business Group on Health have a grandfathered plan option this year.
The Best Jobs Program? Full Repeal Of ObamaCare
Health costs have long been rising for employers. A new survey by the National Business Group on Health found that large firms can expect costs in 2012 to be 7.2% higher than they were this year. And that's after a 7.4% hike in 2010. In 2012, companies will face health care costs approaching $12,000 per employee, according to the National Business Group on Health.
Health insurance rates slow
According to the National Business Group on Health, 53 percent of companies they recently surveyed said they plan to increase the percentage that their employees pay toward premiums, with most raising it by less than 10 percent.
Do Wellness Incentives Really Work?
Companies that want to reduce their health care costs see two ways of doing so: shift more costs to employees and reduce utilization by helping workers adopt healthier lifestyles. We've covered the potential of measuring the return on investment in wellness before [1]. However, a separate question is whether it makes sense to go beyond simply offering wellness programs to offering some type of financial incentive for participating in wellness programs and for achieving positive results. For many employers, incentives are the right thing to do. A survey of 147 large and mid-sized companies conducted by Fidelity Investments and the National Business Group on Health found that the use and amount of wellness incentives is increasing. The study found that companies offered incentives that averaged $430 per employee in 2010, a significant increase from the $260 per employee offered in 2009. Wellness programs can include smoking cessation, weight loss, and exercise programs. Incentives can be in the form of lower healthcare premiums, cash, gift cards, or contributions to health savings accounts. Starting in 2014, the Patient Protection and Affordable Care Act will permit employers to reduce the cost of health care coverage by 30% as a reward for employees who participate in a wellness program and meet certain health-related standards.
Employers tell workers to get healthy or pay up
Next year, one third of employers in the United States plan to reward or penalize workers depending upon their commitment to improving their health. That's a significant jump compared with just 7 percent in 2011, according to a survey commissioned by the National Business Group on Health. "There is no way we will control costs in this country unless we change the health profile of the nation," said Helen Darling, president of the National Business Group on Health, a nonprofit organization whose members provide coverage for more than 55 million Americans. "They literally write checks to the medical claims out of their general assets," Darling said. The anticipated cost per employee is expected to reach $11,176 this year, up from $10,387 in 2010, according to the survey. Enticements for workers to have healthier lifestyles, such as reimbursements for gym memberships, have had limited success. Now, more employers are expecting workers to bear more of the cost. The average hike for employees this year is expected to be just under 12 percent. "Unfortunately, we have an obesity epidemic in the country," Darling said. "If you are obese, there's a pretty high probability that you already have diabetes and you may have a lot of other problems, like knee problems, back problems, depression, you name it." And too many workers still smoke. "We have sort of hard-core problems that do take more than just carrots," she said.
Life Without the COBRA Subsidy
As of Sept. 1, Americans who were laid off between September 2008 and May 2010 are no longer eligible for the COBRA subsidy, which was passed under the American Recovery and Reinvestment Act. The COBRA subsidy covered 65 percent of COBRA premiums for 15 months of the program's 18-month eligibility, meaning unemployed participants are now responsbile for all costs during the last three months. But some employers were surprised to learn the subsidy was coming to an end so soon. Given all of the political posturing and the poor economic environment, those employers could have been under the impression that the subsidy was available for the full 18 months. "The government had extended the subsidy and actually made some of them retroactive if they hadn't acted in time, so that may have caused a perception that because of the high unemployment and the continued economic uncertainty that Congress would have extended the subsidies again," says Steve Wojcik, vice president of public policy for National Business Group on Health. "I'm sure it's going to be a tough situation," Wojcik says. "The long-term unemployed are growing in numbers, and if they still have COBRA eligibility as their subsidies run out, they have to make that tough decision about whether they want to pay the full amount now, minus the subsidies, or give up their coverage, be uninsured and risk having some kind of big health claims without any insurance." According to Wojcik, the average person spends about $6,000 annually on COBRA premiums, amounting to approximately $3,900 in subsidies. While much of the annual subsidy has already been paid, there is still a large cost left over, especially for someone who is still out of work. "It's a lot of money even if you're not on unemployment, but when you're unemployed, I can imagine it's even harder to come up with that money, unless you want to dip into savings, and even then you may need it for other things, too, at that point," Wojcik says. Although the COBRA subsidy may be gone for now, employers should stay on the lookout because there's a chance for its return, Wojcik says. The economy remains sluggish, unemployment is still high, and the 2012 election season is on the horizon. Sure, another government program may alienate some voters given the U.S.'s heavy spending habits, but it might also endear those who are struggling. "The difficulty is that if they do reinstate the subsidy, it will cost the federal government money, and they'd have to find areas to cut to make up for it," Wojcik says. "But I can see that there could be some sympathy for it because of the economic situation, and then looking cynically toward 2012, members of Congress might be eager to talk about what they did to help the unemployed in a bad economic situation."
Health Savings Plans Let Firms Shift More Costs to Workers (1)
Businesses are increasing the use of high-deductible health insurance plans paired with savings accounts to shift more costs to American workers. More large employers are offering high-deductible plans with HSAs or making that coverage the only choice for workers as a way to control costs and prepare for changes in health-care law, said Helen Darling, president and chief executive officer of the National Business Group on Health in Washington. Faster Than Inflation U.S. employers estimate their health-care costs will increase at more than twice the rate of inflation in 2012, or an average of 7.2 percent, according to an August survey by the NBGH, which represents big firms, including 66 of Fortune 100 companies. Employers are attracted to the high-deductible plans because premiums generally are lower and consumers pay more attention to how much care costs, Darling said. Companies also want to avoid the so-called Cadillac tax beginning in 2018, Darling said. The Affordable Care Act signed by President Barack Obama in March 2010 applies a 40 percent levy on employer health-care benefits above $10,200 for individuals and $27,500 for families.
Employers can play critical role in battling child obesity
With the prevalence of childhood obesity in the United States nearly tripling over the past 30 years, now is the time for employers to take the lead in the battle against the growing problem of overweight and obese children, according to the National Business Group on Health. "Child obesity is impacting employers today and will into the future as these children become the workforce of tomorrow," says Helen Darling, president and CEO of NBGH, whose members include 329 large U.S. employers. "Parents have an enormous impact on the childhood obesity epidemic. The good news is that employers can play a critical role in fighting the childhood obesity epidemic by helping families develop healthy lifestyles at work and in the home. In fact, a number of forward thinking companies are already leading the charge." A recent survey of 83 of the nation's largest companies conducted by the National Business Group on Health identifies the following programs employers have in place to help fight childhood obesity: - One third of employers (33%) offer online weight management tools to children. - More than one in four employers (28%) offer telephonic or online coaching for weight management to children Beyond promoting healthy lifestyles in the home, employers will soon face a growing demand for obesity treatment in children. "With the new guidelines for screening under The Patient Protection and Affordable Care Act, many more children nationally will be identified as overweight or obese," says LuAnn Heinen, vice president and director of NBGH's Institute on Innovation in Workforce Well-being. "Employers can provide tools and resources to support and empower employees and work with health plans and community resources to develop and promote new approaches to childhood obesity prevention and treatment." Employer toolkit expanded NBGH also announced that it has updated its employer toolkit, "Childhood Obesity: It's Everyone's Business," to include examples of family-focused wellness programs that four forward-thinking companies are doing to fight childhood obesity. The toolkit also includes a new section on how employers can design their benefit programs to ensure that they are in accordance with new screening guidelines required by PPACA and support obesity treatment options for children. The employer toolkit was developed and updated with support from the U.S. Department of Health and Human Services, Health Resources Services Administration's Maternal and Child Health Bureau. It's available free of charge and can be found at www.businessgrouphealth.org.
Risk-Shifting In Health Care And Its Implications: Part Two
The other approaches for employers facing rising premiums are either to reduce the amount that is spent on subsidizing health insurance, essentially shifting risk; or find a risk-bearing entity that can actually eliminate waste and reduce costs. The former is underway, as the evidence indicates that deductibles and co-insurance are increasingly steadily in the private sector. A recent survey by the National Business Group on Health reveals that 53 percent of employers plan to increase employee percentage contributions to premiums, as they believe this will help reduce overall costs.
Expect to Pay More for Health Coverage Through Work
What changes can I expect to see in my employer's health insurance coverage during open enrollment this fall? The National Business Group on Health just announced the results of its annual survey of large employers and their health coverage plans for the coming year, and several trends are likely to continue for 2012: Most people will have to pay higher premiums for coverage plus a larger share of the cost for each doctor's visit and procedure. Meanwhile, more employers will offer high-deductible health plans with health savings accounts and will encourage employees to choose that option by contributing money to the HSAs. Employers are also investing in wellness programs to help control long-term medical expenses. Employers also hope to control expenses by providing incentives for consumers to pay more attention to their health-care costs: They continue to switch from fixed-dollar co-payments (for example, you might pay $20 for each doctor's office visit) to coinsurance -- you pay a percentage of the cost of each office visit and procedure. "It's a more subtle way to increase what consumers pay," says Helen Darling, president and CEO of the National Business Group on Health. And it encourages employees to find lower-cost care, which will save both the employer and employee money. "If you don't use coinsurance, the consumer doesn't pay attention to the cost," she says. "If the consumer has no financial stake, then there's no hope for controlling health-care costs in this country."
Boost health and productivity with a wellness program
High performance companies: health and wellness leaders Businesses today are left with no choice but to create a healthy workplace culture if they want employees to perform to their best potential. High performance companies such as SAS, Wegmans Food Markets and Google have understood the profound connection between employee health, productivity and insurance costs. According to a report by the SHRM Foundation, more than 75% of high-performing companies regularly measure health and wellness as a viable component of their overall risk management strategy. A survey conducted by Towers Watson and the National Business Group on Health found that 83% of companies have already revamped or expect to revamp their health care strategy within the next two years, up from 59% in 2009. This year, more employers (66%) plan to offer incentives for employees to complete a health risk appraisal, up from 61% in 2009. Also, 56% of employers now offer health coaches and 26% now offer on-site health centres.
The High Cost of Health Care Reform
The White House's own shorthand name for healthcare reform, the Affordable Care Act, may very well turn out to be affordable for the majority of uninsured Americans. For U.S. employers, however, the initial costs related to healthcare reform are expected to be anything but affordable, according to HR and benefits experts. For starters, a June 2011 survey of 329 large employers by the National Business Group on Health, a Washington-based nonprofit that represents large employers on national health-policy issues, reports that employers estimate their healthcare benefit costs will increase an average of 7.2 percent in 2012. "Employers face a multitude of challenges posed by rising healthcare costs, the weak economy, and the financial and administrative impact of complying with the new health-reform law," says Helen Darling, the NBGH's president and CEO. According to NBGH's Darling, the most important thing for HR is that the underlying forces driving healthcare costs higher haven't changed at all, and if anything, healthcare reform will make it harder to control costs because there will be more demand while hospitals and other providers increase prices. "HR executives have to be single-mindedly focused on controlling healthcare costs," she says. "At the same time, the federal government has to start helping reduce costs too. "Like the national debt crisis that we are struggling to solve," Darling says, "we have to solve the healthcare-cost crisis, which is seriously undermining our economy, businesses' abilities to create jobs, working families, our global competitiveness and our standard of living."
The Evolving Wisdom on Health-Plan Design
Many large employers are acting now to implement, or move toward implementing, some elements of the Affordable Care Act (ACA) that will not be required until 2014 or later, suggests the latest report on health-plan design changes by the National Business Group on Health. In some cases, the moves are not necessarily an effort to get ahead of the upcoming requirements; rather, they are in line with ongoing trends in employer-sponsored health-care coverage that the reform law merely recognized and fashioned as "essential" benefits, says Helen Darling, CEO of the nonprofit association, whose 329 member organizations all have more than 5,000 employees. For example, 27% of the 83 employers that participated in the group's research effort are planning changes for 2012 to the annual benefit limits under preventive and wellness services. That may be a seeming nod to the forthcoming ban on annual coverage caps for all types of health-care services, but large companies have been increasing or eliminating caps for years. "They didn't need a law to tell them to do that," contends Darling. "Some decided to change or remove the caps because they're not popular with employees, and some decided it didn't cost all that much to do so anyway." But, Darling notes, a budding trend among "leading" employers in health-plan design is to make available a superior plan for employees who participate in wellness and preventive initiatives that target their particular risk factors, while others would get the lesser plan. "We know from behavioral economics that the most powerful way to motivate people is through loss aversion," she says. "We hate to lose something. So you can say to employees, if you don't do these things to make yourself healthier, you're not going to get the good plan." While employers as a whole have been critical of the ACA on many fronts, Darling pointed to the exchanges as an example of a provision that would be very valuable if the law emerges exactly as intended. It would offer great opportunity for retirees under age 65 who are not yet eligible for Medicare, as well as for part-time workers, including spouses who may work either part-time or seasonally, while also perhaps enabling the dissolution of the expensive COBRA coverage. But, Darling says, "people may be in a bit of a fantasy world. We haven't seen the exchanges, yet there is an image of them as excellent, high-quality, affordable plans that provide everybody who has a low or moderate income with subsidies. But who knows? And anyway, who's going to pay the taxes [necessary to fund the exchanges]? We don't know." Meanwhile, the participating large companies collectively forecast that their health-care costs will rise by 7.2% in 2012, down just a smidgeon from the 7.4% jolt they experienced this year over last. Darling says she's been surprised and disappointed by the size of the annual hikes since the recession began in 2008. To combat the rising costs, more than half of respondents plan to increase the employee-paid share of premium costs next year, while significant numbers will ratchet up deductibles and out-of-pocket maximums (see chart). Those increases would be lower if employees would only heed the advice their employers give them, insists Darling. "Good" employers are telling employees how they can save money within the existing plan, both for themselves and the company. But less than half of people will take a generic drug when there are alternatives to brand-name drugs, and many still buy drugs retail instead of using mail order, according to Darling. Further, even doctors say that more than half their patient visits could have been handled competently and much less expensively by another party, such as a nurse's helpline for advice on how to treat a cold or a walk-in clinic staffed by practitioners such as physicians' assistants for basic diagnostic and treatment services. "Employees are using a lot of health care they don't need," says Darling.
AAFP Task Force Takes Steps to Better Value Primary Care
The newly formed AAFP Primary Care Valuation Task Force reached consensus on two key points during its first meeting here on Aug. 22: Medicare should pay more for primary care services, while also taking steps to better compensate high-functioning primary care practices. Creation and Charge of the Task Force The AAFP formed the task force in July to identify solutions to a system that, over time, has contributed to inequitable and devalued payment for primary care medical services. The task force will concentrate on finding ways to more appropriately appraise the worth of evaluation and management, or E/M, services, which are the most common services provided by primary care physicians. "We need to have a strong primary care infrastructure for the health system, and we also think that payment methodology is a linchpin to getting the kinds of changes in primary care that we want," said Veronica Goff, a vice president with the National Business Group on Health and a task force member. "From a business perspective, we want every individual to have a personal doctor and link into the health care system," she added. "Primary care, when done correctly, is a very efficient use of resources."
Preview: Healthcare Benefits Changes Coming to Open Enrollment
Open enrollment season for healthcare insurance is just a couple of months away and it looks like employees need to fasten their seat belts and prepare for a bumpy ride. With an eye toward cost control and new healthcare reform requirements, employers are preparing to make changes to their healthcare benefits packages. Look for more consumer-directed healthcare, more incentives for prevention and wellness, and across-the-board increases in deductibles, out-of-pocket maximums, and copayments for patient care and prescription drugs. For providers the changes mean that patients will continue to be cost-sensitive in terms of prescription costs and medical care. Expect to see more shopping around for services like lab work and MRIs. There will also be more of an emphasis on receiving preventive health services, such as mammograms and colonoscopies, which no longer have copayments, deductibles, or coinsurance. But nothing in healthcare is really free, so insurers are looking to cover those lost copayments, and deductibles in other ways. In a survey conducted in June by the National Business Group on Health, a trade group of more than 300 large employers, businesses estimated that the cost of employee healthcare benefits would increase by 7.2% in 2012 or more than twice the rate of inflation.
Employees to Pay Higher Share of Health Costs
A majority of large employers plan to require employees to contribute a higher percentage of health care premium costs in 2012, according to a survey released Aug. 18 by the National Business Group on Health. Speaking at an Aug. 18 briefing discussing the results of the annual midyear survey of large U.S. employers, Helen Darling, NBGH president, said U.S. employers continue to struggle with health care costs, with the estimated per-employee cost in 2012 hitting $11,983. In response, employers are turning to cost-management techniques such as increased cost-sharing and focusing on health improvement initiatives, Darling said. According to the report, Large Employers' 2012 Health Plan Design Changes, 53 percent of employers plan to increase the percentage of premium costs for which employees pay, but most employers said they plan to increase the contribution amount by less than 10 percent. Two provisions of the Patient Protection and Affordable Care Act that employers anticipate having the most impact on plans in 2012 are the requirement to extend dependent coverage to children up to age 26 and the restrictions on annual benefit limits, Darling said. Of the 83 employers surveyed in the NBGH report, 59 percent said they do not plan to make any changes to their annual benefit limits for 2012, but 27 percent said they will make changes to their annual limits for wellness and preventive services. The restrictions on annual benefit limits are being phased in until 2014, when they will be banned. While PPACA continues to affect health plans, Darling cautioned against linking new health care law requirements with rising health care costs. "We have serious health care cost problems completely independent of the Affordable Care Act," Darling said. "We have to solve these problems no matter what the impact of health care reform is."
Cost Increases, Changes Coming To Health Plans
Surprise. Surprise. Healthcare costs are going up in 2012, and employers are responding by changing their plans. Here's a snapshot of what they're doing. Employers are deploying a few different strategies:
Projected increases Spurring these changes are healthcare cost projections for next year: Employers estimate their costs will increase by an average of 7.2% in 2012, the survey found. This year, those same employers have seen their costs go up 7.4%. Making better consumers out of employees Another plan employers will use to keep costs down: Offer health plans and wellness programs designed to make employees more sensitive to the costs of their medical care. A rundown:
Large Employers Revamping Health Benefit Programs for 2012
With the cost of employee health-care benefits expected to increase next year at more than twice the rate of inflation, large U.S. employers are planning to have workers share more of the cost next year, according to a new survey by the National Business Group on Health, a nonprofit association of 329, mostly large employers. The survey also found that more employers are adopting consumer-directed health plans and making other changes to their benefit programs as various components of the health-care reform law take effect. According to the survey, employers estimate their health-care benefit costs will increase an average of 7.2% in 2012. That is slightly lower than this year's 7.4% average increase, but it is on a higher base and it still sharply outpaces the economy's anemic growth and business conditions. To help control those increases and begin driving down costs to avoid the Cadillac tax, employers are planning to use a wider variety of cost-sharing strategies. More than half of respondents (53%) plan to increase the percentage that employees contribute to the premiums, while 39% plan to increase in-network deductibles. Additionally, about one in four employers plans to increase out-of-network deductibles (23%) and out-of-pocket maximums (22%) next year. The survey, based on responses from 83 of the nation's largest corporations, was conducted in June 2011. "Employers are facing a multitude of challenges posed by rising health-care costs, the weak economy and the financial and administrative impact of complying with the new health reform law," said Helen Darling, President and CEO of the National Business Group on Health and WorldatWork Keystone Award recipient. "As a result, employers are being much more aggressive in their use of cost-sharing techniques and cost control programs and are making certain that employees have more reasons to be cost-sensitive health-care consumers."
Employers look to consumer-driven plans to lower health costs
The rising cost of health care will soon be reflected even more substantially in employee cost-sharing. A new National Business Group on Health survey shows that large employers anticipate their health care benefit costs to climb 7.2% in 2012. To help control those increases ahead of health care reform's Cadillac tax in 2018, the survey shows employers are planning to use a wide variety of cost-sharing strategies including CDHP premium boosts. "We are clearly seeing a march toward a more aggressive consumer strategy," says Helen Darling, president and CEO of the National Business Group on Health. "If the consumer isn't actively engaged and has some financial stake there is absolutely no hope in controlling health care costs in our country." Darling commented on potential employee morale in the face of perceived benefits that are being taken away. "Because health benefits have become more valuable relative to employee perception, three or four years ago it hit number one [in importance]. It was partly because they realized how much it cost," Darling says. "What people worry about and are demoralized by changes, especially when we're facing so much economic trauma."
Comparison Shopping
Exchanges won't alter landscape
Employers tie lower health plan premiums to tobacco screening
Across the country, a growing number of employers are beginning to incorporate "biometric outcomes" from tobacco screening with the quit-smoking incentives they offer, said Wendy Slavit of the National Business Group on Health. "Most employers use the honor system or an affidavit at open enrollment to determine tobacco use status," Slavit wrote in an email. "However, some employers have started to tie incentives to biometric outcomes. For these employers, employee tobacco status is determined by nicotine testing to indicate negative nicotine levels."
Survey: More health costs shifting to workers
Employers are likely to ask workers next year to take on more of the health care burden because costs are expected to keep rising faster than inflation. The National Business Group on Health on released the report Thursday. Based on responses from 83 large U.S. corporations, 53 percent plan to increase the percentage that employees pay for premiums, 39 percent plan to increase in-network deductibles, 23 percent plan to increase out-of-network deductibles, and 22 percent plan to increase the maximum amounts workers will have to pay out-of-pocket in a given year. Helen Darling, CEO of the National Business Group on Health, said a combination of health care cost increases, the sluggish economy and the expected financial and administrative headaches of federal health care reform is forcing companies to share more of the cost with employees. According to the survey, 73 percent of respondents plan to offer at least one consumer-directed health plan, up from 61 percent this year. Seventeen percent said they either already limit their workers to consumer-directed health plans -- such as high-deductible health plans with health savings accounts -- or plan to move that way next year. The National Business Group on Health features a number of major Nashville-based employers as members, including Cracker Barrel, Dollar General, Healthways and Nissan North America Inc.
Employers expect health costs to rise: survey
Businesses target healthcare cost
NEW YORK, Aug. 18 (UPI) -- A non-profit business association said a June survey indicated U.S. businesses will take more action to curtail healthcare costs in 2012. The National Business Group on Health, which represents 329 large businesses, said healthcare costs are expected to rise 7.2 percent in 2012, more than twice the rate of inflation. Healthcare costs rose 7.4 percent this year. The rising cost "sharply outpaces the economy's anemic growth and business conditions," the group said in a statement.
Employees beware: Higher healthcare costs ahead
NEW YORK (Reuters) - Large employers expect big increases in healthcare costs in 2012, and say they'll pass more and more of those costs on to their workers. That's the result of a new survey by the National Business Group on Health, a trade group for these large companies. "It's a huge burden on businesses and employers," says Helen Darling, the group's president. "Healthcare costs continue to gallop along at over seven percent." Members say they expect their 2012 costs to be 7.2 percent above their 2011 costs, which are trending 7.4 percent above 2010 costs. (Separately, Standard & Poor's reported more modest increases in actual healthcare costs. The average per capita cost of healthcare services covered by commercial insurance and Medicare programs increased by 5.61 percent over the 12 months ending in June 2011. Other employee burdens that can be expected to rise are out-of-network deductibles and out-of-pocket maximums. Companies are also moving away from fixed-rate co-pays, moving instead to cost-sharing models that require employees to pay a percentage share of all rising costs, says Darling. "Employers are being much more aggressive in their use of cost-sharing techniques and cost-control programs," she says, adding that in 2012, companies can be expected to pay almost $12,000 per employee for healthcare costs.
Survey: Employers shift rising health costs to their workers
As healthcare costs continue to rise, businesses are increasingly passing on the added burden to their employees. Higher cost-sharing for employees is the primary way in which employers are trying to control their own healthcare spending, according to a new survey from the National Business Group on Health. The organization, which mostly represents large companies, said more than half of the employers it surveyed plan to make employees cover a greater share of their healthcare costs. "We are clearly seeing a march toward a more aggressive consumerist system," said Helen Darling, president of the National Business Group on Health. Darling said Thursday that shifting from co-pays to coinsurance is "a more subtle way to increase what the consumer pays." She predicted that eventually, only governments and unions will keep offering fixed co-pays. Allowing children to stay on their parents' plans through age 26 has added about 1 percentage point to employers' costs, Darling said. But she said businesses have largely absorbed that increase themselves, rather than passing it on to employees.
Large employers say health care plan costs will rise 7.2% in 2012: NBGH survey
Health Insurers Seek Delay Of New Consumer-Friendly Coverage Forms
Many employers are already required to provide health plan information, said Steve Wojcik, vice president for public policy for the National Business Group on Health, which represents 330 large employers, most of which have self-insured health plans. Complying with the new health law rules would mean preparing two sets of plan information for next year. Pushing back the March 2012 deadline would avoid the duplicative effort, he said.
Blood Pressure Alert: Health Care Costs Set to Climb
The cost of employee health care benefits is expected to rise by more than 7% in 2012, according to a report released today by the National Business Group on Health, a non-profit industry association. For workers, this means it's important to have a strategy when open enrollment rolls around, typically in October and November. For starters, pick the right insurance coverage, says Helen Darling, president and CEO of the National Business Group on Health. If you rarely visit the doctor, consider using a high-deductible plan, which typically has lower premiums but a significantly higher deductible than a traditional plan, she says. (In 2011, such plans had deductibles ranging from $1,200 to $5,950 for single person and $2,400 to $11,900 for a family.) On the other hand, "If you have two kids with asthma and allergies, you may be better off with the HMO," Darling says.
Employers: Health Plans Will Take Bigger Bite Out Of Next Year's Paychecks
Expect to pay more for your job-based health care coverage next year, as employers continue a trend of passing along rising costs to workers. Fifty-three percent of large employers surveyed by the National Business Group on Health said they would increase the amount workers pay toward their premiums next year, although most said the rise would be less than 10 percent. Thirty-nine percent of the 83 firms surveyed said they would increase deductibles for in-network care. The firms surveyed, which together employ about 4 million workers, expect health costs to rise 7.4 percent this year, far higher than general inflation. Next year, they're anticipating a slightly lower increase. Almost three-quarters of the firms (73 percent) will offer workers at least one high-deductible plan next year, up from 61 percent this year. Such plans shift more of the cost to workers, but generally have lower premiums.
Majority of Large Employers Revamping Health Benefit Programs for 2012, National Business Group on Health Survey Finds
With the cost of employee health care benefits expected to increase next year at more than twice the rate of inflation, large U.S. employers are planning to have workers share more of the cost next year, according to a new survey by the National Business Group on Health, a non-profit association of 329, mostly large employers. The survey also found that more employers are adopting consumer driven health plans and making other changes to their benefit programs as various components of the health care reform law take effect.
Survey: Big firms expect more health care hikes
Many big employers will handle another round of health care cost hikes next year by raising the contributions that their workers make toward benefits, according to a survey from the National Business Group on Health. The nonprofit, which works with big companies on health care costs, said Thursday 53 percent of the companies it surveyed plan to increase the percentage that their employees pay toward premiums, with most raising it by less than 10 percent. In addition to raising the premium contribution, 39 percent of employers surveyed expect to raise deductibles for care received inside their insurance network, and 23 percent plan to increase them for out-of-network care, according to the National Business Group on Health study. The National Business Group on Health surveyed its members on their expectations for next year, and 83 non-government companies responded, ranging in size from less than 10,000 workers to more than 100,000. These companies provide their own insurance and have an insurer administer the benefit.
The doctor is in -- your workplace
Need to see a doctor? For an increasing number of American employees, the solution is to stroll down the hallway. "What's different today is the former occupational health centres have been expanded to provide services that would be considered more like primary care, including diagnostic screening and testing, as well as urgent care," says Helen Darling, CEO and president of the Washington, DC-based National Business Group on Health. The savings accrue in part because employees don't need to take off work to travel to their doctor's office, which is often near their home. "In this country, many people in cities have very long commutes [to work] so you basically end up taking the day off," Darling says, adding that companies "don't lose the individual's time which is costly." Employees "love the convenience and accessibility and it also makes them feel like the employer cares about them," Darling says.
Employers adjust retiree drug plans as tax break ends
Reform regulations come quickly, often
Extending cover to adult children has only modest impact on costs
That 2:30 feeling
What is it about the afternoon that makes so many Americans sleepy and unproductive? Whether it's their morning coffee buzz wearing off, lunch beginning to digest or the lack of movement catching up with them, afternoon seems to be the time when fatigue climbs and productivity dips. Experts say a nutritious snack may also offset afternoon fatigue. So will a light, healthy lunch, says LuAnn Heinen, vice president of the Washington-based National Business Group on Health. "The blood sugar takes a spike and there's a let-down if the lunch hasn't been optimal," says Heinen, who oversees the organization's Institute on Innovation in Workforce Well-being. Adding physical activity -- not exactly a workout -- can also help keep the energy level up. Stretching, light calisthenics or even a few yoga positions can get the blood flowing and get your body back on track. "I think people feel a lot better when they break up their sitting time," says Heinen. "It's good for your health and it's good for your mood." She recalls a recent meeting at a client's office where the speaker broke up a PowerPoint presentation with slides dedicated to a movement break. "Every so many minutes during the meeting, you were prompted to stand up and do certain stretches," she says. "And everybody did it." "It's more acceptable to go for a cigarette break than to go for a walking break in some work environments," says Heinen.
The Beginning of the End of Domestic-Partner Benefits?
When gay marriage officially became legal in the state of New York last month, hundreds of same-sex couples rushed to be among the first to take their wedding vows under the new law. Meanwhile, employers in the state had an interesting question to answer: Should they stop offering domestic-partner benefits in light of the Marriage Equality Act? "The trend is likely to be that; in those jurisdictions where marriage is possible, it will be a requirement to get benefits, just as it is for heterosexual couples," says Helen Darling, president and CEO of the National Business Group on Health in Washington. Given the new law, companies in New York are beginning a transition period where their gay employees will have roughly six months to a year to get married before the company pulls back its domestic-partner benefits, says Darling. But she doesn't think a nationwide pullback of domestic-partner benefits is in the works because just seven states currently allow gay marriage. "It won't happen anytime soon because we're not going to have [gay] marriage laws in every state for a long time," she says. "In some states, gay marriage won't ever be passed." Now, says Darling, they don't need to disclose all that personal information. They can simply show a marriage certificate. "It's a lot simpler," she says.
Eliminating Contraceptive Copays Is in Insurers' Interest: View
Should health insurance companies be required to cover the entire range of birth-control services, and do so in full -- no copayments, no deductibles? A panel of the Institute of Medicine, an arm of the National Academy of Sciences, has recommended that the Department of Health and Human Services adopt this mandate. On Monday, Kathleen Sebelius, the HHS secretary, raised the ire of cultural conservatives and fiscal watchdogs by requiring insurers to fully cover contraceptives starting next August. Meanwhile, the average yearly cost to an insurer of providing full coverage for the entire range of contraceptive methods and counseling services (with no copays or deductibles) is about $40, according to actuarial figures compiled for the National Business Group on Health, a nonprofit association of large U.S. employers.
States Moving Toward HDHPs
Helen Darling, president and chief executive officer of the National Business Group on Health, a Washington-based nonprofit organization working on healthcare issues and health policies for large employers, says states could increase the usage of consumer-directed plans if they clearly communicate the long-term benefits of such plans: more control over spending, improved health and accumulation of wealth in the accounts. "Most public employees have the richest benefits of anybody, so states have got to communicate the benefits of choosing HSAs to get employees to go from a zero deductible to a $1,200 deductible," Darling says. "The results will be governed by how serious the benefit managers are about making it succeed -- communicating the details really matters."
Ga. Firm's Blueprint For Taming Health Costs
Meanwhile, more companies are considering giving rewards, such as cash and gift cards, only to employees who demonstrate action and results, according to a Towers Watson survey, the Los Angeles Times reported last year. "Employers see unhealthy lifestyle as the biggest barrier to providing affordable health care coverage," LuAnn Heinen of the National Business Group on Health told the Times.
Newly Married Gay Couples Still Not Recognized by Federal Laws
There are an estimated 50,000 legally married gay and lesbian couples in the United States*. That was before New York State began allowing gay marriages over the weekend. But for many of those couples, marriage equality does not mean financial equality. And some companies are phasing out "domestic partner" benefits in states where gay marriage is legal and requiring gay employees to be married to keep their health coverage. "There's not really a change in philosophy, the domestic partner benefit typically was put in to be fair, because they did not have the option of marriage," says Helen Darling of the National Business Group on Health.
As health care costs rise, more companies invest in fitness programs
"It's good for everyone," said LuAnn Heinen, vice president of the National Business Group on Health, a nonprofit group comprised of large employers. "You perform better at work, you sleep better, you have more energy for your kids." Surprisingly, the trend has largely survived the recession, with many firms choosing to cut bonuses and travel before scaling back on fitness programs, according to a recent survey by the nonprofit. Heinen, of the National Business Group on Health, said the biggest critics she encounters are usually the chief financial officers at companies. "Funding all these programs can really add up, so companies need to figure out where they're going to get results," Heinen said.
New workplace trend; getting paid to get fit
Would it be easier for you to lose those pesky pounds or quit smoking, if your employer paid you to do it? It's a new trend around the nation. Employers are making it more convenient and even slightly lucrative, for their employees to get fit and stay healthy. The Centers for Disease Control backed National Business Group on Health, reports incentive programs are on the rise and employer spending on wellness initiatives is up 65 percent in just one year.
Financial equality still eludes married gays
Some companies are phasing out "domestic partner" benefits in states where gay marriage is legal, and requiring gay employees to be married to keep their health coverage. "There's not really a change in philosophy, the domestic partner benefit typically was put in to be fair, because they did not have the option of marriage," says Helen Darling with the National Business Group on Health.
Women should get free birth control, panel says
An independent panel of doctors and health experts recommended Tuesday that health plans cover a broad range of contraceptives for women without co-pays, setting the stage for another debate over the impact of the new health overhaul. The report noted that contraceptive coverage is now "standard practice" for most private insurance plans and federally funded insurance programs. And since 2007, the National Business Group on Health, an organization of large employers, has recommended coverage of family planning services without cost sharing.
Institute Of Medicine: Insurers Should Offer Birth Control, Other Reproductive Health Services Without Additional Cost Sharing
In a major win for women's health advocates, the National Journal is reporting that the Institute of Medicine will recommend that "health insurers should pay for a range of services for women at no cost, including birth control, counseling on sexually transmitted diseases, and AIDS screening." In accordance with the Affordable Care Act, the Department of Health and Human Services commissioned the report to determine a "coverage floor" or services insurers should provide without additional cost-sharing. The groups was expected to release its official report tomorrow. Dana Goldstein points out that the "American College of Obstetrics and Gynecology and the National Business Group on Health already support co-pay-free birth control as among the most cost-effective preventive medical interventions available; 15.3 million American women use hormonal birth control, which is one of the most frequently-prescribed medications in America."
As Same-Sex Marriage Becomes Legal, Some Choices May Be Lost
Corning, I.B.M. and Raytheon all provide domestic partner benefits to employees with same-sex partners in states where they cannot marry. But now that they can legally wed in New York, five other states and the District of Columbia, they will be required to do so if they want their partner to be covered for a routine checkup or a root canal. On the surface, this appears to put the couples on an even footing with heterosexual married couples. After all, this is precisely what they have been fighting for: being treated as a spouse. But some gay and lesbian advocates are arguing that the change may have come too soon: some couples may face complications, since their unions are not recognized by the federal government. There could be some exceptions, however. Employers who do not contract with an insurance company but instead pay for health benefits out of their own assets -- so-called self-insured plans -- are not subject to the state's insurance laws but are governed by federal law. Most large employers have self-insured plans, said Helen Darling, president of the National Business Group on Health, a membership organization that focuses on health policies for large employers. That means they can choose to cover same-sex employees, but they do not have to. While virtually all large company plans cover legal spouses, she added, some companies offer domestic partner benefits only to gay employees who do not have the option to marry. (Some companies also extend the benefits to heterosexual unmarried couples.) "I am getting a lot of questions about what other employers are doing," Ms. Darling said. "I see a movement coming where marriage will be a factor where marriage is possible."
A Weighty Matter
The VP at National Business Group on Health, and Director at Institute on Innovation in Workforce Well-Being as well as Institute on Health, Productivity and Human Capital, LuAnn Heinen, cites the reason for concern, "The annual cost of obesity to US employers is estimated at USD 73 billion. Obesity and its consequences, especially diabetes and heart disease, are responsible for about 27 per cent of annual increases in yearly healthcare costs."
More employers are offering on-site medical clinics
Major employers across the country, eager to curb fast-rising healthcare costs, are opening their own state-of-the-art health centers where doctors and nurses provide medical care to workers often just steps from their desks. The cost-cutting strategy has been embraced by dozens of companies -- typically large employers that are self-insured and pay their own medical claims, including Walt Disney Co., Qualcomm Inc. and American Express Co. Many of the health centers are full-service medical offices equipped with exam rooms, X-ray machines and pharmacies. Some provide on-site appointments with dentists, dermatologists, psychiatrists and other specialists who treat life-threatening illnesses. Executives say providing in-house medical care keeps workers healthy and productive. But the clinics also help the bottom line by reducing absenteeism and slashing employers' medical bills for outside doctors and emergency rooms. "Employers are seeing the health centers as a way to get more for their money," said Helen Darling, president of the Washington, D.C.-based nonprofit National Business Group on Health.
NYers ask how gay marriage will affect benefits
As same-sex marriage becomes legal in New York --a world financial capital that often sets the corporate tone for businesses everywhere, and a city with a large gay and lesbian community --companies and individuals are wrestling with the changing complexities of their financial realities. For straight couples, the choice has generally been to marry or not to marry, period. But conflicting state and federal marriage laws and questions about corporate benefits policies make financial planning decisions much less cut-and-dried for many gay couples. Steven Wojcik, vice president of public policy at the National Business Group on Health, an association representing 300 large companies on health benefits and health care issues, said most large companies already provide domestic partner benefits, so the New York law might not change anything.
Young adults flock to parents' health plans
Helen Darling, the CEO of the National Business Group on Health, which represents more than 300 large employers, said employers generally didn't like the idea of anything that would add to their health costs. "I don't think anyone is eager to spend more money," Darling said. "This is not something employers would have done on their own." Darling questioned why employers should be required to cover adult children who no longer live with their parents and might be married themselves.
Urgent care coverage notification requirement to stay at 72 hours
HSAs Expected to increase in Popularity with Small Businesses
In less than a decade, HSAs have exploded across the nation. For instance, just 2 percent of all U.S. employers offered consumer-directed, account-based health plans in 2002. By the start of 2011, HSAs were the most popular form of health tax-advantaged accounts! A recent Towers Watson/National Business Group on Health study finds no evidence the growth of HSAs is slowing. The new numbers show HSAs continue to expand with 41 percent of U.S. companies offering an HSA in 2011 and another 12 percent expecting to do so in 2012.
June is National Wellness Month
Among the most important gains for companies are the intangibles. According to LuAnn Heinen, Vice President of the National Business Group on Health, "employees are more engaged at their job and in their workplace, have greater job satisfaction and commitment to their employer because their employer cares about their health." Changes in the Workplace Heinen added that part of that culture change includes improvements in foods offered in cafeterias and vending machines, walking paths, and open stairwells for walking. Some employers, like the Cleveland Clinic, encourage "walking meetings" where employees display colored tags to let others know they are in a meeting and not to be disturbed.
Covering all bases: Preparing for open enrollment, part 3
According to the National Business Group on Health, employers may be unaware of social inequities that exist in the society that can negatively impact employee's health status and result in health disparities between workers.
Wellness program success stems from customization
Consumers May Be Unaware Of Their Right To A Review Of Health Plan Decisions
The health law requires each self-insured plan to contract with three review organizations so that appeals can be processed expeditiously, but federal officials are bending that rule, too. After recognizing that insurers had difficulty finding three review groups, officials agreed to give the plans more flexibility, said Steve Wojcik, vice president for public policy for the National Business Group on Health, which represents 330 large employers, most of which have self-insured health plans. One contract will be enough, he said, "as long as you're confident that the process is unbiased and independent." Still, he said, down the road when the appeals process is fully implemented "this capacity issue is potentially very significant because there have to be a sufficient number of [independent review organizations] to handle the increased expected caseload within the prescribed amount of time the law requires." Wojcik said the new appeals requirements might prompt health plans to approve more claims than in the past to avoid scrutiny from external reviewers. "And the downside is this will mean higher costs for everyone because the plans are covering things they wouldn't normally have," he said. "It's a case of 'be careful what you ask for.' "
Vision Quest
Not everyone thinks HR needs to devote significantly more time and resources to promoting vision benefits. Helen Darling, president of the National Business Group on Health in Washington, thinks communication can only go so far. She says vision benefits are usually delivered in "three sentences" by HR or a benefits administrator. "Does it cover the eye exam? How often? Does it cover contacts and glasses?" she says. "That's it. There's not much more you can say. Everyone knows what it is." But that's OK, she says, because HR "only has so many messages [it can] push." Almost all of the large companies that make up NBGH's membership offer vision benefits, says Darling; however, in a recent survey only 24 percent called the benefit "important" or "very important." Darling says those numbers are low only because people are comparing vision to medical benefits, which are much more sought-after and complicated to explain than vision. Darling also cautions against placing too much emphasis on eye exams being used as ways to detect certain health conditions or diseases. While it's clearly a good thing to get checked, she says, one should not rely on an eye exam to detect those ailments. "You certainly don't want people thinking, 'The way I get my annual checkup is through the eye doctor,' " she says. "You really want to drive people to have an ongoing, continuous, caring relationship with their doctor, whose specialty is taking care of all of you." Nevertheless, vision benefits are clearly important, says Darling -- and companies should recognize their value. "You want people at their optimal, and you can't work at your optimal if you have vision problems," says Darling. "So, the biggest argument for good vision care is that it's part of a package for a healthy, productive and resilient workforce."
Wellness in the Workplace: Bringing Preventive Care Into the Office
Other popular workplace wellness programs include United HealthGroup's Personal Rewards and Quest Diagnostic's Healthy Quest. Companies that already have adopted these comprehensive wellness programs include Maidenform, Viacom, Timberland, the American Diabetes Association, SunTrust and Pitney Bowes. And more employers are jumping on the bandwagon. A recent survey of around 600 employers, conducted by Towers Watson and the National Business Group on Health, reported that by 2012, 33 percent of employers would be adopting incentive-based wellness programs alone -- up from 6 percent in 2010.
Slim your body, not your wallet
If you're among the two-thirds of Americans who are overweight or obese, shedding pounds is a no-brainer way to save. For example, "even losing 7% of your weight may lower blood pressure enough to erase the need for medication," says Cheryl Rock, a professor at the medical school at the University of California, San Diego. Problem is, losing weight and keeping it off isn't easy. Sure, you can diet on your own for free. But research indicates it's harder for many people to stick with a DIY approach than with a more formal one. And some studies have shown DIYers lose less weight than people on structured plans. The three major commercial programs -- Jenny Craig, Nutrisystem, and Weight Watchers -- "are the only ones with [rigorous] randomized studies that confirm that they actually work," says Adam Tsai, assistant professor of medicine at the University of Colorado. No matter what, talk to your insurer and employer: "Many cover some of the cost of weight-loss programs or dietitian visits," says LuAnn Heinen of the National Business Group on Health.
Shift to value-based health plan can cause worker anxiety
Value-based plans are meant to have a more precise influence on workers' choices. Any plan with three tiers of prescription drugs with varying copayments is a value-based plan, said Helen Darling, president and CEO of the National Business Group on Health. "Virtually everybody has something now that's value-based," she said. "It's a question of how extensive it is." While Pitney Bowes uses incentives, many other companies are shifting to disincentives, Darling said, consistent with research suggesting that the prospect of losing something will make people act more dramatically than the chance of getting something. Doing so also puts more of the costs onto workers who don't take actions that could improve their health and keep health care costs down. "Spreading the costs more back to them if they're not taking the steps... that would make a difference in their health is where we are today in the United States," Darling said. "There's much less tolerance, if you will, for letting people neglect their health and not do the things they're supposed to do." "If the fact that this might prevent them from pain and suffering doesn't move them, which it clearly hasn't, then I guess the employer thinks they need to take a tougher line," she added. Darling said the most important way to get employees to buy in is to "communicate and communicate and communicate," and to tie it to money. Resistance to the health plan changes is nothing new, she said, and state employees' concerns are not surprising. "I don't think anybody's ever comfortable when something's being taken away, and as long as they can basically stick the cost to the taxpayers without having to be accountable, they'll keep doing it," Darling said.
Deja vu: Debate Over Medicare Claims Database Heats Up
In a letter to Grassley and Wyden, National Business Group on Health President Helen Darling wrote, "With consumers, taxpayers and employers spending more than $2.6 trillion on health care, it is critical that we have the right information to ensure value for that spending." She continued, "Employers and consumers need to have access to the Centers for Medicare and Medicaid Services' Medicare claims data to ensure that we are able to identify high quality care and efficient, effective performance. Without the volume of patient visits from the Medicare claims data, it is difficult to have reliable data on performance, particularly for Medicare providers."
Facing the Future
Benefits consultants on the cutting edge of the market are also working to address the issue of poor overall health among workers, which Helen Darling, president and CEO of the Washington-based National Business Group on Health, calls "a big problem." "The best consultants are identifying ways to make sure they have a culture of health inside the company, and that they are essentially driving improvement through incentives and programs so healthcare-cost curves will be bent downward because people are becoming healthier." Communication is another area in which these consultants need to be on the ball, Darling says. "Communication, as it is in every area, is the key to success. [It] has to drive change, and so it has to be very powerful," Darling says. We're in a state of relative desperation," Darling says. "So having new ideas that control costs -- but, at the same time, don't upset employees too much -- is key because, if employers going forward aren't bending their own curves for costs, or even reducing them, then they're going to have even more serious problems" as full implementation of the healthcare-reform laws approaches. " ... Being able to call in, or rely on, [the best benefits consultants] to help in these very serious ways is critical," she says, "now more than ever."
Pros and Cons of the Health Care Reform Law
The latest annual survey of employer health plan sponsored by Towers Watson and the National Business Group on Health found that 48 percent of employers currently provide coverage for retirees younger than 65 and pay for part of it. But Jensen predicts they will start sending those workers to the new exchanges in 2014 -- with an employer subsidy in hand--to purchase coverage. HSAs are gaining ground among workplace plan sponsors, mainly because they are tied to high-deductible insurance plans that reduce premium costs up to 30 percent. About 27 percent of retiree plan sponsors offer an HSA option, according to the Towers Watson/National Business Group on Health survey. But 25 percent of companies plan to convert their current retiree health coverage subsidy in the coming year.
Real World Making Health Reforms
"Hospitals are now going to be forced to make changes they've avoided for years," says Helen Darling, president of the National Business Group on Health, which represents larger employers. "If they don't become more effective and efficient, they won't be paid. They also won't survive."
More cancer survivors returning to work
During the next three years, Unum will participate in an initiative led by the National Business Group on Health to develop comprehensive resources for employers on the spectrum of cancer-related benefits and workplace programs. The project, already under way and based on the NCCN Clinical Practice Guidelines in Oncology, aims to: * Establish a 25-member national advisory committee that will develop recommendations for the design and optimization of programs and services, including health plans and wellness initiatives; * Create a quick reference to help employers determine whether their current benefits are consistent with evidence-based cancer care; * Develop a toolkit covering general medical, pharmacy and mental-health benefits for the continuum of cancer care; * Create a set of benefit-manager guides for other strategic audiences, such as disability managers; and * Develop tools for employees, which will include fact sheets, brochures and other literature on various aspects of cancer, treatment and care. "Cancer is a disease of the 21st century," says Helen Darling, president and CEO of the Washington-based NBGH. "One of our realities of the future is the better we are at saving people from heart attacks, the more likely they will die of cancer." As a result, she says, "employers are becoming more and more concerned about cancer in their employees and families." "Clearly," says Darling, "it is important that employers educate their beneficiaries about preventable forms of cancer. Moreover, employers need to implement strategies to manage and support employees who are diagnosed with cancer and also provide programs and services aimed at employee caregivers. "While there is an abundance of information about cancer," she says, "currently, there is a vacuum for the delivery of treatment, prevention and support services associated with cancer in the workplace. The deliverables of this project are intended to eliminate this vacuum by providing systematic, evidence-based approaches to care design and delivery." But with more cancer survivors wanting to return to work, intermittent leave becomes far more crucial for their mental and psychological health, as well as physical, says Darling. "Say a patient has breast cancer and has extensive treatment in a short amount of time. She'll be out for many months to recuperate. Then she gets better and can return, but only for awhile [until chemotherapy or radiation ensues] because the treatment is so toxic." "What's really important to keep in mind with all diseases, including cancer," says Darling, "is that work can be a balm. Having something else to focus on is a real help, Work becomes a place where the patient can connect with something else besides disease. "Most people in most workplaces I encounter are hugely understanding [about this], and are profoundly sympathetic and empathetic in the case of cancer."
Employers tell workers to get a move on
Many corporations are now encouraging employees to move more during the workday: In an April survey by the corporate benefits group Workplace Options, 36% of employees said their jobs offered perks such as wellness coaches, on-site health screenings and fitness programs. And 70% of Fortune 200 companies offer physical fitness programs, according to the National Business Group on Health, with many saving on healthcare as a result.
Health care costs continue growth in 2011
The Milliman report revealed nothing surprising to Helen Darling, CEO of the National Business Group on Health, a non-profit organization that represents large employers on health care issues. Darling, who was not involved in the study, said it offers more evidence of the serious economic and financial dysfunction of the health care system. The health care system continues to outstrip everything in its growth, she said, noting that the economy simply cant support this kind of expense.
Study finds 2011 will be another year of brisk growth in health care costs for some families
INDIANAPOLIS -- Health care costs have more than doubled for some American families over the past nine years, and they show few signs of dropping, according to a report released Wednesday by the actuarial consulting firm Milliman Inc. The employee portion of costs paid for a family of four covered by the most common form of employer-sponsored health insurance will climb to a projected $8,008 this year from $3,634 in 2002. That amounts to an additional $84 a week from household budgets for health care. The Milliman report revealed nothing surprising to Helen Darling, CEO of the National Business Group on Health, a non-profit organization that represents large employers on health care issues. Darling, who was not involved in the study, said it offers more evidence of the "serious economic and financial dysfunction of the health care system." "The health care system continues to outstrip everything in its growth," she said, noting that the economy "simply can't support this kind of expense."
Workout for a payout at Foot Levers
LuAnn Heinen, vice president of the National Business Group on Health and director of its institute on innovation in work force well-being, said incentive-based wellness programs have been a growing trend among large employers for years. Now, the idea is starting to emerge at smaller companies, particularly those that are self-insured. Heinen's organization, a nonprofit that represents employers on health policy issues, recently published a survey showing that 58 percent of large employers use financial incentives to promote healthy behaviors and improve health outcomes. The survey also found that 33 percent of employers plan to implement an outcome-based health program next year. Among Fortune 500 companies, 80 percent have incentive-based wellness programs, Heinen said. "They're motivated because they see a direct impact on their medical cost trend," she said. "They are pretty aggressive population health managers. ... They've come to believe that it is a long-term strategy for recruitment and retention."
The murky future of employee health benefits
According to the 16th Annual Towers Watson/National Business Group on Health Employer Survey on Purchasing Value in Health Care, many employers are seeing a potentially game changing outcome over the next several years. The survey of 588 employers conducted in late 2010 and early 2011 found that employer confidence in the status quo for health benefits has plunged.
At least 600,000 young adults join parents' health plans under a new law
Helen Darling, CEO of the National Business Group on Health, which represents more than 300 large employers, said employers generally don't like the idea of anything that will add to their health costs. "I don't think anyone is eager to spend more money," Darling said. "This is not something employers would have done on their own." Darling questioned why employers should be required to cover adult children who no longer live with their parents and might be married themselves.
College Grads Parting Homework: Pick Health Insurance
Helen Darling, CEO of the National Business Group on Health, which represents more than 300 large employers, said employers generally don't like the idea of anything that will add to their health costs. "I don't think anyone is eager to spend more money," Darling said. "This is not something employers would have done on their own."
HSAs Keep Slow But Steady Pace
In contrast, a new Towers Watson/National Business Group on Health survey of firms with more than 1,000 workers found that 53% offered an ABHP for 2011, up from 33% in 2006. Meanwhile, 66% of employers planned to offer an ABHP in 2012. Companies with at least half their employees enrolled in an ABHP reported their average annual costs per employee were nearly $600 less than firms not offering an ABHP. "A fairly small percentage of companies contribute to HSAs, and I don't think that's going to get bigger," says Helen Darling, CEO of the National Business Group on Health. Darling says that while making consumers more cost-conscious through ABHPs is part of the cost control solution, employers, insurers, and policymakers still need to address the myriad cost challenges of healthcare delivery and reimbursement. "Just changing cost sharing won't solve all those problems," she says. "Anybody who says we can fix the system with only one or two levers is disingenuous or naïve. We have to do everything, and we have to do it all at the same time."
Is Self-Insurance For You?
More recently, employers have begun to leverage the wealth of claims data from their plans to provide wellness and health education programs to employees. "Self-insurance allows employers to control plan design and to collect claims data that they can use to identify the health issues that are driving claims costs in their population," says Helen Darling, president of the National Business Group on Health in Washington, D.C. Self-insurance may help employers contain the costs associated with these mandates. "Self-insured companies that actively manage their costs are in a better position to control costs now that the mandates have taken effect," Darling says. "Self-insurance gives the employer the most freedom to define the benefits and the health plan appropriate for their workforce. Most employers would not consider going back to an insured plan. Things could change to make self-insured plans less attractive, but so far it hasn't happened."
Vision Quest
Not everyone thinks HR needs to devote significantly more time and resources to promoting vision benefits. Helen Darling, president of the National Business Group on Health in Washington, thinks communication can only go so far. She says vision benefits are usually delivered in "three sentences" by HR or a benefits administrator. "Does it cover the eye exam? How often? Does it cover contacts and glasses?" she says. "That's it. There's not much more you can say. Everyone knows what it is." But that's OK, she says, because HR "only has so many messages [it can] push." Almost all of the large companies that make up NBGH's membership offer vision benefits, says Darling; however, in a recent survey only 24 percent called the benefit "important" or "very important." Darling says those numbers are low only because people are comparing vision to medical benefits, which are much more sought-after and complicated to explain than vision. Darling also cautions against placing too much emphasis on eye exams being used as ways to detect certain health conditions or diseases. While it's clearly a good thing to get checked, she says, one should not rely on an eye exam to detect those ailments. "You certainly don't want people thinking, 'The way I get my annual checkup is through the eye doctor,' " she says. "You really want to drive people to have an ongoing, continuous, caring relationship with their doctor, whose specialty is taking care of all of you." Nevertheless, vision benefits are clearly important, says Darling -- and companies should recognize their value. "You want people at their optimal, and you can't work at your optimal if you have vision problems," says Darling. "So, the biggest argument for good vision care is that it's part of a package for a healthy, productive and resilient workforce."
Playing Follow the Leader
There is a dramatic difference in how employers tackle health cost trends. Some are doing "everything possible to control costs and improve workers' health, while others have not been willing or able to do it as aggressively," Helen Darling, president and CEO of the National Business Group on Health told attendees at the Health Benefits 9-1-1: Heightened Urgency to Control Cost and Improve Health conference. Held in March, the Washington, D.C., event is where Towers Watson and NGBH released findings from their 16th annual Employer Survey on Purchasing Value in Health Care. The research reflects the responses of 588 companies that employ 9.2 million full-time workers. Of those workers, 7.8 million were enrolled in health care programs. In 2010, survey participants allocated, on average, $10,387 per employee on health care, representing a collective $81 billion in total health care expenditures, NBGH and Towers Watson experts calculate.
A Culture of Health
Last year, the Mayo Clinic was one of 16 organizations to be awarded the Platinum Award for Best Employers for Healthy Lifestyles by the Washington-based National Business Group on Health. The award recognizes companies that the NBGH believes do a stellar job of promoting healthy work environments and encouraging employees to choose healthier lifestyles. However, a closer look at some of the NBGH's Platinum Award winners, which represent the cream of the crop from among the total of 66 companies honored last year, may offer the next-best thing. The winners exemplify what it means to have a "culture of health," says LuAnn Heinen, who oversees the NBGH's Institute on Innovation in Workforce Well-being, which chooses the winners. "What really distinguishes these companies is that they have a fully integrated health program that's firing on all cylinders," she says. "Having a culture of health means you're not just focusing on the employees enrolled in your medical plan, but offering these programs to all employees and constantly tweaking them to make them better." One Platinum Award winner from last year, window and door-maker Andersen Corp., has had a wellness program in place for the last five years called "A+ Health," which provides a variety of online, in-person and telephone-based resources. "Andersen is significant because, for a mid-sized company, it does a lot in this area," says Heinen. "Union Pacific has this long, amazing tradition of safety awareness," says Heinen. "In the transportation industry, you find that companies often have very strong safety programs, with a great deal of trust between the employees and the safety teams, and [Union Pacific] has been able to layer their wellness program on top of that." Having a strong culture of health also means ensuring that your health-promotion programs are not one-size-fits-all, says Heinen. "You have to segment your employee population, understanding that what may work for one group may not for another," she says. Women, for example, are far more likely to enroll in weight-management and stress-management programs than men, says Heinen. CEOs "walking the talk" is also key when it comes to promoting health awareness, says Heinen.
Shaping Health Care Strategy
Choosing Wisely
The trend toward consumer-driven healthcare can be seen in the dramatic rise of health-savings accounts and health-reimbursement arrangements, which grew to 5.7 million in 2010, up from 1.2. million in 2006, according to the Employee Benefit Research Institute in Washington. And according to the Towers Watson/National Business Group on Health's 16th annual report, entitled Employer Survey on Purchasing Value in Health Care, CDHPs cost -- on average -- about $930 less than traditional preferred-provider plans for employee-only coverage and $2,868 less for family coverage. About 27 percent of the employers surveyed plan to begin offering CDHPs in 2012, the survey found, joining the 53 percent of employers that already have such plans in place.
The future of your health care
Today some large companies offer free health services such as on-site clinics, and many use financial incentives to encourage workers to engage in healthy activities. "They are basically saying, 'We are spending a ton of money on you; we want you to be doing the things you should be,'" says Helen Darling, president of the National Business Group on Health. Within the next few years, to enroll in your company's most generous plan, you may have to get an annual exam, fill out a health assessment, or get a bio-metric screening. Otherwise you'll be stuck in a bare-bones plan with big deductibles and co-insurance, says Tracy Watts, a benefit consultant at Mercer. About 14% of large companies plan to use this strategy this year. Eventually you may have to fulfill these requirements to get any company policy, says Darling.
Wellness pays off for businesses
A national study showed that the number of employers offering incentives to workers to participate in wellness programs had increased to 62 percent in 2010 from 57 percent in 2009. The study was conducted by benefit company Fidelity Investments with the National Business Group on Health. The various wellness initiatives have not only short-term benefits for workers, but long-lasting results for the employers, said Helen Darling, president and CEO of the National Business Group on Health.
Reform Rule May Boost Cost
Employers Want Employees to Own up to Tobacco Use
But for the most part, companies are simply requiring workers who use tobacco products to put more money toward health premiums or excluding them from financial rewards tied to tobacco status. "Employers typically use a voluntary system in which an employee signs an affidavit stating he or she is tobacco-free. By not signing and returning the affidavit, the worker by default is saying he or she is a tobacco user," says LuAnn Heinen, vice president of the National Business Group on Health and director of its institute on innovation in workforce well-being. Still, it may be worth it to employers to add a testing element to their smoking cessation efforts. Notes Heinen, as incentives around tobacco usage become larger, "ensuring workers are tobacco-free is a fight worth fighting, because in the end, it's good for both the employee and employer."
Employers Seek Flexibility in Defining Full-Time Worker for Health Auto Enrollment
During another forum session, panelists unanimously agreed that PPACA's automatic enrollment provisions should require employers to enroll only employees and not their dependents. Helen Darling, president and chief executive officer of the National Business Group on Health, said enrolling only new full-time employees will go a long way toward keeping implementation of the provisions as simple as possible. "This will be a culture change for employees," she said, and the easier employers can make it for employees to understand their options, the better.
Small Firms Don't Know Wellness Pays Off
Lisa Gable, executive director of the Healthy Weight Commitment Foundation, says one of the reasons for this difference in wellness adoption programs appears to be that smaller companies are not aware of the economic benefits of workplace wellness programs. Only 20 percent of smaller companies say they strongly agreed that program benefits exceed costs, compared with 38 percent of the larger employers surveyed, Gable says. The National Business Group on Health, a non-profit industry advisory group, says employers can realize as much as $3.27 in financial benefits for every $1 invested in workplace wellness programs, Gable says.
Panel: U.S. Health care must focus on patient outcomes
"U.S. Health Care: Will Our Kids Be Able to Afford It? Will It Be Any Good?" The forum took place March 31, at the Newseum in Washington, D.C., and included key leaders discussing the next steps in U.S. health care, namely how to focus on quality and efficiency. In addition to Cortese, forum panelists included Joseph Antos, the Wilson H. Taylor Scholar in Health Care and Retirement Policy, American Enterprise Institute; Helen Darling, president, National Business Group on Health; and James Weinstein, director, The Dartmouth Institute for Health Policy and Clinical Practice, Dartmouth Medical School. The discussion was moderated by Michael M. Crow, president of Arizona State University.
Getting Aggressive
When it comes to managing rising healthcare-benefits costs, employers are getting more aggressive in shifting that cost to their employees. The incremental changes that marked their attempts in the past just won't cut it anymore, according to survey findings released by the Towers Watson and the Washington-based National Business Group on Health. One reason for the aggressive stance is that the rise in healthcare costs is unrelenting. Total anticipated annual costs-per-active employee, according to New York-based Towers Watson, are expected to reach $11,176 in 2011, a 7.6 percent increase over 2010, according to the study authors.
30 Ways to Cut Health Care Costs
13. Cash in on wellness benefits. More than 40% of large employers surveyed by the National Business Group on Health now offer discounts for participating in wellness programs, and the average incentive to employees is $380. Some employers may add $75 to your health savings account if you participate in an exercise program, and some add even more if you get a health assessment. 14. Sign up for special programs. Many employers offer cash if you participate in a healthy-living program -- for example, 22% of the employers surveyed by the National Business Group on Health offer discounts on health-insurance premiums for people who participate in tobacco-cessation programs. Others offer free weight-loss or stress-reduction programs and incentives for signing up.
Goodbye to Healthcare Benefits?
If findings from the 16th annual Towers Watson/National Business Group on Health Employer Survey on Purchasing Value in Health Care are any indication, that trend is likely to continue in the future -- to the point where they may not be offering healthcare benefits at all. The survey, which polled HR managers and employee-benefits managers from 588 U.S. companies with 1,000-plus employees, found that only about one-third (38 percent) of respondents are confident their organizations will offer healthcare benefits directly to employees 10 years from now. That percentage is notably lower than in past surveys conducted by the organizations, says Helen Darling, president and CEO of the Washington, D.C.-based National Business Group on Health, who attributes it to the current business and economic climate. "[The survey findings] don't surprise me," Darling says. "The predominant feeling right now is one of uncertainty." These potentially significant changes due to healthcare reform will likely impact recruitment and retention efforts -- a scenario that HR professionals should prepare for, Darling says. "Employers feel very strongly that a good benefits package is a competitive asset, and a competitive benefit," she says. "The recession notwithstanding, we still have a war for talent going on. A talent strategy is foremost in everyone's mind right now. [Employers] are trying to hang on to people with rare skills and talents." As a growing number of companies look to exchanges and other options to defray escalating costs and achieve compliance with new and pending healthcare regulations, an organization's commitment to the wellness of its workforce should remain the same, Darling says. "With the evolution of healthcare benefits -- or at least the financial side of it -- and employers moving on to some other way of providing them, employers will focus on making sure their employees are healthy and productive," Darling says. "The importance of ensuring that the organization's talent is healthy, productive, engaged and able to serve customers is not going to just go away," she says.
What Firms Will Do With Health Care Reform
Employers are taking matters into their own hands as they get ready for the 2011 benefit plan year. There's a growing recognition that the health care bill passed by Congress on March 21 won't help lower costs in the short term, forcing firms to act on their own if they want to survive. In fact, many employers believe the pending health bill will only add to their problems. "Health reform will result in increased costs for employers, and that will mean less generous benefits for employees," says Helen Darling, president of the National Business Group on Health. Also growing: Consumer directed health plans (CDHPs) combining high deductible plans with a tax advantaged savings account. About 60% of companies will make them an option in 2011, up from 54% this year, and 12% will make them the only option, up from 8% in 2010, according to a recent employer survey by Towers Watson and the National Business Group on Health. "Employers offer substantially reduced premiums of between 30% and 50% to encourage employees to choose the CDHP option," says Ted Nussbaum of Towers Watson.
Health reform, age 1, faces tough challenges
Large employers' long-term plans on health care appear little changed at this point. More than 80% of companies say health reform has increased their administrative burden, according to a survey of 588 employers from Towers Watson and the National Business Group on Health. But 85% said the overhaul had no impact on their ability to offer competitive pay raises, and 52% said it prompted them to engage employees in improving their health with programs like disease management and wellness incentives. Overall, 95% said their commitment to offering health benefits to active employees remained unchanged after the law passed, and 91% said the same of the coverage they offer to part-time employees.
Honors Given to Six Employers for Reducing Healthcare Inequality at Work
When it comes to supporting a diverse group of workers, six companies stand out in how effectively they are making sure that their healthcare benefits meet all of their workers needs. The six companies that were honored by the National Business Group on Health (NBGH) as committed to reducing healthcare disparities among their workers and supporting a workplace that is diverse were: Aetna, American Express, H.J. Heinz Company, St. Francis Medical Center's Franciscan Clinic, Verizon, and Wyndham Worldwide. Why were these companies chosen? Here are some of the reasons. A full-time wellness director works for Wyndham Worldwide, whose job is to meet all of the employees wellness needs. For minority women, Verizon has started conducting mammography screenings onsite to increase these women's testing rates. Increased access to quick care has been given to employees that are culturally diverse at The Franciscan Clinic. Heinz has implemented support leaders that are bilingual and encourage wellness activity participation, as well as providing all of their written communication in Spanish and English. Due to health clinics and wellness programs that are onsite, American Express has been able to reduce health risks for its employees that are from ethnic groups. A study has been launched by Aetna on hypertension in African Americans. The president of NBGH, Helen Darling, said it best, when she said these companies (and others like them) "recognize that by addressing health and health care disparities, they are improving the value, quality, and effectiveness of the services their employees receive through health care benefits and productivity programs."
Walker's plan to change contraceptive coverage rule met with praise, suspicion and indifference
According to a National Business Group on Health 2006 report, the average cost of adding contraception coverage for an employer is about $25 per worker each year. The cost of birth control without any insurance assistance is $15 to $50 a month, according to Planned Parenthood. Others argue the long-term savings far outweigh any monthly premium increase. According to the National Business Group on Health, employers can save up to $14,000 every five years by providing the coverage.
Plan changes focus to on employee accountability
Employers are planning a number of aggressive changes to their health plans. These changes share one common theme: making employees more accountable for their medical choices. That's one of the chief findings in the recent Towers Watson/National Business Group on Health Employer Survey on Purchasing Value in Health Care. The study found that an increasing number of firms are turning to consumer-driven health plans (CDHP) in an effort to control costs. In fact, 27% of employers plan to add a CDHP that combines a high deductible with an HRA or an HSA in 2012. Fifty-three percent of companies already have a CDHP in plan, according to the study. Employers will also target specific areas. For example: 68% of employers plan to bump up contributions for dependents. Another one-third of companies are moving to reward or penalize workers based on their biometric screenings -- for weight and cholesterol -- in 2012. That's a major increase from the 7% of employers who are doing so this year.
On Health Law's Anniversary: Predictions For Next Year
The health care law has been on a roller coaster ride since its passage one year ago, moving forward with implementation plans even as opponents throw up legal and legislative challenges to stop it in its tracks. At Kaiser Health News, we wondered where these moving parts might be in March 2012, at the measure's two-year mark. So we asked players and experts from across the nation what they thought the landscape would be like and, in their view, should be like. They discussed issues ranging from the new insurance marketplaces called exchanges to the future of accountable care organizations: combinations of hospitals, doctors and sometimes insurers. Here are their edited responses: Steven E. Wojcik - vice president, public policy, National Business Group on Health said: By March 2012, we hope to convince Congress to adopt medical liability reform that limits how much providers pay in non-economic damages and restricts attorneys' fees. The administration has signaled that it is open to changes, and there's a significant gap in the health care law to reduce the unnecessary, added costs we all pay for defensive medicine. We also will have made sure health care payment reforms pilot projects called for in the health law get implemented quickly and widely throughout the Medicare program because we want to be paying for outcomes and quality not just care. We expect to work through the regulatory process to make sure "consumer directed" or high-deductible health plans are allowed to be offered as rules get drawn up for new insurance exchanges. These plans are the key to getting health costs under control.
Top employers need to offer health cover: Panel
The ROI of Hospital Employee Wellness Programs
A successful employee wellness program requires commitment from leadership, experts say. LuAnn Heinen, vice president of the National Business Group on Health, noted that a program needs both top-level leadership and site-level leadership buy-in in order to really succeed. "Leadership is huge," she said. "You have to communicate what your goals are, why you're doing this, and what's in it for them to participate." "There is an ROI when you really do it," said Heinen. "There's a really, really good ROI." She cited the Health Affairs study, which found that well-designed workplace wellness programs averaged a 3:1 return on investment. The study noted that medical costs tend to fall by $3.27 for every dollar that's spent on wellness programs' and absenteeism costs tend to fall by $2.72 for every dollar spent. Heinen said that an employee wellness program really should be beneficial for everyone involved. Most employers care about their retention rates and their employee satisfaction rates. If everyone stands to benefit financially and health-wise, it can really be a "win-win" for them all.
Employers preparing for big health plan changes: Study
Employers across the U.S. are getting serious about changing their health plans and making employees more accountable for their medical choices, new research says. The main driver of this bolder approach, of course, is costs. According to the Towers Watson/National Business Group on Health Employer Survey on Purchasing Value in Health Care, the total anticipated annual costs per active employee are expected to reach $11,176 (up 7.6% from $10,387 in 2010), and the average employee's share of costs in 2011 is expected to rise 11.8%, to $2,660. Account-based health plans (ABHPs) -- health savings accounts (HSAs) and health reimbursement arrangements (HRAs) are booming, the report said. In 2002, just 2% of all employers offered ABHPs, but by 2011, that number has exploded to 53%. By 2012, another 13% of all respondents plan to add an ABHP. New emphasis on accountability Other plan changes being mulled by employers: --Dependent coverage subsidies: 68% are moving to increase contributions for dependents, with 19% targeting per-dependent contributions, and 35% using or planning to implement spousal waivers or surcharges. --Retiree medical coverage: 26% of employers plan to cease employer sponsorship; 25% plan to convert a current subsidy to a retiree health account, and 23% plan to eliminate employer-managed drug coverage for post-65 retirees and rely on Medicare Part D plans. --Incentives for high-value providers: 28% of employers plan to differentiate cost sharing for high-performance networks or centers of excellence in 2012, and 21% plan to adopt value-based designs over the next year. In addition, 18% plan to offer incentives or penalties to providers for coordination of care, use of emerging technologies or use of evidence-based treatments. --Accountability for engagement: A third of employers plan to reward or penalize their employees based on biometric outcomes (for weight and cholesterol), compared with just 7% in 2011 and 6% in 2010. Social media is one of the emerging creative strategies employers (9%) are using to improve employee health and well-being. The survey also revealed that employers believe the opening of insurance exchanges in 2014 will have some impact on their active (70%) and retiree (78%) medical programs. In addition, more than a quarter of employers (27%) believe the opening of the exchanges will have an extensive impact on their retiree plans. The implementation of the excise tax is expected to have an impact on both active (81%) and retiree (66%) medical programs as well, with 24% and 20% of employers anticipating an extensive impact on their active and retiree programs, respectively.
Employers take big, bold steps on health costs
Even after plan design changes, employers can expect their health care costs to increase by 7% in 2011, a sure sign that an aggressive approach to plan design is here to stay, finds research by the National Business Group on Health and Towers Watson. Overall, the total projected annual costs per active employee are estimated to hit $11,176, up 7.6% from $10,387 in 2010, while the average employee's share of costs in 2011 is anticipated to rise 11.8%, to $2,660. The research shows that there is still a significant gap in employers' ability to reduce health care cost trends. The data reveal that the median two-year trend for 2009 and 2010 is 6%. High-performing companies, however, have a median 1% cost trend. In contrast, low-performing organizations have a 10% cost trend. The median trend for the last four years was 6.3%, but companies that have kept cost trends at or below the norm during the four years have only seen a 1.8% trend. The cost difference between consistent performers (those with a track record of keeping trends at or below the norm) and low performers was more than $2,000 per employee, while the difference between high performers and low performers was $1,745 per employee. "For a consistent performer with 10,000 employees, this adds up to a $20 million cost advantage over a low-performing competitor," researchers note. Consistent performers made a difference with their cost trends by "renegotiating financial arrangements with their current pharmacy benefit manager, changing plan options, rewarding enrollment in healthy lifestyle activities or penalizing nonenrollment and imposing tougher restrictions on receiving financial incentives," according to the survey report's authors. They also were more likely to participate in community-based pilot programs, such as patient-centered medical homes. The findings appear in the 16th annual National Business Group on Health and Towers Watson Employer Survey on Purchasing Value in Health Care. The research reflects the responses of 588 companies that employ 9.2 million full-time workers. The survey respondents employed 7.8 million workers who were enrolled in health care programs, which represented a collective $81 billion in total health care expenditures, according to NBGH and Towers Watson experts. Other key findings on notable planned benefit design changes include: --Dependent coverage subsidies: 68% are moving to increase contributions for dependents, with 19% targeting per-dependent contributions, and 35% using or planning to implement spousal waivers or surcharges. --Retiree medical coverage: 26% of employers plan to cease employer sponsorship; 25% plan to convert a current subsidy to a retiree health account, and 23% plan to eliminate employer-managed drug coverage for post-65 retirees and rely on Medicare Part D plans. --Incentives for high-value providers: 28% of employers plan to differentiate cost sharing for high-performance networks or centers of excellence in 2012, and 21% plan to adopt value-based designs over the next year. --In addition, 18% plan to offer incentives or penalties to providers for coordination of care, use of emerging technologies or use of evidence-based treatments. --Accountability for engagement: A third of employers plan to reward or penalize their employees based on biometric outcomes (for weight and cholesterol), compared with just 7% in 2011 and 6% in 2010. --Social media is one of the emerging creative strategies employers (9%) are using to improve employee health and well-being.
Health Care Reform Law Likely to Stand: Official
More Employers to Offer CDHPs
Survey Notes Major Health Benefit Changes Foreseen to Limit Costs
10 Things Health Insurers Won't Tell You
4."We will pay out-of-network expenses." Yes, there are times when insurance companies will completely cover care even if it's provided by an out-of-network provider. That typically occurs when a plan covers the treatment but an in-network provider -- often a specialist -- is not available close to home or when there's an emergency and you have to get care at an out-of-network hospital. If you know ahead that you're going to an out-of-network provider because no one is available in your community, get the insurance company's permission in writing, says Helen Darling, president of the National Business Group on Health, a nonprofit association of large employers. That way, months later if the insurer disputes the claim, there's proof of the agreement. 9. "We'll do anything to keep you in network." Your favorite doctor is out-of-network, but you don't want to end up with a bill the size of your first mortgage. Finding out the actual cost, however, can be difficult, say consumer groups: When patients call and ask how much an out-of-network procedure will cost, insurers will typically cite the plan's general benefits. If you actually want to know what you'd end up paying, it will take more work -- probably CPT codes for the exact procedures you'll need, plus a strong sense of determination and a fondness for hold music. In-network doctors are simply less expensive for the insurance company. Robert Zirkelbach, a spokesman for America's Health Insurance Plans, says insurance companies want consumers in the plans because it's less expensive and the insurers have screened the providers to ensure quality. "Health plans are able to negotiate significant discounts," he says. Members' going outside the plan can also be bad publicity, indicating they may not be satisfied with the doctors in the plan, Darling says.
Employers leery of change to opt-out provision
Fixing America's Health Care Reimbursement System
A tempest is brewing in physician circles over how doctors are paid. But calming it will require more than just the action of physicians. It will demand the attention and influence of businesses and patient advocates who, outside the health industrial complex, bear the brunt of the nation's skyrocketing health care costs. In an influence-driven government like ours, it is the non-health care business sector that has the organization and leverage necessary to drive the health care changes America so desperately needs. The health care industry represents one dollar of every six dollars in the U.S. economy, but industries outside health care represent the other five. If American businesses, led by groups like the National Business Group on Health, the Pacific Business Group on Health, the Business Roundtable, the National Retail Federation, the U.S. Chamber of Commerce and the National Federation of Independent Business were to advocate for the same policies in national health care reimbursement policy that their members are often implementing in their own on-site clinics, it would have a dramatically positive impact on the nation's physical and economic health.
Thought leaders share health care advice for employers
Medical benefit sponsors remain caught between the proverbial rock and a hard place: rising costs are hitting the bottom line hard, yet uncertainty over regulatory implementation of federal reform legislation -- and the prospect it might be declared unconstitutional by the Supreme Court -- has put long-term strategic decision-making into near limbo. To help, EBN reached out to some of the most influential thought leaders for their best thinking on what employers can and should be doing to cope in the current environment. To deal with reform and combat costs, Darling says "employers must have a comprehensive health care, wellness and benefits strategy"that uses an aggressive cost management and health improvement strategy. In addition, she recommends "sourcing for best in class vendors who provide the best networks, best care management, centers of excellence, and care and disease management that are highly targeted," as well as measuring results with sophisticated data warehouses. Darling believes "[The] number one issue for employers is employee engagement: engagement in controlling costs and in taking responsibility for improving their own health. If employees don't understand what is driving health care costs and what they can do to control them, then employees will pay more and more for health benefits and employers will too." She observes that some 60% to 80% of health problems are preventable and are directly related to choices people make. "For example, they are not: eating the right food in reasonable amounts, being physically active, wearing seat belts and helmets, not smoking and drinking in moderation."
Wellness Incentives on the Rise
Employers' use of incentives to drive wellness participation is on the rise, suggesting momentum and hope for the wellness movement overall. In two recent studies, both employer use -- and employee acceptance -- of incentives and punishments to effect healthier behavior are increasing, in some cases, rather significantly. Incentives provided by employers averaged a total of $430 per employee in 2010 -- a 65-percent increase from $260 in 2009 -- according to a study by Boston-based Fidelity Investments and the Washington-based National Business Group on Health of 147 organizations, conducted between Sept. 20 and Oct. 29.
Health reform includes cash for health
Some private companies have reduced employee health costs by offering cash to quit smoking or serving healthy food in the cafeteria. Now the federal government plans to offer incentives to low-income Medicaid patients who adopt healthy behaviors. On Thursday, the Department of Health and Human Services announced that as part of health reform, $100 million will be devoted to states for incentive programs. States can apply for the grants, which could include giving cash or grocery store gift cards for patients who lose weight, quit smoking or keep their diabetes under control. The private sector has been increasing incentives as well. A study released this month by Fidelity Investments and the National Business Group on Health found that last year big companies spent an average of $430 per employee to encourage participation in health improvement programs. Companies offered cash and gift cards and made additional contributions to health savings accounts. The spending was a 65 percent increase from the year before.
Short-term disability claims flat during recession
Latest survey shows 'opportunities exist' for productivity improvements
The picture shows an overall slight decrease in disability costs to employers from 2008 to 2009. However, the amount is still significant and indicates there are areas where employers can focus on disability management to improve their bottom lines. "When you step back and look at it as a whole, I think there have been some wins and some losses," said Karen O. Marlo, vice president of benchmarking and analysis for NBGH. "It shows there have been some improvements in terms of management of these programs and return to work, but there are still a lot of areas for improvement." The survey of nearly 700 large and midsized employers includes a total absence metric calculated by taking the combined costs of short- and long-term disability and workers' comp and representing those total costs as a percent of payroll. While the median wage replacement cost decreased to 0.7 percent in 2009 from 0.99 percent in 2008, it still equates to $7 million for a company with a payroll of $1 billion going directly to employees "who are absent from work and not contributing to the productivity and profitability of the company," according to the report. The survey shows claims incidence for workers' comp decreased in 2009 with the median annual claim incidence per 100 full-time equivalents at 2.6, compared to 3.7 in 2008 and 4.2 in 2007. That contrasts with some recent reports from other organizations that have indicated frequency may be starting to stabilize. "At this point we're not seeing any trending difference," Marlo said. "Some of that, I'd argue, is attributable to employers focusing on safety and implementing programs that allow them to ensure their employees are following processes and protocols to avoid injury." Other workers' comp statistics from the survey showed: --The median cost per full-time equivalent -- $287 -- was essentially the same after going up the previous year. --The cost per closed claim in 2009 was $9,301, an increase over 2008's $7,223. It includes wage replacement and medical costs incurred over the lifetime of the claims. --The cost per active claim, which measures wage replacement and medical costs for claims that were active at any time during the year, was essentially unchanged from the previous year, at just over $6,000. --The percentage of claims that were indemnity increased in 2009 to 27 percent from 24.9 percent after remaining almost constant for 2007 and 2008. The actual increase for 2009 was 2.8 percentage points. In other areas of disability, the report showed there were fewer short-term disability and long-term disability claims and lower short-term disability costs per claim. However, long-term disability claims costs increased by more than 25 percent. One of the top cost drivers in short-term disability was mental diseases and disorders. However, that was not a cost trigger in group health. "There's a disconnect," Marlo said. "People aren't getting care on the job and then it becomes them needing to go out on short-term disability." She said it's an example of an area where employers can improve productivity. "There are opportunities for employers to become more integrated in the productivity and health of their employees to ensure if people put in a claim for short-term disability that we can get them back to work in a timely fashion."
Employers Increased Wellness Incentives Last Year
Employers are spending more on gift cards, contributions to health savings accounts and other incentives to persuade workers to take part in health-improvement programs, a new survey finds. The survey, by Fidelity Investments and the National Business Group on Health, covered 147 companies with between 1,000 and 100,000 employees. The average employee incentive rose 65% to $430 last year from $260 in 2009. (Companies may not entirely shoulder that cost, choosing instead to pass it on to workers in the form of higher premiums.) The percentage of employers offering incentives also rose last year, to 62% from 57%. Only 12% of employers, however, offered negative incentives, dinging their employees for not participating in programs.
Companies dole out more cash for wellness
Companies are increasingly paying workers for meeting health goals, a study by Boston-based Fidelity Investments and the National Business Group on Health has found. Employers boosted incentives to an average of $430 per employee in 2010, up from $260 in 2009, according to the survey, which included 147 mid- to large-size companies across a variety of industries nationwide. Businesses employed various incentives, including cash, gift cards and making additional contributions to health savings accounts, with 62 percent using positive incentives. A small number - 12 percent - used more punitive measures to motivate staff such as reducing employer contributions to health plans if employees didnt engage in any programs.
More employers using incentives to push wellness programs
Consumer Health: Some Workers Offered Pay, Perks to Stay Healthy
Employers are trying a new tactic to prod their workers to live healthier lives and thus reduce medical costs: more creative and often lucrative incentives. Despite the effects of the recession, many employers are spending more money on wellness programs that aim to help people eat right, get regular exercise, manage stress and quit smoking. And they're experimenting with new ways to motivate employees to switch or stick to healthful habits, said LuAnn Heinen, vice president of the National Business Group on Health, a Washington-based group of large employers. "Everyone knows what to do," she said. "It's not a lack of knowledge that's the problem." Among the incentives: additional time off, prize drawings, workplace competitions, discounts on health-plan premiums or gym memberships, and even cash. Tobacco use is often where wellness benefits are the richest or most punitive. It's not uncommon for large employers to offer incentives of $250 or more to entice smokers to quit, Heinen said. But a small number tack a surcharge onto tobacco users' health-insurance premiums.
Health reforms face legal battle
More Workers Seek Health Info from Employers, Plans
The number of U.S. employees who turn to their employer and health plan for medical information has increased sharply, according to a nationwide survey by the National Business Group on Health, a nonprofit association of large employers. In addition, employees indicated that they were somewhat familiar with "comparative effectiveness research," which compares the clinical effectiveness of various health care interventions to determine the most effective course of treatment. The survey found that: -- 75 percent of workers used their employer as a resource for medical and health information in 2010, a sharp increase from 54 percent in 2007. -- 69 percent rated their employers as completely, very or moderately trustworthy sources of heath information. Meanwhile, the percent of workers who relied on their health plan for health and medical information increased from 67 percent in 2007 to 76 percent in 2010. In addition, growing numbers of workers also relied on health-oriented websites while fewer workers sought information from doctor's offices, published articles, prescription drug package inserts, pharmacists, and medical school, hospital and government websites. Employees face great challenges in navigating a complex, fragmented and hard-to-access health care delivery system, said Helen Darling, president and CEO of the National Business Group on Health. The amount of health care information that consumers need to sift through just to know what they should be doing seems endless and daunting. Our survey shows that workers want their employers to play a role in helping them access medical information about their health and how to make good treatment decisions from sources that are objective, trustworthy and reliable, such as the American Heart Association. Workers want their employers to help them access medical information from objective sources. Using Comparative Research According to the survey, a vast majority of employees are somewhat familiar with comparative effectiveness research, which can help doctors and patients know what type of health care works best by comparing the effectiveness of different health tests or treatments. When asked how much they trust various organizations to conduct comparative research: -- 74 percent of employees cited nonprofit organizations focused on a specific illness as trustworthy organizations. -- 70 percent citied an independent panel of doctors and other health professionals. -- 61 percent cited a college, university or other educational institution. "While employers now pay more than $10,000 per active employee annually for health care, they are not confident that these expenditures are truly improving employee health," observed Darling. As a result, they are now looking for ways to ensure that employees are receiving safe and appropriate quality health care, including care based on comparative effectiveness research. That, however, raises many questions employers need to address including how do employees currently make health care decisions and how do they evaluate which treatments are best for them. Among other key survey findings: -- 85 percent of employees looked for health care information about symptoms before visiting a doctor while 71 percent said they brought a list of questions to ask their doctor during a visit. -- 41 percent, however, indicated they were unsure how to discuss their concerns while 47 percent felt their doctors were rushed during the visit. -- 39 percent support incentives for using proven treatments vs. 16 percent who support penalties for using treatments that research has shown work less effectively. The survey, Employee Attitudes Toward Health Information and Comparative Effectiveness Research, was conducted in mid-October 2010.
Health-Care Companies Staying the Course
Helen Darling, president and CEO of the National Business Group on Health, which represents large companies such as GE, Microsoft and General Motors, said that large employers will continue to implement the required changes to their benefits. "It's the law of the land, so employers are still going to have to move ahead with what they're doing now," she said. Even if the individual mandate were struck down, many of the law's other provisions, such as a push for more research to compare patient treatments would likely continue. Companies already had to implement some changes, such as eliminating lifetime limits on insurance coverage and offering certain preventive services free of charge. But major changes don't take effect until 2014, such as the health-insurance exchanges. "They're going to have to be gearing up to be ready" for those, and if anything changes between now and 2013, "they've got time to refine and tweak."
Survey: Employers are a reliable source for health data
The National Business Group on Health reports a growing number of workers seek health and medical information from their employers. In a survey conducted in October 2010, 75% of employees reported that they used their employers as a resource for medical and health information, a significant jump from 54% in 2007. "We were surprised by that number. Employers, however, in the last five years have started seeing their role as supporting and enabling consumerism," said Helen Darling, president and CEO of the National Business Group on Health, during a press conference yesterday at the National Press Club. As a result, "they have been providing more information and actively making that information available on their websites and intranets," explained Darling at the Washington, D.C. event. Meanwhile, the percentage of workers who relied on their health plan for health and medical information increased from 67% in 2007 to 76% in 2010, according to the survey. Employees have scaled back on accessing health information from the doctor's office, magazine and newspaper articles and pharmacists. For example in 2007, 72% of employees said they receive health information from their doctor's office or clinic. In 2010, the number dropped to 61%. Benefits professionals will be happy to hear that nearly 70% of workers rated their employers as completely, very, or moderately trustworthy source of heath information. "We tell employers to make certain that when passing on health information to workers to cite trustworthy sources," said Darling. For instance, if an employer is sending out information dealing with children, it might be a good idea to cite the American Academy of Pediatrics. The survey involved 1,538 employees at organizations with 2,000 or more workers. The survey participants were between the ages of 22 and 69 and receive their health care benefits through their employer or union. Other key findings from the survey include: * Nearly 85% of respondents looked for health care information about symptoms before visiting a doctor while 71% of respondents said they brought a list of questions to ask their doctor during a visit. * However, 41% indicated they were unsure how to discuss their concerns while 47% felt their doctors were rushed during the visit. * Almost four in ten employees (39%) support incentives for using proven treatments versus 16% who support penalties for using treatments that research has shown work less effectively.
Employees rely more on employer, health plan info: NBGH
Big Employer, M.D.
Workers at big U.S. employers are more likely than they used to be to turn to their employers and their health plans for health information, according to the National Business Group on Health (NBGH). The NBGH, Washington, has published that finding in a summary of results from a survey of 1,538 workers ages 22 to 69 at U.S. employers with 2,000 or more employees. All participating employees get health benefits through their employers or through their unions. The percentage of workers who say they have used their employers as a source of medical information increased to 75% in 2010, from 53% in 2007. Over that same period, the percentage of workers who turned to their health plans for medical information increased to 76%, from 67%. Participants also were asked about their views on comparative effectiveness research. About 74% said they would trust nonprofit organizations focused on a specific illness to come up with evaluations of the effectiveness of various treatments, and 70% said they would trust an independent panel of doctors and other health professionals. About 61% said they would trust a college, university or other educational institution to conduct comparative research. About 39% of the survey participants said they support use of incentives to persuade plan members to use what are believed to be the most effective treatments. Only 16% of the participants said they support use of penalties to keep plan members from using treatments that are believed to be less effective.
Employers Increasingly a Resource for Health Information
The number of U.S. employees who turn to their employer and health plan for medical and health information has increased sharply over the past few years, according to a nationwide survey of employees conducted by the National Business Group on Health. The survey found that three in four workers (75%) used their employer as a resource for medical and health information in 2010, a sharp increase from 54% in 2007. More than two-thirds of respondents (69%) rated their employers as completely, very or moderately trustworthy sources of heath information. The percent of workers who relied on their health plan for health and medical information increased from 67% in 2007 to 76% in 2010. A press release said growing numbers of workers also relied on health-oriented Web sites while fewer workers sought information from doctor's offices, published articles, prescription drug package inserts, pharmacists, and medical school, hospital and government Web sites. Other key findings, according to the press release, include: * 85% of respondents looked for health care information about symptoms before visiting a doctor while 71% of respondents said they brought a list of questions to ask their doctor during a visit. However, 41% indicated they were unsure how to discuss their concerns while 47% felt their doctors were rushed during the visit. * Almost four in ten employees (39%) support incentives for using proven treatments versus 16% who support penalties for using treatments that research has shown work less effectively. The survey also found a vast majority of employees are somewhat familiar with Comparative Effectiveness Research (CER), which can help doctors and patients know what type of health care works best by comparing the effectiveness of different health tests or treatments. When asked how much they trust various organizations to conduct comparative research, 74% cited non-profit organizations focused on a specific illness as trust worthy organizations, while 70% cited an independent panel of doctors and other health professionals. Just over six in ten (61%) said they trusted a college, university, or other educational institution to conduct comparative research. The survey, Employee Attitudes Toward Health Information and Comparative Effectiveness Research, was conducted in mid-October, 2010. A total of 1,538 employees at organizations with 2,000 or more employees responded. Respondents were between the ages of 22 and 69 and receive their health care benefits through their employer or union.
Tweaking Health Reform
Large employers are steering clear of Republican efforts to repeal the Patient Protection and Affordable Care Act (PPACA). Instead, they are focusing on surgically altering individual Department of Health and Human Services rule-makings where bureaucrat interpretations of broadly worded healthcare reform provisions could negatively affect company health plans this year. To the extent that new Republican chairs of congressional committees hold oversight hearings to shine a light on imple-(mentation imbroglios, business groups welcome that attention. Steve Wojcik, vice president of public policy at the National Business Group on Health, agrees that federal agencies have shown some welcome flexibility, even prior to the midterm elections.
Obama Offers Hope
Repealing the bill is an impossibility, says Helen Darling, president of the Washington-based National Business Group on Health, who says that Obama "set the right tone" in his speech by emphasizing the need for Republicans and Democrats to work together to correct some of the problems with the law. Should that talk turn into reality, she says, "that's a plus for employers," noting she was particularly struck by the president's advocacy of medical malpractice reform. "That has been a major issue for employers for many years because of the consequences of defensive medical practices" that drive up costs as doctors order costly, unnecessary tests to protect themselves from potential legal liability, Darling says. Many of the upcoming crucial decisions that will determine how the healthcare law impacts employers will be regulatory -- and she says that, since the election that saw the GOP pick up 60-some seats in the House, she has seen "more than lip service [being paid] to changes in working together" for compromise. The nod toward revising the healthcare reform bill was positive, Yager agrees, but "the proof is in the pudding" and will require a "willingness on both sides, both him and the Republicans in Congress, to try to make the pact more workable."
Dip in disability claims coincides with recession, NBGH finds
As I was growing up, I had a tough as nails, old-school grandpa. He never called a repairman; he fixed everything himself. He grew his own produce, long before organic, local-grown was in vogue. And he was fond of saying, "You do what you have to do to get to work, even if you have to drag your leg behind you." I thought of this as I read news from the National Business Group on Health, which revealed that its latest research shows U.S. employers received an unexpected, but welcome fallout from the economic recession - fewer short and long-term disability claims and lower short-term disability costs per claim. The Employer Measure of Productivity, Absence and Quality (EMPAQ) annual survey found that STD claims declined 17.3% from 8.1 claims per 100 covered employees in 2008 to 6.7 claims per 100 covered employees in 2009. LTD claims dropped 26% from 4.6 claims per 1,000 employees to 3.4 over the same time period. The survey also found that STD costs declined 15.9% from $343 per employee in 2008 to $296 per employee in 2009. LTD costs, however, jumped by more than 25% from $10,507 per claim in 2008 to $13,226 per claim in 2009. Even with the rise in costs, that sounds like a lot of workers - perhaps fearful of layoffs during the height of the recession - may have been dragging a leg behind them, so to speak. "When the recession began, many employers anticipated their short-term disability claims would increase," says Helen Darling, NBGH president and CEO. "However, this recession appears to have caused a somewhat opposite effect, with decreases in claims in 2009. The collapse of the housing marketing and the unemployment picture may have caused employees to delay taking time off from work, especially for elective medical procedures." Do NBGH's results align with your company's experience regarding disability claims? Share your thoughts in the comments.
Recession's Impact: STD Costs Declined While LTD Costs Surged
U.S. employers received an unexpected but welcome fallout from the 2008-09 recession: fewer short- and long-term disability claims and lower short-term disability costs per claim. Long-term disability costs, however, jumped 25 percent, according to a report by the National Business Group on Health, a nonprofit association of 300 large U.S. employers. The Employer Measure of Productivity, Absence and Quality (EMPAQ) annual survey found that: --The incidence for short-term disability (STD) claims declined 17.3 percent from 8.1 claims per 100 covered employees in 2008 to 6.7 claims per 100 covered employees in 2009. --STD costs declined 15.9 percent from $343 per employee in 2008 to $296 per employee in 2009. --Long-term disability (LTD) claims dropped 26 percent from 4.6 claims per 1,000 employees in 2008 to 3.4 in 2009. --But LTD costs jumped by more than 25 percent from $10,507 per claim in 2008 to $13,226 per claim in 2009. The EMPAQ annual survey is based on responses from 648 large and mid-sized U.S. companies. When the recession began, many employers anticipated their STD claims would increase. When employees experience anxiety regarding impending workforce reductions, their subsequent behavior often causes employers to feel the impact in their benefit plans, said Helen Darling, president and CEO of the National Business Group on Health. However, this recession appears to have caused a somewhat opposite effect, with decreases in claims in 2009. The collapse of the housing market and the unemployment picture may have caused employees to delay taking time off from work, especially for elective medical procedures. The unemployment picture may have caused employees to delay taking time off from work, especially for elective medical procedures. Other Absence Programs Concerning other leave programs, survey respondents reported: --FMLA. A median annual incidence for Family and Medical Leave Act (FMLA) claims of 14.9 per 100 covered employees in 2009 up from 12.5 in 2008. --Workers' comp. The incidence of workers' compensation claims was 2.6 per 100 employees in 2009 down from 3.7 in 2008. The report noted that for a large employer, an increase in the number of FMLA claims from one year to the next can have a substantial impact on productivity and the bottom line, something particularly hard to absorb in a down economy. Even as the economy begins to improve, companies remain under growing pressure to constrain costs while at the same time increase the productivity of their workers, said Darling. We expect companies will be taking a hard look at all of their absence programs. Identifying areas where better tracking, management and reporting for these programs will be all that more critical.
A health plan to save you money
If you don't know about high-deductible insurance plans, you will soon. These controversial plans are increasingly offered by employers. Also known as consumer-directed health plans, they offer clear cost-saving benefits, such as lower premiums and the opportunity to manage increasing health care costs. But if you get seriously sick, you'll be socked with high deductibles. But there are pluses for the duly warned. "If you're not sick very often, you may be better off in them," says Helen Darling, president of the National Business Group on Health. "You'll save money." "I'd rather have lower amounts taken out of my paycheck," says Darling, "manage my own health care and use generic drugs." Don't go to emergency rooms if you can avoid it, she says -- you can save a lot of money. However, if your high-deductible plan ends up being an ill fit, consider changing to a more traditional health insurance plan. You can do it once per year. "If you're not organized enough," says Darling, "you'll want something else you'll pay more for."
Employers Adjusting to Mental Health Parity Act
With the new requirements of the Mental Health Parity and Addiction Equity Act going into effect at the start of 2011, many organizations are now making adjustments to comply and to avoid prohibitive cost increases. That seems to bear out with the National Business Group on Health's findings from a summer survey it conducted of its 300 members, primarily Fortune 500 companies and large public-sector employers -- including healthcare purchasers -- that provide health coverage for more than 50 million U.S. workers, retirees and their families. None of those respondents said they would be dropping their mental-health benefits, but 89 percent said they would be adjusting them in response to the law, says Steve Wojcik, vice president of public policy for the Washington-based organization. The Parity Act, which was signed into law in 2008, prevents large health plans from setting higher co-payments for mental-health visits than those for medical visits, or limiting doctor visits for mental-health care, among other things. Most of the adjustments NBGH members are making, says Wojcik, are in reductions of the cost-sharing responsibilities for employees for mental-health providers. One-third of respondents, he says, "are lowering the mental-health co-payment to equal that for the medical side." Fourteen percent, however, are increasing their medical co-payments for employees "to equal the mental-health side of the party equation," he adds. "Luckily, I haven't heard of a single [NBGH member] dropping mental-health benefits," Wojcik says, "but I am hearing a lot of questions about 'How do we maintain parity to comply?' " The larger employers not only are in a stronger position to support the mental-health portions of their healthcare plans, he says, "they also get it -- they understand the importance of mental-health care for the company's overall productivity and even cost benefits" of the overall health plan. "They seem to understand that if you eliminate it altogether," Wojcik says, "you might pay more on the other end, through necessary prescriptions." Mental-health benefits, he says, "can not only help with maintenance medication, but with overall workforce issues such as productivity, absenteeism, presenteeism, even other medical costs." In some healthcare issues, he says, "if you don't treat the depression [or other underlying mental ailment], then you're impacting medication compliance, overall wellness and healthy lifestyles, etc.," those things that can have a much greater impact on the workforce as a whole. In fact, NBGH heavily promotes integrating mental health and medical benefits through clear and constant communication between the patient and all physicians involved, mental and medical, says Wojcik. It also stands behind the argument for better integration of medical records, including online, so care providers and physicians are fully aware of all the treatments and medicines affecting any one patient at any time. "If this report from Kaiser indicates some organizations are beginning to drop mental-health benefits altogether [which it does, primarily for smaller and mid-sized companies]," he adds, "our experience shows this is a very, very bad idea."
Obama's olive branch to Big Business
In recent weeks, President Obama has taken significant steps to try to repair his administration's frayed relationship with the business community. Another natural ally would be the National Business Group on Health, whose 300 corporate members provide health insurance to 50 million American workers, retirees and family members. President Helen Darling says that although her members are concerned the legislation doesn't go far enough in controlling health costs and improving quality, they understand the new system will be better than anything that would result from outright repeal.
Rhetoric and Reality of Health-Law Repeal
Newly emboldened Republicans want to repeal the Obama health law, a symbol of all that they--and many voters--dislike about President Barack Obama and congressional Democrats' approach to governing. If you were a business executive and employer, would you really favor repeal? At the National Business Group on Health, a collection of nearly 300 big employers, President Helen Darling, a former corporate-benefit administrator and Republican Senate staffer, says about executives who call for repeal: "If they really understood it, they wouldn't." "I don't think we'll get a better solution in the U.S. in our lifetime" Darling said. "If it gets repealed, or gutted, we'll have to start over and we'll be worse off."
Employers upping the ante on wellness incentives
This year, to cash in on some of the generous incentives employers are offering as part of their wellness programs, employees will actually have to do something more exhaustive -- like participate in a class that helps them lose weight or quit smoking. In fact, 42% of large employers said they'll require their workers to complete a health coaching class or disease management program to earn a financial incentive in 2011, according to a survey of 507 employers by Towers Watson and the National Business Group on Health.
Repeal alone won't solve health care's urgent needs
During the recent political campaigns, Republicans touted a repeal and replace strategy for the nation's health care mess. On Wednesday, House Republicans plan to hold a vote on repealing the new health care law, but no replacement is in sight. This suggests that the problem can wait and that the nation can afford to revert to the old system for the foreseeable future. Not true. Forty-three percent of employers surveyed last year say they have lost confidence in their ability to provide affordable health benefits a decade from now, according to the National Business Group on Health. That's up from 27 percent in 2008. Last year, the percentage of workers with private insurance was the lowest since the government began keeping data in 1987.
Six changes in health care that may affect you
Congressional opponents of the new health care overhaul are threatening to repeal the Affordable Care Act that was signed into law by President Obama on March 23, 2010. "The child doesn't have to be your dependent, doesn't have to be living with you, can be married or unmarried, and doesn't have to be attending school," according to a spokeswoman for the National Business Group on Health.
Pro/Con: The fairness of health insurance incentives
Wanna make a fast buck? Quit smoking. According to the National Business Group on Health, which represents large employers including Wal-Mart and Wendy's, about 68% of its members either offer a discount of several hundred dollars on health insurance premiums to employees who quit smoking, or provide other incentives or penalties to make it happen.
The price is (not) right
In an effort to maintain comprehensive employee health benefits while controlling rising health care costs, employers increasingly are relying on an array of wellness programs aimed at creating a healthier workforce. This trend should continue to gain momentum with employers given the larger incentives built into the Patient Protection and Affordable Care Act. Yet, many employers have implemented these programs without first developing an integrated strategy that clearly outlines targets and goals. This is one of the findings of a recent survey of 121 large U.S. employers conducted by the National Business Group on Health and Fidelity Investments. The survey provides insight into the breadth of, and financial investment in, health improvement programs that employers have implemented, as well as the challenges employers face in measuring the success of these programs. The survey revealed three key findings: 1. Employers are investing in numerous health improvement programs. 2. Few employers set measurable goals or are able to calculate the return on their investment in these programs. 3. Employers underestimate the investments they make in health improvement programs.
A Healthy Bottom Line
The motivation for creating an incentive-rich environment stems from the difficulty many companies have in encouraging employees to participate in comprehensive wellness programs. An annual survey by the National Business Group on Health reports that the No. 1 obstacle to improving employee health and reducing health costs is low levels of employee engagement.
Get ready for a healthy rise in medical expenses
A survey by the National Business Group on Health, a nonprofit that advocates for large employers on health care issues, found that nearly half of companies require workers to refill maintenance prescriptions by mail order. Another 37 percent of employers have mandatory generic substitution, which requires that you opt for the generic version of a drug, if available. (In both cases -- mail-order prescriptions and generic alternatives -- you can still opt to go to a retail pharmacy or take the name-brand drug, but you won't receive the typical reimbursement.) Make sure you speak to your doctor about generic options or get up to date on the cheapest way to fill a prescription. Also, be ready for new rules for employer-provided medical accounts (such as a flexible spending account), which allows you to put aside pretax dollars for qualified medical costs. Starting in 2011, the list of approved expenses is shrinking: Over-the-counter drugs will no longer qualify unless prescribed by a physician.
Consumer Driven Plans Continued to Grow in 2010
Helen B. Darling, president and CEO of the National Business Group on Health, maintains these plans will continue to grow in number. We're seeing slow and steady growth with this model. Just as there was slow and steady changes until more Americans were in managed care plans or PPOs, now we've got CDHPs. We think in a few years the changes will be more substantive," says Darling. Starting next year, that growth will accelerate. In our research, we're seeing that 20 percent of the businesses we surveyed are going to put in CDHPs at 'full replacement,' meaning the entirety of their health plan.
Law Prompts Some Health Plans To Cut Mental-Health Benefits
The National Business Group on Health surveyed large corporations and found that 89% reported having to make some changes to their plan to be compliant with the law, and 18% increased deductibles to cover the new costs. "The big issue with employers is, 'Well, how much is this going to cost?"' said Doug Nemecek, Cigna's senior medical director for behavioral health. They also want to know what limits they can have, if any, on mental-health benefits.
Fighting a Growing Global Issue Through Workplace Wellness
Large employers in the U.S. are investing in programs to counter obesity. Fifty-two percent of large employers offered weight loss programs in 2009, explains LuAnn Heinen, vice president of the National Business Group on Health (NBGH). These large employers offer onsite fitness centers, assessments on healthy food choices, and include coverage for registered dieticians in their health plans. For U.S. employers with global operations, the need is also paramount. While it is crucial for employers to take the same initiative in overseas operations, management must be sensitive to the local culture and infrastructure, says Jayne Lux, vice president of the Global Health Benefits Institute. U.S. employers can take critical steps to address the impact of obesity in their international operations and ensure that healthy choices are the easy choices. * Start at the Top - A company wide health initiative must start with top management in the U.S. and filter through all layers of an organization across the globe. * Involve all Stakeholders - Leverage governmental programs and partner with local management and employees to ensure that all involved will understand, champion and participate in the initiative. * Offer Nutritious Food - Provide healthy and nutritious food in company cafeterias and vending machines. * Get Physical - Encourage employees to walk and cycle to work and to take the stairs and regular exercise breaks. Install on site gyms and provide subsidies for public transportation and gym memberships. * Provide Ongoing Support - Ensure that employees have access to individualized counseling and support.
Law Will Proceed, Administration Says
WASHINGTON -- A court decision striking down a central provision of the new health care law will not disrupt efforts to carry it out, even though the ruling could increase confusion and embolden critics, Obama administration officials and employers said Monday. Helen Darling, the president of the National Business Group on Health, which represents more than 300 large employers, said she doubted that the law could be made to work if people were not required to buy health insurance. There is no alternative, Ms. Darling said. She predicted that, in the absence of a coverage requirement, the law would collapse as premiums rose to reflect the high cost of covering people who were less healthy than average.
Transparency Gaining Steam
Helen Darling, president and CEO of the National Business Group on Health in Washington, says that with the big jump in companies offering CDHPs this year, employers -- and employees -- need as much medical information as possible so informed decisions can be made. "An employer should be spending a fair amount of time making certain they give employees choices that allow them to maximize opportunity for savings," Darling says.
For a thin employee, a fat bonus
Studies have begun offering some evidence that incentives can change behavior. A survey by the National Business Group on Health, in coordination with consulting firm Watson Wyatt, found employees were more likely to join lifestyle-management and wellness programs when offered a financial inducement.
Employers' health-care costs soar
The cost to employers of providing health benefits soared 6.9 percent on average this year, according to a national survey released last week, an increase some experts say was driven by the growing use of expensive imaging devices in hospitals and an expanding population of aging and obese patients suffering from chronic conditions. Helen Darling, president and chief executive of the National Business Group on Health, a nonprofit membership organization consisting of some of the largest corporations in the nation, said the new health care law could add to medical costs next year. The law requires "that you have to cover dependents up to age 26," said Darling, who also was not involved in the Mercer study. That and other provisions of the law could add "one full percentage point alone" to the costs.
Where you live = how you die
Health care changes in 2011 remain minor for most
One of the biggest changes people will see is in health savings accounts and flexible spending accounts. Those programs allow employees to contribute pre-tax earnings for health care expenses, including co-pays and deductibles, medication and disease maintenance products. Next year, consumers can no longer use that account to buy over-the-counter medications unless they have a prescription. According to the nonprofit National Business Group on Health, that move will generate $10 billion in the next 10 years and make the accounts less valuable, since many people use them largely for those types of expenses.
Health Industry Cool To Complete Repeal Of New Law
Employers, particularly large employers, have already put considerable time, effort and money into implementing the parts of the law that have already taken effect. And just the possibility that the law will be repealed or substantially changed could present a serious problem. "It takes a long lead time to execute any policy, so at this point having a lot of uncertainty and policy volatility really works against helping us to move toward solving the problems of the country," said Helen Darling, president of the National Business Group on Health, which represents many of the Fortune 100 corporations. Plus, says Darling, with the number of uninsured Americans at 50 million and growing, "starting over would make it virtually impossible to make real progress anytime soon." That's not to say that the health care industry loves the law. No segment of the industry got everything it wanted, and everyone is busy lobbying for something to be changed. "There are plenty of opportunities for improvement, fine-tuning and actually adding some significant enhancements, especially in controlling costs," Darling says.
As feds look to cut costs, lower-premium health plans gain enrollees
More enrollees in the Federal Employees Health Benefits Program's popular nationwide fee-for-service plans are choosing insurers' lower-cost options -- likely a reaction to years of rising premiums. According to Pricewaterhouse Coopers Health Research Institute, medical costs in the U.S. are expected to rise 9 percent in 2011. The National Business Group on Health estimates that health care benefit costs will increase an average of 8.9 percent. The California Public Employees' Retirement System has meanwhile approved an overall 9.1 percent increase in health premium costs.
Health savings accounts make insurance sense for many
Reasons to consider a health savings account (HSA) over a flex account: "Money for retirement health care expenses. If you enjoy exemplary health and rarely touch your HSA, you can use money from your account to pay for medical expenses when you retire, says Helen Darling, president of the National Business Group on Health. That's significant, she says, because even with Medicare, retirees often have large out-of-pocket medical costs. "Lower premiums. In most cases, the higher your deductible, the lower your monthly premiums. But to determine whether the trade-off is worth it, you need to sit down with your enrollment documents and a calculator, Darling says.
Flex spending accounts less flexible under new health law
Relatively few employees use these accounts, but many of them who do suffer from chronic illnesses and rely heavily on the accounts. "Statistically it's not many, generally less than 20 percent of employees have anything in a flexible spending account but the small number who do can have very big expenses," said Helen Darling, president of the National Business Group on Health.
Employers ready to raise the stakes for health incentives
"Employers see unhealthy lifestyle as the biggest barrier to providing affordable healthcare coverage," says LuAnn Heinen, vice president of the National Business Group on Health, a nonprofit association of large U.S. employers. That perception seems justified. A study by Duke University published in October's Journal of Occupational and Environmental Medicine found that annual U.S. employee health and productivity costs associated with obesity alone are an estimated $73.1 billion. And there's no sign of that expense decreasing. Wellness programs have, so far, mostly brought employers only modest cost savings, if that. A historically low level of employee participation is the main reason experts cite. "You launch programs, and 10% or 15% of the eligible population participates. If you get to 20%, you're doing really well," Heinen says. The types of activities and incentives employees will see are likely to expand next year. "But you'll have to do more to get them," Heinen says. "It's about doing something, rather than just taking a questionnaire." A 2010 annual survey of 507 employers by Towers Watson and the National Business Group on Health found that 42% of large firms will require employees to complete health coaching or a disease management program in order to earn a financial incentive in 2011. And 17% said they either had in place or were considering plans in which employees would have to maintain a healthy body mass index (BMI), normal blood pressure or cholesterol levels, or show improvement toward those goals to earn their reward.
Health insurance options may be changing
If you select a new plan, or your employer offers new plans, you might find that there are more safeguards included, by law, in your coverage: Free preventive care, no limits on the lifetime value of your coverage and your adult children, up to age 26, can stay on your plan, no matter what state you live in. But with those changes (and even if the changes hadn't taken effect), you can expect to pay more for health insurance coverage next year. Survey after survey of employers large and small has shown businesses are expecting their own insurance costs to rise anywhere from 6 to 10 percent in 2011. One survey, by the National Business Group on Health, forecast a 9 percent increase in total costs. "The main thing is to read the material," said Helen Darling, president of the National Business Group on Health. "The plan that is good for [employees] now may not be the best one for them next year." Generally, if coverage costs go up for the employer, the business will pass on about 20 percent of that increase to employees and eat the other 80 percent, Ms. Darling said. But employers are trying to be more flexible in how those costs are being passed along, meaning you might have more options when it comes to high-deductible health plans. Those cost more when you use health services, but less will come out of your paycheck each month.
5 Tips For Acing Open Enrollment
Employer-sponsored health expenses will rise nearly 9% in 2011 over last year, according to the National Business Group on Health. A lot of employers are passing along these costs to employees via higher out-of-pocket costs and copays. Scrutinize higher copays and premiums. Copays -- such as for emergency services and specialty care -- will likely be increased, says Helen Darling, president of National Business Group on Health. Employers are also increasing premium prices. To save money, check out your company's insurance plan options. Big companies usually offer at least three. Calculate costs by going to the company -- or plan -- website and entering parameters on the calculator. "It will calculate the best plan for you," says Darling. Employers also offer incentives to employees to improve wellness while reducing premiums, such as getting health assessments or maintaining a healthy lifestyle. "You can save about $386 per year," she says. "If you have a health savings account, look at high-deductible plans carefully," says Darling. "If you're a smart consumer, you might be better off with one." The exception: family plans, in which there are more costs. Darling says that many people don't make any changes during open enrollment. "Use company tools and resources," she says. "If there's an 800 number, call it. A lot of people spend more money than they should."
Some Companies Shift Health Costs to Better Paid
It feels so much worse this year than it has in prior years, said Helen Darling, president of the National Business Group on Health, which represents employers providing health benefits. If health care reform hadn't happened, there would be more companies going in this direction, said Ms. Darling, alluding to the period between the law's passage this year and 2014, when it is expected to take full effect.
Health care law brings many expensive changes to FSA, HSA use
The move was designed to help pay for health care reform legislation and is expected to generate $10 billion in 10 years, says Steve Wojcik, vice president of public policy at the National Business Group on Health, a nonprofit organization that represents large employers on national health policy issues. The change "certainly makes HSAs and FSAs less valuable," Wojcik says, though the accounts still can be used for things such as doctor visit co-pays, dental work or other over-the-counter medical supplies. Another short-term option could be stockpiling over-the-counter medicine, though Wojcik warns shelves could be bare come late December, if everyone tries to do so at the last minute.
Open enrollment time is back: Make sure to read fine print
In each of the plans pay special attention to the covered benefits, monthly premiums and other out-of-pocket costs. Chances are they are all going up. In fact, a recent survey of large companies by the National Business Group on Health found that 63 percent of employers plan to increase the percentage of health insurance premiums paid by employees in 2011.
Open enrollment: A year to pay attention
In 2011, 63 percent of employers will raise the percentage employees contribute to premium costs, 46 percent will increase out-of-pocket maximums, while 44 percent will increase in-network deductibles, according to the Washington, D.C.-based National Business Group on Health, which surveyed 72 large employers.
Future murky for health care reform law
Workers: Brace for health care cost hikes in 2011
The National Business Group on Health, a nonprofit representing large employers, said a recent survey of corporations showed many plan to use more cost-sharing strategies to control rising insurance costs. Sixty-three percent plan to increase employee premium contributions; 46 percent will raise out-of-pocket maximums; and 44 percent will increase deductibles for in-network services.
Five ways GOP might untrack health reform
After speaking with experts, we've compiled the following list of five things Republicans might do to disrupt the implementation of the Patient Protection and Affordable Care Act. 1. "Repeal and replace." Despite presumptive Speaker of the House John Boehner's call for repeal, Daniel Sulton, partner with Ford & Harrison LLP, believes this is a long shot. In the realm of possibilities, this option "probably ranks pretty low on the list," he says. After all, the Republican Party does not have sufficient votes to push repeal through the Senate, and even if they did the President would exercise his veto power and neither Houses of Congress would be able to override a veto. "A lot of [the "repeal and replace" language] was campaign rhetoric. Realistically, the President is not going to sign legislation that significantly alters one of his signature legislation," says Steve Wojcik, vice president of public policy at the National Business Group on Health. So not until 2012 would they likely have the ability to repeal the entire law. 5. State-level intervention. Due to large GOP gains in gubernatorial and state legislature contests, Republicans could begin to pass mandates stating that the states would not be obligated to enforce an individual mandate or incur additional expense on health care reform. Further, the Republican majority of Governors are tasked with implementing Medicaid expansions as well as the state-run health insurance exchanges for small businesses and the uninsured. They could decide how many resources go into developing exchanges with the option not to develop exchanges and leave their set-up to the Federal government. "One important factor in the election was the pick-up at the state level. The states have a significant role in implementing this health care law, in terms of the exchanges and the Medicaid expansions. The elections have profound implications at the state level possibly even more than the congressional level here in Washington," Wojcik informs. Wojcik believes Congress will primarily focus on jobs, and adds that it wouldn't be wise to spend too much time on health care repeal or retardation because if they do, then they will be in the same position the prior congress was in.
It's open enrollment season on your wallet
This is the time of year when employees often have to make choices about their healthcare coverage for the following year. It's called open enrollment season, but this year, it may feel more like open season on your wallet. With government-mandated changes that broaden health care coverage, the policies have gotten better (they typically will pay 100 percent of preventive care, for example), but they've gotten more expensive, too. The National Business Group on Health, a group representing large employers, estimates that premiums for company-paid plans will rise about 8.9 percent next year. Those low deductibles will cost you. You will pay for them in every premium, says Helen Darling, president of the National Business Group on Health. People often work against their own economic interest, but you should realize that you can actually save a lot of money by choosing a plan that costs you less out of your paycheck. If you can afford to meet higher deductibles and copays on your own, you can opt for a plan that has lower premiums and save money in most years.
Push for High-Deductible, HSA Plans Gain During Benefit Enrollment Season
Helen Darling, president of the National Business Group on Health, based in Washington, a membership organization representing large employers, says companies need to clearly communicate the potential cost savings to employees. It's a huge paradigm shift for employees, she says. Employees have to pay attention. In some cases they may have to pay for their office visits. Americans have gotten used to having everything covered. You just pay a copayment and then you get your notice of benefits. This is a very different experience. It's a major change management and communications challenge, and employers have to be ready.
Large firms seek to change, not repeal, health law
Big companies have been consumed with the details of complying with the law's most immediate requirements, including allowing adult children to remain on their parents' policies until age 26 starting next year, said Steve Wojcik, vice president for public policy for the Washington-based National Business Group on Health, which represents more than 300 large employers on national health-policy issues. They're saying this is the law, this is what we need to do, so let's just focus on that, Wojcik said. We know there's a climate of uncertainty, but we need to act on what the law requires us to do now. A key priority for large employers is making sure the administration of new government requirements is as simple and straightforward as possible, he said. With changes to health benefits for the 2011 open-enrollment season already worked out, big employers are turning their attention to two of the provisions next in line for them to address: how to calculate the value of employees' health benefits to include on their W-2 forms and how to automatically enroll workers in a default health plan of the employer's choosing when necessary. There are some ambiguities about how to value the benefit and what to report, he said of the W-2 issue. Longer term, large employers would like to see the law adjusted to crack down on rapid health-care cost growth, Wojcik said. We hope there's an increased effort to really address the cost drivers in health care, which was promised in the beginning of the process and then dropped along the way.
Three Financial Reasons to Get a Flu Shot
Flu shots are often free. Many companies offer free flu shots. According to a National Business Group on Health survey, 79 percent of employers that have consumer-driven health plans (also known as high-deductible plans) offer free flu shots, while 67 percent of employers with traditional health insurance benefits offer free flu shots to workers. If your employer doesnt give shots for free, expect to pay anywhere from $25 to $29 this flu season, the CDC says.
How will the election affect your finances?
Your health insurance. You'll keep those early consumer protections, like the ban on lifetime payout limits and the right to keep your 20-something kid on your policy. Republicans will try to chip away (or kill) the big central point of the legislation -- the requirement that companies offer and individuals buy coverage. But that won't happen as long as Barack Obama holds the veto pen. What you will see is a lot of theater in the form of argumentative oversight hearings, says Helen Darling, president of the employers group, the National Business Group on Health. "They will focus on things that embarrass the regulators." That could cow rulemakers into writing rules that fall easier on the insurance and medical industries around the edges: Limiting the kinds of things that are considered preventive care or the appeals process for consumers who want to fight their insurance company, for example.
Employers Blame Reform for Premium Rise - but Maybe It's Just Politics
In any case, few provisions of the Affordable Care Act have gone into effect yet. Those that have - such as elimination of pre-existing condition exclusions for children, extending dependent coverage to age 26, and the first step toward eliminating lifetime coverage caps - may account for 2.5 to 5 percentage points of the overall increase in insurance costs, according to one benefits consultant. But Helen Darling, president of the National Business Group on Health, says the reform-related portion of the increase is only about 1 percent.
Eligible expenses change next year for flexible spending accounts
Drugstores are busy places in December, and it's not just because scented soap and singing toothbrushes make excellent last-minute holiday gifts. They also get a lot of business from people looking to spend what's left in their flexible spending accounts before they're forced to surrender the balance. That could change next year. New restrictions that take effect Jan. 1 will make it more difficult to burn off money in your flex account by stocking up on aspirin and cough syrup. With benefits enrollment season under way at many companies, it's important to understand these changes before you decide how much to contribute to your 2011 account. It does mean, though, that you'll need to plan ahead. If you already have a doctor's appointment scheduled this year and know you'll need to buy over-the-counter drugs in 2011, ask your physician to write you a prescription in advance, says Helen Darling, president of the National Business Group on Health. That will save you the cost of scheduling another appointment to get your prescription.
Health care costs rising, but there are ways to tackle costs
The big question, of course, is will costs ever come down? There's no evidence to suggest they will, said Helen Darling, the president the National Business Group on Health, a non-profit association of large employers. She said we can try to drive them down, but we can't force them to. While she estimates the health care reform law is probably only adding about 1 percentage point to the expected health insurance increases for next year, in the end the biggest problem may be in the mirror. We should blame ourselves and change our behavior, she said, referring to employees, employers, insurers and health care providers.
Firms Push Wellness
General Mills has a corporate culture that consistently encourages workers to stay active and healthy. Among other things, employees conduct business meetings while walking, cross-country ski on campus during "Fitness Fridays" and attend cooking classes. It's part of the consumer-products company's long-established wellness program, which General Mills says has helped it keep increases in health-care costs in the single digits, way below the national average. LuAnn Heinen, vice president of the National Business Group on Health, says some companies are even experimenting with placing stationary exercise equipment outside of the company gym so people can, say, check emails while exercising.
Flexible spending account rules changing in 2011
This new rule won't take effect until Jan. 1, but if you put money into an FSA account, it's worth thinking about now, because some doctors may require an office visit to get the qualifying prescription. It makes sense to ask for the documentation during a visit already planned, says Helen Darling, head of the Washington, D.C.-based National Business Group on Health, which advises large firms on handling employee health expenses. No plans to see the doctor any time soon? Darling suggests asking a physician to e-mail, snail-mail or fax a prescription based on a recent visit without an office visit. Keep in mind, though, that some doctors' offices may charge a fee - though probably smaller than the cost of an office visit - for handling paperwork. Darling says she hopes the new changes raise public awareness about FSAs and induce more people to set aside funds in the accounts.
No quick savings for 'doing it right'
In many ways, Baptist Health South Florida does everything right to keep its employees healthy, including subsidizing on-site gyms open 24-7 and offering discounted low-fat meals in its hospital cafeterias. With its 13,500 workers making it the largest nongovernment employer in South Florida, it has been a leader in such wellness initiatives for at least five years. In theory, such moves help keep healthcare costs down. Such activities have gained Baptist plenty of recognition, including five platinum awards for Best Employers for Healthy Lifestyles, presented by the National Business Group on Health, and a Pioneering Innovation Award from the Centers for Disease Control and Prevention for its obesity and control programs.
Health benefits open enrollment season is here
A National Business Group on Health survey of 72 large employers conducted this spring and summer projected health-care costs to increase an average of 8.9 percent in 2011, slightly higher than the 7 percent increase in 2010. Of the companies surveyed, 63 percent expected to increase employee percentage contribution to premiums, 46 percent expected to increase out-of-pocket maximums and 44 expected to increase in-network deductibles.
Is a high deductible health plan right for you?
HRAs can also be rolled over year-to-year, but that's often where their similarity to HSAs ends. Employers have a lot of flexibility in designing HRAs, to the point where some plans may look exactly like traditional HMOs, with co-pays, preferred provider networks, and the like. Unlike an HSA, the HRA doesn't have to be portable - it's up to the individual employer to decide whether you can keep the money when you leave. It's really the company's money, explains Steve Wojcik, vice president of public policy for the National Business Group on Health. It's not an actual account. It's just a promise that they'll pay your medical expenses.
Research shows cost of employee obesity
Navigating the Fallout
The news reports have been pretty continuous -- companies and organizations threatening to cancel employee- or retiree-healthcare plans because of an unwillingness or inability to comply with regulations and restrictions in the healthcare-reform law. Word first broke in May that AT&T, Verizon, Caterpillar and John Deere were all considering dumping their healthcare coverage in exchange for paying fairly hefty penalty fees to the government. Those considerations are ongoing. Then a survey, released in August by the Washington-based National Business Group on Health, showed a majority of large employers revising health-benefit programs for 2011 in response to the legislation -- with nearly two-thirds (63 percent) planning to increase premiums for employees and 60 percent considering dropping retiree-health coverage in the future.
Prescription Abandonment: Walk-Aways Aren't Just for Mortgages Anymore
Don't expect the increased cost-sharing to end anytime soon; a recent survey of big employers by the National Business Group on Health found that companies expect to mitigate the burden of higher health costs by passing more on to their workers via higher premiums and higher out-of-pocket limits.
Microsoft to employees: Pay for health care
WASHINGTON:Microsoft Corp, the world's largest software company, said it will require employees to contribute to their healthcare benefits starting in 2013, citing the rising cost of providing worker coverage. Some of the largest companies in the US project a median 8.3 per cent increase in healthcare costs next year, according to the National Business Group on Health, a Washington-based nonprofit organization. Microsoft may be considering a "modest" change in benefits, said Helen Darling, the group's president. "Even with the evolution and changes they have in mind, which I think are modest, it will still be way up there in terms of comprehensiveness and relatively low cost to the employee," Darling said. Her group has nearly 300 members, including Microsoft.
What's Happening to Your Health Plan?
There isn't much that you can do about cost shifting, but you can cut costs in other ways. Helen Darling, who runs an employer coalition called the National Business Group on Health, advises employees to take advantage of the cost calculators on insurers and employers' websites to figure out how rich a plan they really need. "Most people are going to be better off taking less out of their paycheck," she says, than having gold-plated coverage.
Microsoft Workers to Contribute to Health Care Plans
Microsoft Corp., the world's largest software company, said it will require employees to contribute to their health-care benefits starting in 2013, citing the rising cost of providing worker coverage. Some of the largest companies in the U.S. project a median 8.3 percent increase in health-care costs next year, according to the National Business Group on Health, a Washington-based nonprofit organization. Microsoft may be considering a modest change in benefits, said Helen Darling, the group's president. Even with the evolution and changes they have in mind, which I think are modest, it will still be way up there in terms of comprehensiveness and relatively low cost to the employee, Darling said. Her group has nearly 300 members, including Microsoft. The average U.S. employee contribution to health-care plans is 20 percent, Darling said.
Open-enrollment season brings more benefits pain
As October once again brings open-enrollment season, the annual check-up to see how much more of our paycheck will go to health benefits, workers are anticipating higher premiums, bigger deductibles and more coinsurance. They're right to worry. Even as the economy recovers, containing costs will remain a corporate imperative. Employers expect healthcare expenses to increase nearly 9 percent in 2011, according to a National Business Group on Health (NBGH) survey released in August. Much of that jump will be passed along to workers: two-thirds of firms reported they expected to increase the portion employees will contribute to premiums, and nearly half will hike up deductibles or out-of-pocket costs, or both. Most companies are doing what they can to keep underlying costs as low as they can, said Helen Darling, NBGH's president. But they do expect workers to share in more of the burden. Another easy way to save is adding to a flexible spending account (FSA). Workers can contribute pre-tax monies to pay for health-related expenses, including deductibles or co-pays, and some employers even match these funds. In 2011, there is no limit on how much can be added to a FSA. With taxes rising this year, this is essentially a gift from the federal government that everyone should take advantage of, Darling said. Doing so could mean more than 30 percent more pay in certain tax brackets. Lifetime or annual maximum payouts have also been prohibited, and all new insurance plans are required to provide free preventive care, such as mammograms, flu shots and cholesterol tests. Citing the high cost of such reforms, some companies have threatened to scrap insurance coverage altogether for employees. Others are muddling through, trying to determine how the new regulations affect them. Some plans will be grandfathered in for the time-being, Darling said. Employees shouldn't automatically expect to see all these changes right away.
Survey: More Employers Turn to HRA Plans
Employers are increasingly self-insuring some of their medical benefits to better control insurance costs and save on premiums. A survey released in August by the National Business Group on Health revealed that 61 percent of respondents will offer a consumer-directed health plan in 2011.
Ease the Pain of Higher Health Care Costs
Large employers expect their health-care-benefit costs to rise 8.9%, on average, in 2011, compared with 7% in 2010, according to a survey by the National Business Group on Health.
Narrow Networks: Will you be in or out?
Employers know that quality measurement is imperfect, but they believe it's good enough to use to shape narrow networks, said Helen Darling, executive director of the National Business Group on Health. Business leaders think that physicians' "style of practice" -- how likely they are to order tests or prescribe certain drugs -- drives up the cost of health care, she said. Using a narrow network strategy to deal with that difference in care has yet to be proved, but employers at least feel ready to try it out. "If we are right about both hypotheses, about quality and practice style, then the best network should deliver the highest quality at the most reasonable price," Darling said.
Have Illness, Will Travel?
Two years ago, Bob Ihrie, senior vice president of employee rewards and services for home-goods retailer Lowe's, decided to investigate "medical tourism" as a potential way to reduce health-care costs. The basic idea: have employees travel to places like Costa Rica or Singapore for certain surgeries that cost thousands of dollars, if not tens of thousands, less than U.S. hospitals typically charge. So far, however, this intriguing concept has remained just that. Few companies have signed up, and even fewer employees have packed their bags. A 2008 study by the National Business Group on Health found no employers offering it, but about 40% planning to evaluate it at some level.
A consumer primer for health insurance changes in 2011
If you buy a lot of ibuprofen, this could affect the amount you put aside in your account. But even with the new restrictions, flex accounts can save you a lot of money, says Helen Darling, president of the National Business Group on Health. In addition to prescription drugs, you can use the money for co-payments, deductibles, and dental and eye doctor appointments. Your plan administrator should provide a list of products and services that are covered by your flex plan. Health insurers must allow adult children to remain on their parents' employer-provided group plans until age 26. This is the most significant change taking effect this year, Darling says. In the past, many employer-provided plans wouldn't cover a child unless the child was claimed as a dependent on the parent's tax return, and some required that the child live at home, Darling says.
Health Care Law May Hamper Limited Insurance Plans
Limited benefits plans have grown popular the past few years as health care costs have climbed, said Steve Wojcik, vice president of public policy for the National Business Group on Health. Employers in the retail or hotel industries offer this basic coverage as a way to keep workers and improve employee productivity by cutting health-related absences.
Higher Healthcare Costs in 2011
WASHINGTON -- The amount employers spend on their workers' healthcare costs will reach a five-year high in 2011, and employees will also face larger out-of-pocket costs for their medical care next year, according to a forecast released Monday by the consulting group Hewitt Associates. Because of higher medical claim costs, an aging population, and changes under the new healthcare reform law, employers can expect to pay nearly 9% more toward their employees' healthcare costs than they did in 2010. The findings are in line with a recent survey by the National Business Group on Health that asked large employers what they expected to pay for their workers' medical costs in 2011. The answer: about 9% more than in 2010.
Facial Stress: Worker tension can be costly for companies
Companies could end up paying the cost through more workers calling in sick, more job-related mistakes and higher turnover. For years, experts have said a little bit of stress is good. But they were referring to the short-term jolt that comes before making a presentation, not the extreme kind prevalent in workplaces today. "We're way beyond the level of it being motivating," said Helen Darling, president of the Washington-based National Business Group on Health.
Will healthcare reform lead to higher premiums?
Another recent study by the National Business Group on Health (NBGH) found nearly two-thirds of employers planned to ask employees to contribute more toward their premiums in 2011. Insurers across the country have blamed new requirements under the health reforms for raising premiums by as much as nine percent. Furthermore, several major carriers, including Cigna, WellPoint and CoventryOne, have already said they will end child-only health policies rather than extend coverage to children with pre-existing conditions, as the Affordable Healthcare Act stipulates as of September 23. How to insure all Americans was a very important issue we needed to solve, and this is a start down that path, said Helen Darling, NGBH's president. What is still worrisome is that there is nothing in the law that controls costs.
CONSUMER HEALTH: Health-Care Changes Kick In
Will my health-plan costs rise because of the new benefit requirements? That depends. A recent survey of large employers from the National Business Group on Health suggested the new rules related to health overhaul will add about 1% to the cost growth projected for their 2011 health plans. Many employers are scouring their plan designs for ways around cost problems.
Debating the Costs of Prevention and Wellness
Still, while longevity may present problems from a federal fiscal standpoint, it is proving beneficial to employers. According to Helen Darling, president of the National Business Group on Health, who also participated in today's summit, more employers are turning to wellness programs to get their employees fit. Healthy employees drive down insurance costs, in addition to reducing absenteeism and improving productivity. Employers who offer wellness programs will now be able to get a refund of 30 percent of the cost on insurance plans, as part of the Affordable Care Act.
A consumer's guide to health care overhaul, 6 months in
Q. Will my health insurance cost less? A. Probably not. Health insurance premiums have been increasing steadily over the last decade, and that trend is continuing. According to a new report from the Kaiser Family Foundation and the Health Research & Educational Trust, workers nationwide on average are paying 14 percent, or $482, more for family health insurance coverage this year than they were last year. Employers, struggling with the recession, aren't increasing their share. Instead, they're shifting more costs onto employees, according to the survey. (Kaiser Health News is a program of the foundation.) A recent study by the National Business Group on Health found that almost two-thirds of employers planned to ask employees to contribute more toward their premiums.
Aging in Place - A Graceful Living Option for Seniors
Like other large companies, Pitney Bowes offers a panoply of support services to its 22,000 U.S. employees, including flexible work arrangements, caregiver support groups, online tutorials for end-of-life legal issues, and counseling on hospice and palliative care. Along with General Electric, PepsiCo and IBM, Pitney Bowes is working with the National Business Group on Health to design an end-of-life toolkit for employers that will offer guidance for employees who are giving care to someone with a terminal illness.
Employers strive to minimize 2011 increases
Plan for Changes in '11
Employees need to pay extra attention during open enrollment this fall. Health-care benefits are expected to improve for many workers, but choices are expected to be more complicated and expensive as employers try to comply with the Patient Protection and Affordable Care Act, which will be phased in over a few years. Among the changes to expect: additional coverage for young adults, well care and pre-existing conditions, but also higher premiums, co-pays and out-of-pocket expenses, according to industry surveys. Most employers also plan to increase efforts that encourage workers to participate in health-and-wellness programs. "This is not the year to stay where you are," says Helen Darling, president of the National Business Group on Health, a nonprofit association of large employers. "Look at all the ways you can reduce your own costs." That, she says, includes purchasing generic pharmaceuticals, using urgent-care centers when an emergency room isn't necessary and staying healthier by losing weight, exercising and not smoking.
Employees' health costs likely to rise
A majority of large U.S. employers plan to make major changes to their health care plans in 2011, according to a National Business Group on Health survey. The survey found that 63 percent of employers plan to increase the percentage employees contribute to the premium, up from 57 percent in 2010. The survey was based on responses from 72 of the nation's largest corporations representing more than 3.7 million employees.
Record rise in U.S. uninsured: 50.7M
Although the health care law signed by President Obama in March is designed to insure an additional 32 million people in public and private programs, it doesn't fully kick in until 2014. For the next few years, experts say, the problem could get worse. The average cost to insure a family of four is already about $14,000. "Eventually, more people will be covered if everything goes the way it should starting in 2014," says Helen Darling, president of the National Business Group on Health, which represents large employers. "But that's four years away, and there's going to be a lot of financial pain and economic burden before 2014."
Health reform begins: What changes mean to you
Q: Will my health insurance cost less? A: Probably not. Health insurance premiums have been increasing steadily over the last decade and that trend is continuing. According to a new report from the Kaiser Family Foundation and the Health Research & Educational Trust, workers nationwide on average are paying 14 percent, or $482, more for family health insurance coverage in 2010 than in 2009. Employers, struggling with the recession, aren't increasing their share. Instead, they're shifting more costs onto employees, according to the survey. (KHN is a program of the foundation). A recent study by the National Business Group on Health found almost two-thirds of employers planned to ask employees to contribute more toward their premiums.
SOS: Recession-era work force riddled with stress
For years, experts have said a little bit of stress is good. But they were referring to the short-term jolt that comes before making a presentation, not the extreme kind prevalent in workplaces today. "We're way beyond the level of it being motivating," said Helen Darling, president of the Washington-based National Business Group on Health. "It will be hard to recover economically if we don't find better ways to help employees address stress." Walid Wahad, owner of Wahad Construction, a high-end Miami homebuilder, confronts on a daily basis the stress of luring new business and keeping his staff employed. "As a business owner, my responsibility is not to panic or panic privately," he said "I have to put on a positive face in front of my employees." Surprisingly, while his type of stress is echoed by most corporate executives, studies show head honchos are less at risk for health issues than one would expect. As it turns out, it's not really the high-powered, fast-paced executives succumbing to stress. Those who suffer most have unsupportive bosses or hold lower-level jobs with little control over their schedules or work culture, according to studies by the famed neuroscientist Robert Sapolsky. Sure, staying late at the office night after night can be exhausting, but it's not going to kill you. The person most at risk for stress-induced heart disease isn't the executive with an endless to-do list - it's the frustrated janitor, the legal secretary with worries about job security, or the single mother with no flexibility in her hours. Meg Florian, project manager at Wahad Construction, finds that her stressors are different from Wahad's. "I deal with a lot of subcontractors, and I find people just don't pay attention. You have to repeat yourself. There's a lack of care and focus." Trying to fix mistakes, she said, causes her stress. Florian says she hasn't found a release - yet. She is considering yoga. Wahad sets the example for his employees; he has fit yoga into his routine for 20 years. He says it makes him a better boss and person. "I leave the company after a day with anxiety, about maybe something that went wrong. Yoga is a filter I go through before I get home. ... All the negative energy, I leave it there." By now, most employers know their workers are dealing with stress, not all of it business-related. "On top of the stress in the workplace, they are stressed about their finances, their kids, their parents. There is so much to worry about right now," Darling said. "That won't change until the economy turns around."
Poor working conditions contribute to employee meltdown
Companies could end up paying the cost through more workers calling in sick and more job-related mistakes. "We're way beyond the level of [stress] being motivating," said Helen Darling, president of the Washingtonbased National Business Group on Health. "It will be hard to recover economically if we don't find better ways to help employees address stress."
Businesses Tackling End-of-Life Issues
The goal of employers with such programs is to help workers plan ahead and make informed decisions about the future, says Pam Kalen of the National Business Group on Health, which is developing a tool kit for employers interested in setting up a program.
Large Employers Are Still Unsure About the Future of Retiree Drug Benefits
According to a recent survey, a majority of large employers are still undecided regarding whether to make any changes to retiree drug benefits in anticipation of taxation of the Retiree Drug Subsidy in 2013. Under the recently enacted health reform law, the RDS will cease to be deductible, and the 28% subsidy will be subject to a corporate tax effective Jan. 1, 2013. According to the National Business Group on Health's annual survey of large employers' 2011 health plan design changes, released Aug. 18, 69% said they had the issue "under review." The survey was conducted in May and June and is based on responses from 72 large corporations representing more than 3.7 million employees.
Health insurance costs to rise under health-care reform
Companies are not waiting for 2014 to begin to adjust their health insurance plans in the wake of the new law. They expect an 8.9 percent rise in their health-care benefit costs next year, up from 7 percent this year, according to a survey of 72 of America's largest companies released last month by the National Business Group on Health. As a result, just under two-thirds of these employers planned to increase the percentage that employees contribute to the premium; 46 percent expected to raise the limits on what workers pay out of pocket before coverage kicks in, the survey found.
Open enrollment changes for 2011
This fall, during your employer's open-enrollment period, you can expect to pay more for plans recently modified in the health care overhaul. A recent survey of large companies by the National Business Group on Health found that employers estimate their health care benefit costs will increase by an average of 8.9 percent in 2011, compared with an average increase of 7 percent this year. These employers are continuing to boost premiums and co-payments, but they're also beefing up programs that encourage employees to lower their medical expenses.
A World Without Open Enrollment?
The National Business Group on Health in Washington, which represents large company members, reported last month that its members expect increased costs of almost 9 percent, up from 7 percent in 2010.
Cost-shifting rises in poor economy
Government Declares War On Small Business
According to the National Business Group on Health, the typical large business will see its health insurance costs rise 9% next year.
Employers Push Costs for Health on Workers
Companies may be at a point where they are no longer willing or able to protect their workers' health benefits, said Helen Darling, the president of the National Business Group on Health, an organization representing employers that provide coverage. She says that companies expect that their costs will only go up more under the new health care law because it requires them to provide more benefits, like coverage for preventive care. "There's a sense we can't keep up," Ms. Darling said. "We can't afford to continue to subsidize what's happening." Her group's own survey, conducted last month, found that almost two-thirds of employers said they planned to increase the percentage their workers would have to contribute toward premiums next year. More employers may be changing their view of providing health benefits, moving toward contributing only a fixed amount rather than maintaining certain levels of coverage, she said. "It's a portent of the future," Ms. Darling said.
U.S. employers push rising cost of healthcare onto workers
Reporting from Washington -- Strained by rising healthcare costs and the sour economy, U.S. employers are pressing workers to shoulder the added burden alone as employees pay higher insurance premiums and more out-of-pocket expenses for their medical care. The average employer-provided family health plan now costs workers nearly $4,000 a year, up 14% from last year, according to a survey by the nonprofit Kaiser Family Foundation and the Health Research and Educational Trust. That is the largest annual increase since the survey began in 1999 and a marked change from previous years when employers generally split the cost of rising premiums with their employees. Indeed, the average employer contribution to a family plan did not increase at all this year, meaning the entire increase was borne by workers. Overall, premium growth slowed slightly this year to 3%, with the average annual cost of a family health plan reaching $13,370. Workers picked up 30% of that bill. The average plan for a single individual cost $5,049. At the same time, workers also saw average copays for routine office visits rise 10% and deductibles continue their surge upward. In 2010, more than a quarter of American workers with employer-provided health coverage are in plans with deductibles of $1,000 or higher. "It's really bad news for everybody," said Helen Darling, president of the National Business Group on Health, an organization of large employers that provide coverage to about 50 million workers, retirees and dependents.
Workers more stressed than ever
Companies could end up paying the cost through more workers calling in sick, more job-related mistakes and higher turnover. For years, experts have said a little bit of stress is good, referring to the short-term jolt that comes before making a presentation, not the extreme kind prevalent in workplaces today. "We're way beyond the level of it being motivating,' says Helen Darling, president of the Washington-based National Business group on Health. "It will be hard to recover economically if we don't find better ways to help employees address stress.' By now, most employers know they have a stressed-out workforce, not all of it business related. "On top of the stress in the workplace, they are stressed about their finances, their kids, their parents. There is so much to worry about right now,' Darling says. "That won't change until the economy turns around.' Still, most employers haven't figured out what to do about it, and some have no interest in trying. In Topolski's case, she was fired the day after her panic attack. She has since sued her former law firm, Davis Wright Tremaine, for $1 million. Those employers who are attempting to address stress mostly are encouraging workers to use employee assistance programs, which provide mental health counselors. Employee-assistance programs and HR consultants report a notable uptick in calls about job stress in the past two years. Darling says any size business with a health plan should be able to make counseling available to workers. Any additional cost to the employer, she says, is worth it.
Special Report on Health Benefits: Butting In
What is the exit strategy from financial incentives? There's no easy answer, but LuAnn Heinen, a vice president at the National Business Group on Health, suggests that instead of rolling out a new financial incentive year after year, progressive employers try to motivate employees by promoting other tangible benefits, including better sleep, reduced stress and higher productivity. But it remains to be seen whether quality of life can compete with money in motivating employees to become healthier and help companies reduce medical costs.
Rules set process for claims appeals
Employers shifting more toward consumer-directed health plans
More than half of large employers plan to offer consumer-directed health plans next year, many as a means of lowering their health benefit costs. More than six in ten (61%) employers will offer a consumer-directed health plan, with a high-deductible plan combined with a health savings account favored by 64% of those respondents, according to a National Business Group on Health study of 72 large employers' plans. Among employers offering a CDHP, the number moving to a full replacement plan doubled from 10% this year to 20% in 2011. "Consumer-directed health plans are living up to their expectations as a way to help save employers money and put employees in greater control of their health care," said Helen Darling, president of the National Business Group on Health, in a statement. "In fact, offering these plans was the most often-cited tactic by employers to control costs. We fully expect that employer interest in CDHPs, and especially full-replacement plans, will continue to increase in the future."
Employers expect larger rise in plan costs
Competition needed to lower health costs
Employers Tighten Belt on Wellness Programs
The popularity of corporate wellness programs has surged in recent years as employers search for new ways to curb rising healthcare costs. While many of these initiatives have been successful in lowering employee obesity levels and improving the overall health of the workplace, the current economic recession is forcing many companies to make tough choices when it comes to the funding of such programs. LuAnn Heinen, vice president of the National Business Group on Health and director of the Institute on Innovation in Workforce Well-Being, said research has shown that employers still firmly believe in the goals of health and wellness programs, but they are also conscious of the ailing economy and its impact on corporate spending. "They remain committed, but they are looking for ways to make sure their investment is sustainable," she said. "The bar is being set higher, and they want to make sure they are acting economically responsible and only choosing the value propositions." A survey by the NBGH in conjunction with Towers Watson found that a growing number of employers are tightening their requirements for workers to receive financial incentives connected with wellness programs. Researchers found that, while more than half (53 percent) of large employers offer financial incentives to employees who enroll in health engagement activities (such as weigh management or smoking cessation programs), participation alone is no longer enough to earn an incentive. More than one-third of employers (37 percent) now only reward those workers who meet the company's requirements for completion of a health engagement activity, and many (29 percent) only reward employees who participate in multiple activities. Ted Nussbaum, senior consultant with Towers Watson, said that companies are growing frustrated by their employees' low use of expensive health improvement programs. "As employers continue to empower workers to be more health focused, they are beginning to target and reward those workers who demonstrate a real commitment to making positive lifestyle changes," he said. ENGAGEMENT AND EVALUATION Heinen said that the options for corporate wellness programs are limitless, with companies no longer only providing on-site gyms but also providing nutritionists, discounts for fitness programs in the community and a wide range of incentive programs for participating in healthy activities. "There has been an explosion in the wellness field, and there are so many programs that companies are able to layer on," she said. "Companies now have to look where they are getting participation. If you are offering a program option and no one is going, there are going to be no positive outcomes. That's why today you hear everyone talking about engagement." With skyrocketing healthcare costs, employers are realizing that simply cutting back in light of the economy isn't the answer. Heinen said that employee satisfaction surveys and health assessment questionnaires are a solid way of determining where you are getting the biggest bang for your wellness bucks. In addition, companies, she said, should be looking for inexpensive program options that can be implemented without breaking the bank. "I think, first and foremost, employers need to explore and exploit every low-cost and no-cost idea," she said. "Let's not forget what we can do without a significant financial investment." Some of these options, according to the NBGH, include providing walking maps to locations around the community; offering flexible work schedules to facilitate physical activity, stress reduction and self-care; implementing screen savers that encourage employees to take time out each day for one small health improvement task; and distributing apples with wellness brand stickers to employees as they enter the building. Helen Darling, president of the NBGH, said that, although employers face a challenging road ahead, in the end, those companies that are "most effective at empowering their workers to be engaged consumers of care will find greater success at keeping costs low" and will likely be rewarded with a healthier, more productive workforce.
Health-Insurance Changes for 2011
These large employers have already been boosting employees share of the premiums and co-payments over the past few years, and they realize that increasing employee costs cannot be their only solution -- especially because many workers have had stagnant wages and may have a spouse who lost a job, says Helen Darling, president of the National Business Group on Health.
More Businesses Penalize Workers for Unhealthy Living
The survey came out at roughly the same time that another survey by Hewitt and the National Business Group on Health showed how dependent employees are on employers for health insurance. Sixty-one percent of employees who responded said they relied on their employer-provided coverage to cover medical costs. The National Business Group on Health believes federal lawmakers could do more to encourage wellness. It notes that current tax code addresses expenses for disease treatment but not for prevention or for behaviors that maintain health. Among the changes it recommends is redefining "qualified medical expenses" to include expenses used to maintain health and wellness, such as exercise, weight management and nutritional counseling. The organization also advocates that employees be able to use pre-tax dollars to pay for health and wellness activities.
Healthy choices at U.P.
In the latest awards year, U.P. was one of just 16 companies nationwide to earn platinum. It was the only railroad or transportation company among 66 employers recognized, and it was the only company in Nebraska to be honored. Other reasons for the award include an overarching strategy that involves communicating with employees, support from upper management and integrating encouragement with tangible rewards, said LuAnn Heinen, vice president of the National Business Group on Health. The organization has 290 member companies, including 64 of the top 100 largest firms in the country. "These programs aren't stagnant," Heinen said. "You look at what's working and not working. What can I pull off, what do my employees want?" Austad said other health- and wellness-related programs at Union Pacific include the employment of 40 occupational health nurses stationed across the network to answer employees' questions. The company also offers $100 health savings account grants for workers who complete annual health assessments.
The Early Word: On the Road
Simultaneously, the National Business Group on Health will hold a briefing to discuss the results of a survey of large employers on changes they are making to their health care benefit programs after the new health care reform law, according to The Associated Press.
Paychecks to Shrink Because of Higher Health Premiums, U.S. Companies Say
Workers will pay more for their health care next year as U.S. companies prepare for provisions of the overhaul signed into law by President Barack Obama, according to a survey released today. About 63 percent of businesses plan to make employees pay a higher percentage of their premium costs in 2011, said the Washington-based National Business Group on Health, which surveyed 72 companies that employ more than 3.7 million people. The survey showed 46 percent plan to raise the maximum level of out-of-pocket costs that workers must bear. The companies surveyed expect their costs of health-care benefits to rise an average of 8.9 percent next year. The legislation Obama signed in March will contribute an estimated 1 percentage point to the higher expense, Helen Darling, the business group's president, said at a press conference in Washington today. Employee-paid portions may see small increases, she said. "They're usually very small increments," Darling said. "It could be as little as 1 percent."
Survey: Big employers expect 2011 health cost hike
Large employers expect their health care benefit costs to rise 8.9 percent next year, and more will ask their employees to make a bigger contribution, according to a survey from the National Business Group on Health. The nonprofit, which works with big companies on health care costs, said Wednesday their members tell them they expect costs to rise more than the 7 percent increase they expected on average for this year. A total of 63 percent of employers who responded said they planned to increase the percentage employees contribute to their premiums. That's up from 57 percent last year. More employers also say they plan to raise the annual maximum amount employees pay for health care costs. A total of 61 percent intend to offer a consumer-directed health plan in 2011. Those typically pair insurance that carries a high annual deductible with an account fed either by an employer or by the employee through pretax contributions to help cover costs. The National Business Group on Health said its survey was based on responses from 72 companies, each with more than 5,000 employees. These companies provide their own insurance and have a health insurer administer the coverage.
Health reform spurs change for big employers: survey
Most of the companies surveyed also plan to shift more costs to employees to encourage them to limit spending as one of several efforts to rein in rising costs, according to the report by the National Business Group on Health. The group, which represents large employers on healthcare issues, based its findings on a survey of 72 of its member companies in May and June. Members include many of the largest U.S. employers, including Wal-Mart Stores Inc and General Electric Co, but the report does not say which companies were surveyed. The debate on healthcare reform, especially over whether it will increase costs for individuals and small businesses, has become a major issue ahead of the November midterm elections in which Democrats are fighting to maintain control of Congress. The report shows companies expected their healthcare costs to grow by nearly 9 percent on average in 2011. That is about two percentage points higher than the 7 percent average increase for 2010, but just one percentage point was linked to the mandated changes under the law. "U.S. employers have long struggled with healthcare costs," Helen Darling, National Business Group on Health president, said on Wednesday. "We as large employers know we are in the middle of a transformation, a transformation of how healthcare is financed and delivered in this country." The law passed this spring includes several provisions that employer-based health insurance plans will have to abide by once the rules take effect on September 23. The survey found that 70 percent of the companies will have to eliminate lifetime dollar limits, or a cap on the amount an insurer will pay for covered expenses, while 13 percent will no longer be allowed to deny coverage for children with costly preexisting medical conditions. About a quarter will have to end annual limits on benefits. Over half of the companies surveyed planned to tinker with benefits despite the risk of losing protected grandfathered status under the law and having to follow more new rules. New plans or those that lose grandfathered status must cover preventive services such as mammograms and colonoscopies at no additional cost to patients. They also must allow access to a pediatrician or obstetrician without a referral. "They're not holding up changes they want to make to maintain or retain grandfather status," said Darling. "They actually don't think it's that important."
CMS announces modest hike in Medicare Part D premiums
Consumer advocates critical of the doughnut hole since its creation in 2003 have cheered the new benefits for seniors. But the National Business Group on Health (NBGH) this week issued a potential warning for those who thought that closing the coverage gap could mean only good news for seniors. A survey unveiled by the NBGH Wednesday found that 5 percent of the nation's largest companies plan to drop health coverage for retirees in 2011, while another 60 percent are eyeing that possibility in the future. The reason? NBGH attributes it, at least in part, to "making Medicare Part D benefits richer as the 'doughnut hole' closes."
Health Care Costs to Continue Rising for Employers, Study Finds
Employers are bracing for more health care cost increases over the next few years as the new health care law unfolds, according to a survey released today. The National Business Group on Health's annual survey on health care plans found that more than half of the U.S. employers it surveyed were planning to make changes to their plans even though they might lose their "grandfather status." "Grandfather status" applies to those insurance plans that existed on or before March 23, 2010, to which no major changes have been made. It is in keeping with President Obama's pledge that those Americans who like their plan, will be able to keep it. The NBGH estimates that more than 50 percent of health care plans will lose their "grandfather status" after the first year. But they are likely to still keep offering the older plans for employees who want to keep them, alongside new insurance plans that offer provisions and benefits mandated by the new law. U.S. employers continue to struggle with health care costs, a trend that began 20 years ago, Helen Darling, the group's president, said at a news conference today. "They're going to be paying the tab for a very long time," Darling added. To cut costs and limit spending, employers are promoting cost sharing and shifting more costs to employees, according to the survey. The survey was conducted from May to June. Even though it was right after the health care law was passed and some rules have since then changed, employers had a "pretty good sense of where this was headed," Darling said. Most of the changes are expected to come in 2012 and in 2014, when insurance exchanges -- marketplaces where eligible people can shop for coverage -- are expected to start. Cost Issue for Employers Employers included in the survey estimated that on average, their health care costs would increase by seven percent in 2010 and 8.9 percent in 2011. Employers said they are looking at controlling their costs by offering consumer-directed health plans, which emphasize health savings accounts and reimbursement arrangements to keep medical expenses low; wellness initiatives to improve employee health; and increasing employee cost sharing. Darling said the good news in this year's survey was that employers are offering more incentives to employees for participating in wellness activities. Seventy percent of employers surveyed said they will remove lifetime dollar limits on overall benefits, while 37 percent said they will make changes to annual or lifetime limits on specific benefits. Several provisions of the new law go into effect next month, but many Americans may not see those benefits until their insurance plans are renewed. Plans that are renewed after Sept. 23, 2010 will have to extend coverage to young adults under 26, who will be able to stay on their parents' plans. The law also bars insurance companies from denying coverage to children because of pre-existing conditions and cancelling coverage except in the case of fraud. Insurers will have to provide preventive services such as mammograms and colonoscopies without cost sharing or charging co-pays. Because of the new law, 63 percent of the employers surveyed said they will be increasing the employee percentage contribution to premium costs in 2011, up from 57 percent last year; while 46 percent said they will raise out-of-pocket maximums compared to 36 percent last year. Darling said the increase could be small, but the survey did not indicate by how much on average the employers planned to raise premiums. Retiree benefits are also expected to be impacted. According to the survey, 33 percent of employers are planning to eliminate coverage for future retirees to curb costs. The NBGH surveyed 72 companies, although it would not name the companies. Another report released today by private research firm Robert Wood Johnson Foundation said that while Americans' confidence in their health care plan fell when the law was passed earlier this year, it has since then gone back up to previous levels.
HHS uses webchat to trumpet benefits of healthcare reform
The HHS event was staged on the same day that the National Business Group on Health released a survey finding that many large employers plan to hike costs and cut benefits to their workers, largely as a result of new requirements in the health reform law.
Companies Help Employees Provide End-Of-Life Care
Pitney Bowes - along with General Electric, PepsiCo and IBM - is working with the National Business Group on Health to design an end-of-life toolkit for employers. This kit will help caregivers and employees who have been given a life-limiting diagnosis. Addressing the topic is a business imperative, says Stephen Kiernan, the author of Last Rights: Rescuing the End of Life from the Medical System.
Progress for people with disabilities -- but not everywhere
It's critical for employers to comply with the spirit as well as the letter of the law, said Helen Darling, president of the National Business Group on Health, which represents nearly 300 large employers. "To maintain our standard of living, we really have to have every human in the country highly productive," she said. "It's in our selfish interests to make that happen. That's what a lot of the Americans with Disabilities Act is about." In a previous job at a large company, Darling was asked by an employee with a chronic disease that compromised her balance whether her employer would cover the costs associated with walking her service dog when she was on business travel. "That wasn't a big problem," she said. "This woman was obviously doing remarkable things to continue her job, to be a success, and what she was asking was truly reasonable." Where the law gets tricky is around how much and what kind of accommodation is required for people who have mental or behavioral disabilities, she said. "It's in really hard-to-pin-down-and-respond-to disabilities that it's a challenge." "It's very hard to find jobs these days without stress," she said, citing the example of someone who might want the same job and pay but without the negatives. "You're in a complicated dilemma then. Even in a big company, you just can't take somebody and say 'We'll put you way over here' unless that kind of job is available." Still, some of the ways employers can better accommodate workers with disabilities involve common alternatives, such as telecommuting, that benefit all employees, she said. "That would help a lot of people with disabilities because some of the challenges are just getting to and from work," Darling said. "That's a challenge for everybody."
No Matter the Language, Communication Key to Successful Lifestyle Changes
Technology can be an inexpensive way of providing wellness coaching around the globe, according to Elizabeth Greenbaum, but the big challenge is language. And, that doesnt just mean translation. Its about enculturating your message, which is a much more difficult task. You have to know your audience and speak to what they understand. It has to be tailored to the population that its aiming to help, said Greenbaum, a senior manager with the Global Health Benefits Institute. For example, she noted that a nutrition program aimed at a U.S. audience might give guidelines about how many pieces of bread might be included in a diet. But in India the typical diet is very different and the nutrition coaching must reflect those differences. The term physical activity can mean different things to people in different cultures, Greenbaum said. You have to speak about health in terms they can understand. If a message doesnt speak to the intended audience they wont hear it. If you want to effect change it needs to be specific, she said.
The Mental Health Balance
A little-noticed federal law affecting mental health and substance abuse benefits kicked in on July 1, and its cost implications could dwarf those of the earliest corporate implementations of the high-profile healthcare reform legislation. The Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA) requires companies with more than 50 employees that cover mental health and substance abuse to equalize financial requirements and treatment limitations for depression, schizophrenia, drug addiction and similar conditions with those set for physical illnesses. The government's interim final rule specifies how companies are to comply. It establishes six care categories, such as inpatient in-network and inpatient out-of-network, and says medical and mental health or substance abuse coverage must be equalized in each category, with limitations on mental health benefits no more restrictive than those for medical or surgical benefits. The government could modify provisions when it publishes a final rule, but no one knows when that will be. Meanwhile, companies must comply with the interim rule. Steve Wojcik, vice president of public policy at the National Business Group on Health (NBGH), which represents large employers, says his members estimate that MHPAEA will increase health insurance costs by 1%. "With all the changes required by the new healthcare reform law, 1% for mental health comes at a bad time," he says. Companies can avoid the new law's requirements by canceling mental health plans, but Wojcik says large companies are unlikely to do so. "Large employers recognize the value of mental health coverage in terms of illnesses such as depression," he explains. "Addressing those is important to employee productivity."
ROWE and Healthy Lifestyles
"Telecommuting reduces the time spent traveling to and from work, so it eliminates (at least on those days) a significant stressor, a waste of time and a 'vitiator' of productivity," says Helen Darling, president of the National Business Group on Health in Washington. Wilsker, who works from home, poses this question: "Do you know how much stress I had walking down to my office today? Not much." Darling does say family stressors have the potential to replace other stressors."Those with children in the home will need reliable child care," she says. "Spouses and family members will need to behave toward you just as they would if you were in your office talking with 'the boss.' "
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