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November 16, 2017

When will we stop talking about health care reform?


Employers, employees, consultants, brokers, lawyers, accountants, Congress and especially media have not stopped talking about health care reform since 2010 when the Affordable Care Act was signed into law. We have been exposed to an endless parade of predictions, horror stories, varied outcomes, higher costs, reporting, complexity and hand wringing. It is now 2017 and the barrage of stories, coupled with the same horror, outrage and, at times, optimism continues. While it doesn’t look like this is going to stop anytime soon, I would argue it’s time to stop and focus on what really matters.

The vast majority of Americans get their health insurance from employer-sponsored plans, as employers want to offer good health plans to employees, at a reasonable cost, and produce what drives the success of their business. If the success of the business is measured in profit, surplus, or final outcomes, the noise over these last seven years is one very big distraction.

So, what is actually important to employees, and by extension employers, covered by these plans? Everyone is looking for reasonable protection from the risks of a costly health condition. Therefore, the best way to mitigate this risk is by being as healthy as possible.

Businesses need to alter their perspectives, both on the employer and employee level, by focusing on the following four factors if they want to encourage a healthier workforce:

  1. Assess the risks of an employee population. In order to examine the risks facing an employee population, programs should be focused on offering “knowledge doors” for employees to walk through. We all like to know about ourselves (yes, even our health), so employers should offer biometric screenings, push for primary care visits, and make all manner of self-discovery available. I am always surprised by how many employees really appreciate this focus.
  2. Identify changeable risk drivers. What are the identified risks that are changeable? Yes, employees will need to change some behaviors, but any effort is well rewarded. Smoking is the easy one. Go further by examining health plan claim history for patterns of diabetes, metabolic syndrome, obesity, musculoskeletal, etc. Review drug plan usage for cholesterol, depression, hypertension drug usage.
  3. Pick two  or three conditions to eliminate in the next 24 months. While this is a huge task, having a goal, asking for help from employees, monitoring progress and sharing it all with employees will not only create more engagement, but will begin to create a culture where health matters.
  4. Watch and try to measure changes in employees. The first thing that will change is attitudes. Yes, people will talk about the new emphasis on their health. There will be a gradual infection of the workforce with excitement and progress. It will make a difference.

What I suggest is a systematic risk identification and mitigation program. No employer purposefully ignores risks in the workplace. So why would any employer purposefully ignore what may be an even bigger risk to the workforce – employee health?

If employers approach their employee health plans with these principles in mind, it may end the unproductive speculation about health care reform.



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