The prescription for tackling soaring employer-sponsored health care costs

Talk about sticker shock. Most employers will see a 6% to 9% increase in health care costs next year. According to health care research institute, KFF, employer-sponsored insurance covers almost 159 million people under 65 in the U.S. Did you know that 15% of your plan members account for a staggering 80% of total plan costs?

Forward thinking employers aren’t just waiting for the bill, they’re taking action on the front end, embedding health care professionals into their workplaces to help teammates manage long-term chronic conditions such as diabetes, hypertension, respiratory, cardiac, and gastrointestinal issues.

“An ounce of prevention is worth a pound of cure.”

Providing hands-on, intensive health management significantly reduces health care utilization, and you guessed it, plan costs, by an average of a 5-to-1 return on your investment. It also leads to better employee satisfaction, which in turn helps you recruit and retain a quality workforce.

Plus, healthier employees equal more productive ones. Don’t take it from me. My colleague at Curally, Dr. Ernie Vesta, has seen it firsthand. His work and the work of our nurse-led care teams play a crucial role in working closely with clients facing complicated and expensive medical conditions such as cancer, renal failure, advanced cardiac, and orthopedic issues.

They do this by providing “health care management,” a set of resources devoted to services and activities organized through principally three functions: identifying populations with modifiable risks, ensuring alignment of available services to the needs of the population, and arranging for the right clinical personnel to deliver the needed services.

Of course, the key is for your employees to be willing to participate in their own health care. Evidence of the unwilling or noncompliant participant is all around. In its study of patient noncompliance, the Journal of the American Osteopathic Association cited findings from World Health Organization analyses on the extent of the problem:

• Approximately 125,000 people with treatable ailments die each year in the United States because they do not take their medication properly.
• 10% to 25% of hospital and nursing home admissions result from patient noncompliance.
• 50% of prescriptions filled for chronic diseases in developed countries are not taken correctly, and as many as 40% of patients do not adhere to their treatment regimens.

When it comes to medical decisions, only by engaging the plan participant (patient), taking into account their values and preferences, can a good medical decision be made, where benefits outweigh the harms.

In an international study of patients with complex health needs, countries with higher levels of patient engagement had better quality of care, lower medical error rates and greater satisfaction in the experience of care.

The path forward

Better patient engagement increases patient perception of control, increases trust and decreases uncertainty. Specifically, engaging patients in health care decision making results in multiple benefits, including higher patient satisfaction with their care; greater patient knowledge about their conditions, tests and treatment; more realistic expectations about benefits and harms; and increased likelihood that patients adhere to screening, diagnostic or treatment plans.

In some cases, Dr. Vesta and his team have identified instances where individuals under their management were not properly diagnosed, were not utilizing the most competent physicians, and were bewildered about the proper path forward.

Related: Employers prioritize benefits amidst talent shortage and rising costs

The question now is not just about managing health care costs but about finding effective and sustainable solutions, because year-over-year additions to your company’s bottom line aren’t feasible.

As the landscape of employer-sponsored health care continues to evolve, innovative approaches will hold the key to a healthier and more cost-effective future.

Bob Daubenspeck, an HR veteran who’s currently Chief Business Officer at a company called Curally.