hand-picked for success

According to a recent review of SHPS’ clients, best-in-class companies that implement healthcare consumerism strategies are experiencing a 2 to 3 percent increase in their healthcare cost – while those not implementing such strategies are experiencing increases averaging 9 percent.

Every employer is different, and not all can develop comprehensive consumer-driven programs on their own. While there’s no single healthcare consumerism model that meets everyone’s needs, there are many financial, administrative and clinical services that can help. The challenge is choosing the right combination of services to drive behavioral change, improve employee health and reduce healthcare costs. And SHPS is the uniquely positioned as a single source for providing these solutions to employers.

Some of the most common strategic “bundles” SHPS’ clients deploy when launching their healthcare consumerism strategy include:

Bundle #1: Financial and Clinical Integration
In this strategy, an employer would integrate spending accounts, nurse line services, an online health portal, decision support tools, care management programs, incentives and integrated metrics. This approach is commonly used in large organizations with more than 10,000 employees.

Through integrated financial and clinical programs, this model engages employees with chronic and catastrophic conditions – offering the most significant impact on existing healthcare costs. Incentives are used to drive participation and behavioral change, while decision support tools guide employees through the complex healthcare system.

This bundle’s ability to work with multiple health networks is particularly important for employers. Organizations are free to switch health plans as they wish, without losing the essential elements of their consumerism strategy. Plus, actuarially validated integrated metrics assist employers in continuously analyzing and modifying the program to ensure it achieves the desired outcomes – lower healthcare costs and empowered healthcare consumers.

Bundle #2: Integrated Health and Productivity
With this approach, employers design their consumerism program around care management, absence management and disability management, supplementing it with an online health portal and integrated metrics. It works best in large employers with established, mature human resource departments. Here, the employer is likely to have an aging population nearing retirement, low workforce turnover, organized labor unions and shrinking margins due to increasing healthcare costs.

In the integrated health and productivity model, the focus is on improving the well-being of employees and ensuring that they appropriately manage their conditions. This improves their quality of life – both inside and outside the office – and maintains their productivity during work hours. And through integrated metrics, employers can calculate the true costs associated with absences, employee disabilities and prevalent health conditions – and look for new ways to lower those costs.

Bundle #3: Healthcare Administration Outsourcing
Employers searching for ways to reduce costs associated with their health and benefits administration often consider a healthcare administration outsourcing model. In this strategy, an employer – typically a mid-sized to large employer with 5,000 to 30,000 employees – uses a single vendor for eligibility and enrollment, spending account management, COBRA, carrier exchange services, integrated metrics and an online health portal.

Through outsourcing, human resource departments avoid the hassles associated with administering complex, integrated benefits – allowing them to focus on important strategic issues. For employees, receiving the basic building blocks of healthcare consumerism introduces them to monitoring healthcare expenses, improving unhealthy behaviors and making responsible health decisions.

Bundle #4: Integrated Healthcare Consumerism
For organizations looking to adopt a holistic model, the integrated healthcare consumerism solution combines all health and benefit programs into a single delivery system. Only a handful of large organizations use this approach, which includes comprehensive benefits administration services (i.e. eligibility and enrollment), care management programs, spending account services, health and wellness strategies, employee assistance programs, online health portal, integrated metrics – and sometimes even nutritional guidance in employee cafeterias.

Integrated healthcare consumerism is designed to focus an organization on an integrated strategy, providing consistent messaging on changing behavior and delivering integrated metrics to validate the program’s results to executives.

Common elements ensure success
Many combinations of SHPS solutions can build a foundation for healthcare consumerism. And because we understand that you already have existing vendor relationships, we’ve built flexible solutions that are easily integrated with other health benefit organizations. Regardless of the source of your solutions, for healthcare consumerism to flourish in your organization, it’s critical to adopt a strategy that:

• Integrates all components into a single program with consistent messaging;
  
  
• Redesigns the health and benefit vendor selection process to assess their suitability with your overall health consumerism model;
  
  
• Assigns a single company executive with complete accountability for all program aspects, including design, vendor selection, metric analysis, and continuous improvement; and
  
  
• Creates a benefits team that combines clinical, actuarial, communications, administration and measurement functions into a cohesive unit.

To arrange a meeting with a senior program strategist at SHPS who can work with you and your third-party advisor to configure a strategy for your organization, please complete the “Contact Us” form. We look forward to sharing our insight and developing a recommendation on the best approach for developing your healthcare consumerism strategy.