Achieving Your Health Goals

sip-wellnessNow is a good time to evaluate the resolutions you set months ago. Sometimes we tend to create goals that are too broad, such as “eat better” or “lose weight”. Rather than focusing on the end goal, it can help to break it down into steps.

Crafting S.M.A.R.T. goals can help you make positive changes that have staying power – here’s how:

Specific: Instead of a vague objective such as “manage stress”, come up with a specific action item, such as “do a 3-minute breathing exercise before work and before bed.”

Measurable: How will you know if you reach your goal? Track your progress in a journal or calendar.

Attainable: If you’ve been sedentary and want to start exercising it’s best to start with something you know you can do, like a 15-minute walk on Mondays, Wednesdays and Fridays, and build on your progress.

Relevant: Do your goals align with your interests and values? Don’t just take up running because your best friend is a runner. Go with something you love and really enjoy, like walking or swing dancing.

Time-specific: Rather than setting a goal to meditate for 15 minutes, 3 times a week for eternity, set an end-point – say, one month. When you reach that goal, assess your progress, make adjustments and set another short-term goal.

It’s never too late in the year to revise your resolutions and establish goals you can achieve.

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Small Businesses Doing More

sip-smallbusinessAccording to Deloitte Consulting LLP, small and medium sized employers with 100 or more workers are contributing considerably more towards the cost of employee and dependent healthcare benefits than legally required – about 73% of the total cost, on average. Regional differences also exist, with companies in the Northeast contributing more toward the cost of family coverage and companies on the West coast contributing more to individual coverage.

Even as healthcare costs continue to increase, consultants agree that employers of all sizes will continue to contribute significantly to healthcare benefits as the job market continues to tighten and retaining top talent remains a top priority.

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Fighting Specialty Drug Costs

Prescription-drugsTo help control rising specialty drug costs, the National Business Group on Health has issued a lengthy report including 5 public policy recommendations they hope will educate the marketplace and encourage effective, strategic partnerships.

According to NBGH officials, plan design is the key to managing the use of specialty prescriptions as well as the costs. The report details progress resulting from the aggressive use of utilization review, case management and prior authorization for specialty drugs. Other measures yielding positive results are the design of a specialty tier into the benefits plan and taking measures to administer specialty prescriptions in a facility separate from the hospital. Prescriptions authorized by a hospital or billed under the medical benefit are harder to track and often more costly.

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Doctors Go Retail

healthIf you live near a large shopping mall, chances are you’ve noticed vacant stores, thanks to the rapid growth of online shopping. Many retail vacancies are being filled by doctors, dentists, physical therapists and other healthcare professionals looking for ways to become more accessible to their communities. To generate more foot traffic, one dental network will open clinics in 36 retail centers this year.

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Paid Sick Leave Bug Spreading

paid-sickAs if businesses in Illinois don’t have enough concerns, the General Assembly has introduced bills mandating a minimum of five (5) paid sick days per year for Illinois workers. Employees would be able to use the time to care for themselves or a family member, attend a medical appointment for themselves or a family member, miss work due to a public health emergency or because they or a family member has experienced domestic violence abuse. The bills were presented for a second reading earlier this spring, with no resolution to date.

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There’s an App for That

phone-appThe majority of employers now educate employees about health and wellness through apps and portals – a practice expected to increase significantly in the year ahead. As a result, more and more health-related smartphone apps and wearables are coming on the scene.

The movement should come as no surprise, since poor diet is a major problem in the U.S. and technology is doing more to help employees make behavioral changes. It makes sense that employers become part of the solution. As health plan sponsors, they want to do everything possible to help employees improve their overall health and keep healthcare costs in check.

One app designed to improve employee nutrition is called Zipongo, created in 2011 by a physician named Jason Langheier. The app presents the healthiest options via a mobile device, whether the user is grocery shopping or eating out. It offers healthy recipes and highly personalized solutions based on the user’s biometric data, while considering existing food allergies and personal preferences. Zipongo’s solutions are currently in use at more than 150 companies, including Google and IBM.

Now is the time for employers to intervene for better health among employees. With a wide-ranging number of health-related apps to choose from, employers should investigate their options thoroughly and be sure that the ones they select work as advertised and are a good match for their organization and their employees.

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Responding to Growing Demand for Transparency

medical-iconsExperts agree that a lack of true price transparency has contributed significantly to the inefficiency in healthcare. Several websites compare the costs for certain procedures at varying hospitals, but it’s still very difficult, if not impossible, to make an informed choice when preparing for a non-emergency procedure. As a result, most people still go to doctors participating in a covered network and follow physician referrals when a specialist is required. In most cases, these choices are made without any knowledge of the cost.

Powerful Mobile Technology

Today, leading TPAs are providing self-funded health plan members with a variety of very powerful mobile transparency tools. One new mobile app enables members to identify fair pricing for more than 200 common procedures, including surgeries, imaging and diagnostic testing. By linking a rewards program, the app awards financial incentives when high quality, competitively priced providers are selected over those with lesser ratings.

Another software maker that describes a third of healthcare procedures as “shoppable”, has introduced a mobile app that enables plan members to search for physicians by procedure, location and price. This tool even goes beyond facts and figures to provide detailed descriptions of the procedure being searched. When members need further assistance, care navigators are available to provide online support via a live chat option.

Expert Administration Still Matters

While a totally open pricing system may never be possible in a business as complex as healthcare, TPAs are making self-funded health plans more transparent all the time. Strategies such as Reference Based Pricing and Concierge Health Advocacy are having a tremendous impact on cost and employee engagement. And while insurance carriers typically withhold claims data from fully insured groups, TPAs are experts at helping their clients put valuable claims data to work to identify cost drivers and manage chronic conditions in ways that help the plan avoid catastrophic claims in the future.

As the transition from volume to value-based healthcare continues, more responsibility will land in the hands of plan members. Smart employers know that a well-designed health plan can foster positive change and lower costs only if members understand their benefits. As long as self-funded plans, highly personal service and creative ideas are allowed to flourish, the number of engaged consumers capable of making economically wise healthcare decisions will continue to grow.

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