As more and more employers are adjusting benefits plans to improve the health of their employees and reduce their healthcare costs, findings from the nonprofit Center for Health Value Innovation (CHVI) show that not only are employees not engaged, employers are spending money without paying attention to the results they are getting – or aren’t getting.
[See also: Highmark study: Employee wellness programs cut healthcare costs.]
The first results from CHVI’s Health Value Accelerator, an online tool employers can use to figure out how to best use their benefits and resources, found that 20 cents out of every dollar of revenue is going toward healthcare costs that are under-managed.
The HVA became available to employers last spring. So far, more than 50 fully- and self-funded employers ranging in size from three to 100,000 employees have used the HVA. The employers using the tool have combined, annual revenues of more than $215 billion and $2.8 billion worth of healthcare costs.
What employers are not keeping a watch on is “stunning” said Cyndy Nayer, CHVI president and CEO. “What it says is it’s not just about incentive ... it’s about the culture,” she said. “Is the CEO involved? Are you communicating often enough? Are you watching and holding your service providers accountable?”
Key findings from the results include:
• Employers offer tools that should support workforce engagement, but they are not tracking the use or the outcomes, such as behavior change or risk reduction.
• Incentives do not guarantee engagement or better outcomes; in fact, some companies showed better outcomes without incentives for prevention and wellness screenings.
• Most employers do not know how their employees manage their health, or which programs work, until there is a care claim, often for use of the emergency room.
• When asked about the engagement level of senior management, there is more engagement in companies under 5,000 covered lives.
• Few employers can relate the size of the diagnosed chronic care population (i.e. diabetes, hypertension, depression, high cholesterol) to the success in managing these diseases.
• Few employers know the adherence rates of their populations, but they know the total costs of the drugs. In value-based design for chronic disease, the lack of adherence is a key indicator of waste.
The results of the data collected from the first users of the HVA clearly show, said Nayer, that “not only is not everybody aligned, but the employer is not keeping an eye on where the dollars are going.”
CHVI is urging employers to take a more active role and set up a risk management approach based on outcomes. An outcomes-based contract is “incredibly important” Nayer said. Everyone from the employer to the contractor to the employee needs to be held accountable. “That’s how this (managing costs) is going to get done,” she said.
Follow HFN associate editor Stephanie Bouchard on Twitter @SBouchardHFN.