1. Identify the Sources of Healthcare Spending-Understanding the root causes driving your company’s healthcare costs is the best place to start. Gathering available historical data provides a wealth of knowledge and allows an employer to better understand their employee population health as well as procedures or network choices that are driving costs.  For example: Increased utilization of a specific high cost behavior or procedure

2. Create a long term plan-Change can be achieved when employers define actionable steps that will drive results.  For example: Educating and aligning all stakeholders on common goals.

3. Develop Partnerships with Vendors-Collaboration between employers, insurance carriers, provider networks, care management companies, and especially employees is vital to working toward common goals.  For example:

  • Using anchor based pricing concepts with key providers
  • Reducing employee co-payments for care related to costly chronic conditions to eliminate barriers to successful care coordination.
  • Creating incentives to drive employees to cost-effective alternatives.

4. Engage your employees with incentives and/or penalties-Impact will be limited unless employees are part of the process of change. Transparency of costs and plan choices as well as rewards for participating or achieving specific goals are the foundation of an effective employee engagement strategy.

5. Prevent Abuse, Waste, and Fraud-Adopt strategies focused on identifying schemes targeted at your healthcare budgets.  For example: Billing mistakes, duplicate claims, uncoordinated care delivery, unwarranted utilization, preventable admissions, improper coding, or unbundling of services.