David Goldberg.
Solutions for Savings
JEFF COWART
The rising cost of health care
benefits for employees is a con-
tinuing challenge facing West
Virginia business executives,
and those leading the state’s
health systems are not immune to this. Hospital CEOs must
work diligently every day to provide the highest quality of
care at the lowest cost while providing competitive benefits to
attract and retain employees.
In an effort to share best practices with other hospital
CEOs, David Goldberg, president and CEO of Mon Health
System, and David Ramsey, president and CEO of CAMC
Health System, teamed up to create a list of opportunities
that, if acted upon, can help hospital administrators around
the Mountain State manage and control their benefit costs.
While this is not an exhaustive list, it provides a solid jumping-
off point for those who want to identify solutions to the unique
challenges they are facing.
Managing the
Challenges of
Health Care Costs
Lifestyle Management
One of the best ways to lower health care costs is to be pro-
active rather than reactive. The lifestyle adjustments employees
make now can greatly reduce the time they spend in doctors’
offices later as well as the costs of prescriptions and procedures
down the road. Helping your workforce manage chronic and
common conditions like weight, cholesterol levels and diabetes
can generate significant cost savings.
Population Health Management
In the rapidly changing health care environment, providers
are innovating and adapting continuously to maintain delivery
of the highest quality care at the lowest cost. Health systems
like Mon Health and CAMC are embracing value-based care in
which reimbursement models are based on how well a hospital
helps its patients stay healthy and its partners control costs. Pop-
ulation health management, which aims to improve the health of
an entire group or population, uses sophisticated data to track
troubling unhealthy trends in both individuals and communi-
ties. Having programs and initiatives like this in place allows
health systems to pass on their knowledge and help their regional
businesses tailor a wide range of solutions to the specific needs
of their workforce.
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WEST VIRGINIA EXECUTIVE
David Ramsey.
Employee Incentives
One way to control costs is to incentivize employees to take
an active role in prevention and living healthier lifestyles. For
example, in 2018 both CAMC and Mon Health provided
either a credit to health insurance premiums or to the pay-
checks of employees for doing things like abstaining from
smoking, completing a wellness profile, getting blood work
done, reaching diet and wellness goals and participating in a
variety of exercise classes.
Another proven program is offering a health savings
account to employees. Monies are placed in pre-tax accounts
and grow tax-free, and as long as they are spent on qualified
items, they are dispersed tax-free. Studies show consumers are
more likely to shop around and find the most cost-effective
health care solutions when they have a personal stake in man-
aging the money.
Employee Education
Educating employees on the most efficient ways to receive care
is also proving to be an effective tool in managing costs. For
example, an over-reliance on emergency rooms by employees
for the treatment of what might be frightening yet less serious
medical conditions is a significant driver of higher costs.
Educating employees about the signs and symptoms of true
emergencies and the availability of nurse or physician hotlines
and non-emergency walk-in clinics is essential.
Insurance Plan Evaluation
Be sure to evaluate your insurance benefits plan and shop
regularly. A study from the Kaiser Family Foundation found
only 57 percent of small businesses look at other insurance
carriers every year. The ones that did were able to find an op-
portunity to move carriers one-third of the time. This also
gives companies a chance to make sure their benefits struc-
ture is properly designed, rewarding good health care usage
and reducing unnecessary expenses.
Primary Care Doctor Relationships
Encourage employees to establish a relationship with a primary
care doctor. In this relationship, the physician gets to know
the patient and can evaluate and treat conditions or symptoms
that might be connected in a holistic way, providing early
intervention on what might be a trend toward more chronic
conditions. The primary care physician becomes the quarter-
back in the coordination of care that might involve other
specialists with the ability to help avoid duplication of services
and thus lower costs.