Better Health Decisions: Whose Responsibility?

Organizations are introducing consumer-driven health plans with the intention of migrating responsibility for health decisions away from the employer and onto the employee. However, many organizations have found that despite doing so, their costs remain high and employees still tend to make poor health care choices.

To illustrate this, companies with a high percentage of their employees in a consumer-driven health plan have still seen high single digit health-care cost increases consistent with those organizations that do not have such plans in place. With a significant amount of company dollars dependent on these employee's decisions—roughly $7,000 per employee per year—organizations are looking for ways to influence those decisions.

While employees often receive access to decision-support tools and resources, a growing number of organizations now actively train their employees to be smarter health consumers. Some organizations even go so far as to give employees cash incentive or medical premium discounts to encourage them to learn about their health and benefits. While this may seem surprising given that health information is freely available on the Web, the benefits to employers of driving informed decision making are real. The Benefits Roundtable, the Corporate Executive Board's network of benefits executives, has estimated that approximately $1,350 can be saved per employee per year as a result of improved employee health decision making. Since these cost savings drop straight to the bottom line, organizations must educate employees.

Organizations at the forefront of this effort train their employees to be better health consumers through these methods:

Targeting the right barriers—Employees face critical barriers during interactions with the medical and insurance system that prevent them from making cost-effective decisions. For example, employees need better access to lower-cost urgent care clinics instead of high-cost emergency rooms. A simple solution is to distribute geographically targeted information on local medical centers and their availability to employees. Keeping up the dialog—Leading organizations communicate continuously about informed health decision making by providing tips and suggestions to employees, rather than communicating only in advance of open enrollment as most organizations do. Bringing coworkers into the conversation—Internal social networks of employees have a significant influence on employee perceptions and actions. Use coworkers to communicate and promote health- and benefits-related messages. Leverage multiple channels to reinforce the message—A message needs to be repeated at least three times to have any influence on individual behavior. Develop communication plans that use technology to track the number of times a key health-related message is delivered to employees.

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