Giving employees more responsibility for their health care expenses can help reduce unnecessary spending. That’s the upside – in fact, it’s the point -- of a consumerism strategy. But for low-wage earners, the stiffer cost-sharing requirements that come with a consumerism strategy can present a financial hardship, or may even result in avoidance of necessary care. We’ve all seen news stories about people in emergency medical situations opting to use Uber to get to the hospital because they fear the cost of an ambulance ride. While you can argue the pros and cons of that decision, there’s no debating that employers worry that cost concerns might cause an employee to skip a needed medication or put off seeing a doctor about a chronic condition – or experience debilitating stress over medical bills.
Last week Beth Umland’s post – the first in this three-part series -- helped put the problem in perspective by showing that average cost-sharing requirements tend to be higher in companies with a lot of low-wage employees. The issue may be most pressing in these organizations, but just about all companies have some low-wage employees. In this post, I’ll share some strategies to help ease out-of pocket medical cost pressures through plan design and access to care. Next week, we’ll write about strategies that address social determinants of health.
Plan designs to manage cost share
Focused access to care
As benefit platforms and decision-support tools become more sophisticated, it’s becoming more feasible for employers to offer employees more health plan choices for a more personalized benefits package. The additional choices might be plans with very focused networks or just different types of plan design features. We are finding that “one size does not fit all” when it comes to health care. As the rules change, there are more opportunities to drive better value for a wider range of needs. It’s a good time to assess how well your benefit designs match up to your population needs.
Don’t forget to tune in next week for part 3 in this series.