Healthy Choices, Lower Costs

If you look around, study U.S. health reports, or even review an employer’s group biometric screening results, you get the same feedback.  A majority of Americans are unhealthy and much of this is a result of lifestyle choices and habits.

At the same time, more and more small employers are moving toward self-funded health plans to gain control over costs and to avoid health care reform taxes and constraints that are driving costs up.  For the first time, small employers can see the real costs of their health plan.

This is a real “ah-ha” moment.  For employers who have opted to adopt self-funded health plans as a means to lower total health plan costs, this prompts two questions:

  1. Do my employees know their health risks and are they doing something about it?
  2. What is the most efficient way to lower health care costs in the long run?

There are short-term and long-term answers to these questions.

Short-Term Answers

If you haven’t engaged in conducting a biometric screening for your employees or incented employees to receive an annual physical, this should be the first step.  Biometric screenings provide members with information about their personal health risks, including cardiovascular, diabetes, and metabolic syndromes.

What this does for a health plan  In the short-term, the biometric screening limits catastrophic risks (uncontrolled diabetes, heart attack, stroke) that cause costs to rise dramatically.

The screening prompts individuals to see their physician who will prescribe a medication to manage a risk identified at the biometric screening.  This can increase prescription drug costs to the health plan.  So, education and incentives for employees to choose generic drugs over brand name drugs is an essential next step.  Here’s why:

A local business promoted generic drug use with its employees.  The result was great.  Seventy-two percent (72%) of all prescriptions filled were generic.  Brand name drug use (only 18%) was still 50% of the total prescription drug costs.  Imagine if all prescriptions taken were brand name!

Look at the striking difference in costs between a brand name drug and an equivalent generic drug to treat a lifestyle condition:

Long-Term Answers

With catastrophic risks coming under control through an annual biometric screening, a major first step has been taken.  Educating employees about generic drug use and even mail order prescription fills will go a long way towards limiting the prescription drug costs of the health plan.  However, this is just the beginning of reducing health care costs.  Even if the majority of health plan members elect to take generic prescriptions, this cost for a group plan can easily be 40% to 50% of the total annual cost.  Long-term lifestyle changes must occur to have the chance to wean individuals off prescriptions.

This change goes hand-in-hand with a wellness program.  Such programs incent and support employees as they make essential lifestyle changes.  Doing so can result in permanently lowering health care spending... and this powerful combination of a healthy life and lower costs is something we all want to see.