How To Expand Employee Benefits While Keeping Costs Under Control

Benefit strategy design is an ongoing balancing act for many employers.

The ultimate goals of a benefit strategy are to support employees’ health, wellness, and morale, while also attracting (and keeping) the best talent. But even when you’re doing everything you can to take care of your employees, it’s not easy to create and maintain an effective benefit strategy while also grappling with constantly rising healthcare costs and other business pressures.

This guide is for employers who are ready to expand benefits for employees while keeping cost under control. When you design your benefit strategy with advanced primary care (APC) at the center, you’ll be able to step outside the cycle of rising healthcare costs and achieve what really matters: connecting employees with the best possible care.

Working within a limited system: benefit strategy constraints

You want to provide your employees with benefits that go above and beyond, but the typical fee-for-service health plan puts that goal under constant pressure. Every year, you’re battling rising costs that are caused by a production-based care model and annual cost inflation. You, your insurance broker, and your insurer are all trying to find a way to work within this system to do what seems almost impossible: protect benefits and control cost.

Limited response to rising costs

Rising costs translate into tough decisions for employers. No matter how hard you work to come up with compromises, you’re often faced with two options you don’t want: cut benefits or keep them as-is through cost-shifting to employees. For example, rising costs often force employers to reduce wellness programs or increase deductibles and co-pays.

On average, large organizations can expect to spend 15% more on their benefits plan each year.

Next year, when costs rise again, employers are back where they started — looking for ways to keep cost under control. Over time, the cycle of spiraling costs, fewer services, and unhappy employees distort benefit strategies until they no longer work to achieve the organization’s goals.

Lack of flexibility leads to carve-out programs

As you design your benefit strategy, you’re always thinking about how to meet the evolving needs of your employees. But health plans often aren’t robust or flexible enough to meet a wide range of employee needs like mental health and wellness support.

To provide a well-rounded benefit strategy, the only option is to add supplemental plug-in programs from multiple vendors, which add a management burden to the benefit team and make it more complicated for employees to understand and use their benefits. And although preventive care for mental health and wellness has been shown to have a positive impact on employees, the cost of incorporating those services as add-ons poses a challenge for employers who are already contending with the high cost of providing basic healthcare services.

If you’re ready to overcome these challenges and transform your benefit strategy, here are the four essentials to focus on.

4 keys to a standout
benefit strategy

1. CLEAR OBJECTIVES

Rebuilding a benefit strategy presents an opportunity for employers to meet business goals and better support the needs of their employees. When setting the main objectives for a benefit strategy, it’s important to utilize claims data and insights to understand what employees need and what’s working. Which services would provide real value and contribute the most to prevention? Where are additional services needed?

For example: High ER or urgent care utilization often points to an upstream issue like a lack of available primary care. High-quality, easy-to-access primary care should be a central goal of every benefit strategy. It’s the most effective path to improving your employees’ care experience, helping them engage with their health, and achieving better long-term outcomes.

To identify gaps in a benefits plan, collaborate with employee representatives, HR staff, and leadership to get a broad picture that is informed by multiple perspectives.

The key is to shift the objective of your benefit strategy away from “treating employees’ health symptoms” and set a more transformational goal: lower costs while helping employees achieve better long-term health outcomes.

Healthcare, especially effective primary care, has the power to not only dramatically impact the lives of employees but to also strengthen an organization’s culture. When employees feel cared for and supported, they approach their work in a more positive way.

2. Competitive offerings

If you’re like many employers, millennials might make up a large (and increasing) percentage of today’s workforce, and they approach healthcare benefits differently than previous generations. If an organization wants to attract talent from this segment, the benefit strategy must reflect what millennials are looking for: personalized care, more convenient access, digital tools, and telehealth options.

Many potential employees have already experienced challenges with benefits from previous employers — constant modifications, creeping costs, complex benefit packages with multiple vendors, or sparse care that doesn’t address their mental and emotional health. If you can offer high-value, easy-to-access benefits that they can count on, you’ll be able to attract and retain talent that will strengthen your team.

3. Clear communication

It’s essential that employees understand how to use their benefits. Clear communication, internal initiatives, and incentives lead to appropriate utilization of health benefits — more use of primary care that prevents the need for specialty or urgent care. This, in turn, leads to lower cost, because employees achieve better long-term health outcomes and don’t rely as much on specialty or urgent care services.

An organization’s leaders, HR administrators, and employee representatives should all get involved in raising awareness of benefits so that everyone understands the best ways to access and utilize them.

4. Adapting to challenges

Traditional benefit strategies that rely on fee-for-service care will keep employers in the cycle of rising costs and continuous modifications — and as a result, limit their ability to adapt and respond to other challenges.

Here’s an example: the COVID-19 pandemic dramatically changed many employees’ immediate healthcare needs and priorities. Virtual care and other telehealth solutions became a necessity, but most employers had very little flexibility to make sure that kind of care was available to their teams.

But it is possible to save money while maintaining the flexibility you need to offer competitive benefits that improve the health, satisfaction, and retention of employees. To do so, employers need to be ready to be adaptable and embrace forward-thinking solutions, such as:

Choosing a health plan that includes APC
Improving virtual care and telehealth to increase employees’ access to care
Tailoring benefits to meet the specific needs of your employees

How to adapt your current benefit strategy

As you know, balancing improved benefits with reduced costs is often at the center of tough benefit strategy decisions. But it doesn’t have to be. The most effective benefit strategies accomplish both — because they are built on a health plan that puts primary care at the center. This gives employers the opportunity to control costs, improve employee health and satisfaction, and become more competitive with their benefit offerings.

You can do more than just save benefits. You can even improve them — while controlling cost.

Improve your benefit strategy with APC

APC is the foundation of a competitive benefit strategy. APC is an evolution of primary care that delivers improved health outcomes, member experience, and savings through aligned incentives, a clinically integrated care team approach, and a population health model supported by rich informatics.

When your employees have open access to high-quality primary care, they’ll be more likely to follow through on regular health screenings, build strong relationships with providers, and achieve healthy behavior change that improves their long-term health outcomes.

APC increases employees’ engagement with their health. As a result, the number of medical claims (and the cost of care) will first increase, as people start accessing the care they’ve been needing.

As high-quality care results in better health outcomes, claims and cost of care will decrease in the long term.

Four signs that a benefit strategy offers high-quality APC:

Expand the boxes for more information.

Longer appointments

When employees have time to build a trusted relationship with their primary care provider, they’re much more likely to engage with their health and begin to address the root causes of health concerns.

Providers who listen

Empathetic listening is the approach that providers use to help patients unlock behavior change. By building trust and understanding with each person as an individual, providers can help employees build self-efficacy and pursue healthy lifestyle changes that improve their quality of life.

Focus on physical, mental, and emotional health

Primary care providers can do much more than treat immediate symptoms and refer patients to specialty care. The primary care setting is the ideal place for employees to receive whole person care.

Embedded health coaching

When employees have access to trained health coaches and behavioral health support within the primary care setting, they’re more likely to achieve healthy outcomes through behavior change.

Tailor health access to the needs of your workforce

Your organization is unique, and so are the needs of your employees. It’s important to be aware of changing trends in how benefits are delivered and consider whether you should incorporate them into your benefit strategy.

For example, many organizations are expanding employees’ options for accessing benefits in light of an increasingly dispersed workforce. Remote employees need to be able to access their benefits regardless of proximity to a physical care center. COVID-19 created an urgent need for telehealth and virtual health solutions — but more broadly, it exposed how important it is for organizations to have a nimble benefit strategy that can adapt to meet the changing needs of employees.

For some organizations, it makes sense to set up a dedicated care center for employees, while a shared care center is the best strategy for others. For large enterprises, the ideal solution may be to add an onsite primary care center to their campus so that employees can access their care just as easily as they can access any other aspect of their job.

For organizations with a dispersed workforce, it may make the most sense to partner with an aligned carrier or a partner who offers robust telehealth/virtual first care. Ask your insurer to consider offering primary care, so that you can help your employees achieve better health outcomes. Here’s the bottom line: There are multiple solutions that you can use to make sure your employees can easily connect to their health benefits.

Should you add APC to
your benefits or access it
through your health plan carrier?

Access to high-quality primary care is the foundation of an effective benefit strategy.

In response, many employers use self-funded health plans that allow them to adopt the financial risk for their employees rather than paying a premium to an insurance company. When employers adopt the financial risk, they have the power to change the dynamic: setting up a high-deductible health plan and reinvesting the savings in primary care. Whether you provide that care directly, through your insurance plan, or through a primary care partner, you can make sure your employees get the best primary care.

The following case study demonstrates how employers can improve benefits and control cost by self-funding a value-based approach to primary care.

How primary care helped a city improve benefits and reduce spending

Faced with skyrocketing healthcare costs, the City of Kirkland in Washington State was ready to try an unconventional approach to their benefit strategy. Their 10 million dollar budget was steadily increasing yearly by 11% and they couldn’t sustain that trajectory for much longer.

The City didn’t want to reduce benefits (and indeed could not, due to agreements with labor unions.) Instead, they set a seemingly impossible goal: reduce spending and improve benefits.

An unconventional strategy

The City consulted with Keith Robertson of Alliant Health Services and, together, they came up with a bold, new benefit strategy:

Move employees to a high-deductible plan and directly re-invest resources into employee benefits
Get into the business of primary care in order to provide employees with unlimited access to free or low-cost primary care

The City couldn’t achieve its goals by relying on the network of a traditional plan. Instead, they chose to turn primary care into a fixed cost by partnering with Vera Whole Health. Vera worked with them to provide primary care directly through their own care center.

They were dedicated to the best outcome and willing to go out and do that. They basically blew up their entire benefit strategy and built it from scratch.
Keith Robertson, V.P./Corporate Benefits Consultant at Alliant Insurance Services

Immediate results

Strong incentives and clear communication about the new benefit model led 90% of employees to engage with the new care center. At long last, employees were getting preventive treatment when they needed it. This meant that chronic conditions were effectively managed and fewer health concerns became elevated enough to require an ER visit. Employees could even have generic prescriptions filled onsite for free.

This simplified, targeted model created a better experience for employees, which increased utilization of primary care by 23%. Employees became more and more engaged with their health and this in turn led to improved health outcomes and a reduction in claims dollars. Costs fell by $137 per member per month.

The City saw a 25% reduction in healthcare costs and a 15% net savings in the first two years of care center operation.

The City of Kirkland proved that employers can improve benefits, increase utilization, and reduce costs by providing primary care directly to their employees.

A powerful alternative to a self-funded health plan

Getting into the business of primary care is an effective benefit strategy solution for employers — but it’s not the only one. There’s another way that you can provide your employees with high-quality primary care and achieve the same results. Look for an insurer that provides APC.

Many payers are getting into the business of providing APC themselves, for the same reasons that employers are — to improve employee/member experience, improve health outcomes, and lower the total cost of care. This is good news for employers for whom building and managing their own care center isn’t the right choice, so ask your carrier about this option. By finding an insurer network that embeds APC into its health plans, you can connect your employees with innovative, easy-to-access care — without the ownership.

Weighing the benefit: By working with an insurer that offers built-in primary care at the center of their plan, you can finally control costs while offering better benefits and a better care experience for employees.

If you want to step outside the cycle of rising costs while providing your employees with more comprehensive benefits and helping them improve their long-term health, you can. The key is to design your benefit strategy with high-quality advanced primary care at the center.

To learn more about how APC can transform your benefit strategy, contact us today.

Download as PDF Get in Touch