News You Can Use: When it comes to wellness, employees say out of site, out of mind

I have a treadmill in my home, and it's a good thing I do. Otherwise, I likely would not exercise. I have the same attitude toward health care; I prefer to go to retail clinics because I don't need an appointment and their hours fit my schedule. Convenience is king. Apparently, I'm in good company, and employers are noticing.

A recent Mercer survey finds that employers who offer primary care services at an onsite clinic can control health-care costs by providing a lower-cost option and to improve productivity by reducing time lost for workers to receive care offsite. Some 31% of large employers offer occupational health clinics, 14% offer a clinic to provide primary care and 10% are considering adding a primary care clinic this year.

Of course, the inevitable response is: Well sure, we'd love to have an onsite clinic but they're too expensive. However, according to Mercer, some employers have found sharing clinic services to be a workable, cost-saving solution. The survey finds 11% of respondents currently share their clinic with another employers and 13% would consider sharing.

And relating back to my 'convenience is king' argument, Mercer finds that 86% of employers cite “convenience (in terms of time and effort) for their employees” as an important or very important objective in offering an onsite clinic. Among other reasons:
* 77%, better access to preventive care.
* 75%, encouraging employees to make better use of health/wellness programs.
* 74%, control of overall health spend.

For more from EBN on onsite health, click here.

News You Can Use: You're damned if you do and damned if you don't on health reform, CBO reports

A new report from the Congressional Budget Office explores the various proposals on the table for reforming the nation's health care system and concludes there aren't many options that will overwhelmingly benefit both employers and employees.

Although most surveys find employers in favor of health reform, among the proposed options to increasing the number of Americans with health coverage -- essentially, premium subsidies and/or individual or employer mandates to obtain/provide coverage -- most would increase costs, CBO finds. And higher costs for employers likely would ultimately mean lower pay for workers (and less taxable income for the government).

Got an idea for how best to reform the health care system? Comment below to share it with us, or click here to share it with the Obama administration.

News You Can Use: Specialty drugs driving Rx cost increases

A report from Haldy McIntosh and Associates for Medco finds 60% of plan sponsors believe that specialty medications are the leading driver of spending growth. This is a sharp increase over last year's survey, where only 25% of respondents shared this view.

To help curb rising costs, plan sponsors are considering programs like pharmacogenomics (personalized medicine, in plain English). Such programs include genetic testing to find how an individual will metabolize a drug to ensure it is prescribed in the right dose.

Other cost-cutting strategies are more conentional, with 65% of organizations offering a wellness management program, 70% a disease management program 46% planning to increase cost sharing over the next 18 months.

Click here to read EBN coverage of how one employer brought specialty pharmacy costs under control.

News You Can Use: Average deductible tops $1,000

New survey results from Mercer reveal that for the first time this year, employees' average annual deductible for single coverage topped $1,000 -- a troubling sign for employers and workers alike who are struggling to pay for health care.

The average single person must now pay $1,001 in out of pocket expenses before coverage kicks in, a 17% increase from last year's average $859.

"Raising the deductible has become the fallback for employers faced with cost increases they can't handle," Mercer consultant Laura Baker told the LA Times. "It's the easiest way to reduce cost without taking more out of every employee's paycheck."

Michelle Dimarob, legislative affairs manager for the National Federal of Independent Businesses, added: "This is very reflective of the tough economic times we're in. Health care is truly a pocketbook issue for both employers and employees."

News You Can Use: CDH gets boost from economy

Although flagging in recent years from low employee enrollment, consumer-driven health plans are getting a serious second look from employers that cannot sustain any more rate hikes amid the struggling economy, AIS Health reports.

Insurers and employers are drawn most strongly to HSAs, but HRAs remain a viable option, according to AIS's findings.

News You Can Use: Workers foregoing health coverage over cost

Did you have fewer takers this year during open enrollment? Blame the economy.

New survey results from BearingPoint, Inc. and Zogby International show that, due to the economic crunch, nearly 10% of employees are more likely to either drop their health insurance plan or switch to a less expensive one with fewer benefits.

Workers making less than $25,000 a year and workers age 18-24 are most likely to switch to a cheaper plan or drop coverage altogether. Among ethnic groups, Hispanics are most likely to put cost over care.

Further, the survey reports 15% of respondents were more inclined to take less medications or forego prescriptions because of financial strain.

Scone: In search of HSA advice, assurance

Two weeks ago – after much discussion with my husband, fine-tooth-combing our family budget, using three comparison tools and a medical cost estimator, and reading every page of communication my employer sent on the subject – I enrolled my family in a high-deductible health plan with an HSA for 2009. I still wonder if I did the right thing.

Ever since, I’ve found myself preparing for a sort of health care Armageddon – scheduling myself, husband and children for every doctor’s and dentist appointment we need, weaning my infant daughter off a long-term medication, and informing the specialist she sees (and that we adore) that we likely won’t be back to see her because I’m not sure we’ll be able to afford the office visit come January.

Although it took much consideration, I feel railroaded into my decision. The HDHP I was offered carried about the same premium as the current PPO that covers my family now –already near the top of what our family can afford. The more traditional health coverage options were two and three times what we currently pay, and there’s no way we could sustain that (while continuing to save for retirement and meeting our monthly expenses).

So, I did the only thing I could do: checked the HDHP option, funded my HSA up to the deductible and hoped for the best.

Even though I can’t change my decision now, I still question it. I’ve discovered that writing about this topic and living it are two different things – and I consider myself much more informed than my colleagues at other non-benefits-related publications.

So I turn to you EBN readers, the exceptional pros that you are, for advice and assurance (and promise not to hold you accountable). Any recommendations you have would be great; just tell me what you would if I worked at your company.

News You Can Use: Your medical tourism travel agent

A recent LA Times article provides an international price list, research tips and information links for consumers considering having surgery performed overseas. As economic belt-tightening and higher deductibles have consumers seeking cheaper health care options, and Aetna, Blue Shield of California, HealthNet and PacifiCare all allow some form of covered cross-border care, the more your employees know, the better.

Tip of the Day: The copay tipping point

Keith Bruhnsen, assistant director of benefits at the University of Michigan, offered advice to employers on strong cost-containment strategies to manage specialty drug costs at EBN’s 21^st Benefits Forum and Expo.

“Sometimes there are co-pay challenges to members if the employer has a co-insurance model. I have heard from many specialty pharmacy experts that about $50 is where people start having some difficulties in managing the cost,” Bruhnsen said. Employers need to how their workers are going to respond to co-pays on specialty pharmaceuticals.