HUMAN Capital - Fall 2015 - (Page 24)

FEATURE blurred Lines: Human resources and Health-Care information bY aNDrea SHaNDro, Co-PrINCIPal, VITal ParTNerS INC. benefits renewals and reporting can provide a window into employees' health and health habits. Human resources teams frequently look at this information with a lens of explaining benefits costs, premium increases or decreases and future trends. Some renewal reporting, available for employers with more than 10-20 employees, can provide data that plan sponsors could turn into measures that could potentially reduce benefits costs. but how can renewal information be transformed into action? and how do you take action on that information without breaching the confidentiality of a particular employee or their dependent family member? Health and dental utilization reporting is designed to ensure that employees' health information is confidential, which is why insurers do not provide specific data for groups with fewer than 10-15 employees participating in the plan. otherwise, the plan sponsor or business owner might be inclined to try to identify an employee who is accessing massage treatments or who is being treated for a particular condition and treat him or her differently. Here are some areas to consider when analyzing your benefits renewal information. drug utilization reports Drug utilization reports are broken down into several categories. Insurers will often provide reporting according to the top drugs claimed by total cost, by number of scripts, and by therapeutic classification. 24 | www.hria.ca Consider a wellness program: The number of scripts or prescriptions can point to conditions or symptoms that are widely being treated in your organization. large numbers of prescriptions to treat high blood pressure or high cholesterol might be reduced with the introduction of a wellness program. tackle dispensing fees: If you notice that the number of prescriptions is increasing from year-to-year, you could provide education regarding dispensing fees. encouraging employees to access the pharmacy at Costco or other lower cost providers could save each time a drug is dispensed. (Please see sidebar "2015 average alberta Dispensing Fees," prepared by Vital Partners Inc.) Some organizations choose to implement a dispensing fee deductible or a dispensing fee maximum to induce plan members to actively select a lower-cost pharmacy. If employees have a $5 to $7 dispensing fee maximum and had to pay an extra $3-5 out of pocket each time they purchased a drug, they might be inspired to search out lower-cost pharmacies. Some insurers are implementing programs that are designed to encourage active health care consumerism as well. If a plan member purchases a drug from a pharmacy inside a network, co-insurance is increased (they would get 90 per cent reimbursement instead of 80 per cent). If they choose a pharmacy outside of the insurer's network, the coinsurance level would be lower. In-network pharmacies also promise additional savings and services such as lower than average prescription drug costs and dispensing fees, in addition to free home delivery service for maintenance medications used to treat conditions like diabetes and high blood pressure. Some plan sponsors are uncomfortable advocating consumer behaviour for their plan members. but pharmacy networks are proving cost effective. The potential savings realized through Great West life's pharmacy relationship with Costco ranges from 7.5-18 per cent of extended healthcare costs. Great West life estimates that on average, group plans that have added their pharmacy network value plan have three times more prescriptions filled at the in-network pharmacy than plans without that option. Plan design: looking at drug utilization data in conjunction with the rest of the plan design could also be helpful. With many plan sponsors cutting paramedical practitioners to save costs in a volatile economy, are the savings of reduced coverage for massage therapy being offset with increased drug claims for pain relievers or muscle relaxants? Mandatory generic: brand name drugs are often highlighted in the reporting. If your plan has not already moved to a mandatory generic platform, take note of the number of brand name drugs that are being used by plan members and their dependents. educating plan members and their dependents about the importance http://www.hria.ca

Table of Contents for the Digital Edition of HUMAN Capital - Fall 2015

Leadership Matters
Tech Talk
Building for Success at Alberta Health Services
Fostering Collaboration and Consultation in Developing AHS’s People Strategy
AHS HR Service Delivery Model
Transforming HR in AHS
Implementing Organizational Change Adoption
Leadership Development and the LEA DS in a Caring Environment Capabilities Framework
Blurred Lines: Human Resources and Health-Care Information
Curbing Absenteeism
HR’s Role in Creating and Maintaining a Psychologically Safe Work Environment
HR’s Response in an Emergency Natural Disaster
Legal Source
Policy Corner
Index of Advertisers/ Advertisers.com

HUMAN Capital - Fall 2015

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