Health Care Cost Management

Foundation Publication Search Results

These summaries were compiled from Foundation Publications Search, a database of articles, research reports and books published by the International Foundation and the International Society of Certified Employee Benefit Specialists.


eACOs: Fixing the Broken Triangle in Health Care.
Brice, R. Anthony; Kimberly, Mary; Woodard, Tanisha; Benefits Magazine; v54 no11 pp 30-39 Nov 2017; journal article

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Abstract : Interest in employee accountable care organizations (eACOs) is growing among employers looking for ways to control health care costs.
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Quick Look: Health Care Costs.
Benefits Magazine; v54 no11 p 60 Nov 2017; journal article

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Abstract : Here's a look at costs for employer-sponsored health insurance in 2017 and how employers and employees plan to manage health care costs.
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Benefit Trends: Employers Emphasize Worker Well-Being.
Held, Justin; Benefits Magazine; v54 no8 pp 8-10 Aug 2017; journal article

Availability : International Foundation of Employee Benefit Plans
Abstract : Among the findings in "Workplace Wellness Trends: 2017 Survey Results," an International Foundation report, is a shift in employer rationale for offering wellness initiatives as evidenced by offerings that extend beyond physical health to address community and social health, employee growth and purpose, and mental health.
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Do Your Homework to Ensure Savings and Value From Health Care Coalitions.
Cahn, Linda; Benefits Magazine; v54 no8 pp 34-39 Aug 2017; journal article

Availability : International Foundation of Employee Benefit Plans
Abstract : Purchasing coalitions have the potential to help health care plans save money, but finding the right coalition with the right expertise and coverage structure requires plan sponsors to do their due diligence.
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The Colorado State Innovation Model: Integrating Medical and Behavioral Health Care.
Melek, Steve; Benefits Quarterly; v33 no3 pp 63-67 3rd Qtr 2017; journal article

Availability : International Foundation of Employee Benefit Plans
Abstract : Thanks to funding from the Center for Medicare and Medicaid Innovation (CMMI), the state of Colorado soon will implement and test its proposed model for health care innovation, entitled "The Colorado Framework." This article discusses how and why the model, integrating primary care and behavioral health as its cornerstone, creates a system of clinic-based and public health supports to spur innovation and health care cost savings. It also describes the current health care delivery challenges in Colorado and how payment model reforms--including capitation, risk adjustment, and gain sharing--are necessary to achieve sustainability.
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The Implications of the Rapidly Rising Cost of Employer-Provided Health Insurance for Earnings Inequality.
Warshawsky, Mark J.; Benefits Quarterly; v33 no3 pp 52-62 3rd Qtr 2017; journal article

Availability : International Foundation of Employee Benefit Plans
Abstract : Health insurance for a high-paid employee costs an employer the same amount as health insurance for a low-paid employee. At the same time, health care costs and, therefore, health insurance premiums are growing much more rapidly than earnings. Therefore, it is reasonable to expect that--while earnings will indeed become more unequal over time--total compensation will not become more unequal or, when considered over the entire labor force, at least will not become as unequal. Direct empirical evidence supports this hypothesis, based on unique, unpublished survey data about employer compensation costs collected by the Bureau of Labor Statistics. The supporting results hold both for the period 1996 to 2008 and for the period 1992 to 2010. A regression estimated over the period 1990 to 2014 also bolsters the understanding that the rising cost of health care is a major cause of increasing earnings inequality. This finding suggests that the best policy is to reduce inequality would be to effectively control the rate of growth in the cost of health care.
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Pharmacy Benefit Integration: A Connected Approach to Total Medical Cost Savings.
Vancura, Michelle; Benefits Quarterly; v33 no2 pp 16-19 2nd Qtr 2017; journal article

Availability : International Foundation of Employee Benefit Plans
Abstract : Pharmacy and medical benefit integration's most meaningful value lies in obtaining a comprehensive understanding of someone's health journey. An effective way to control health care costs for all stakeholders and improve overall wellness is to understand and manage health conditions in their entirety, not just the prescriptions. This article highlights (1) how pharmacy and medical benefit integration provides a more holistic view of health, (2) how individuals inquiring about their pharmacy benefits can be successfully engaged to participate in health coaching and other programs available through their medical benefits, (3) how integrated data provides real-world insights for evaluating the value that drugs and health management programs deliver and (4) what plan sponsors might attain in cost savings through the use of integrated benefits.
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Group Captives: Are They Right For You?
Hoitt, Jim; Benefits Magazine; v54 no3 pp 14-19 Mar 2017; journal article

Availability : International Foundation of Employee Benefit Plans
Abstract : Joining or establishing a group captive is becoming an increasingly popular option for self-funded health plans looking to manage cost increases.
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Bringing Workforce Health to the Top Line--Expanding the Value Proposition for Workforce Health Improvement.
Parry, Thomas; Sherman, Bruce; Benefits Quarterly; v33 no1 pp 56-61 1st Qtr 2017; journal article

Availability : International Foundation of Employee Benefit Plans
Abstract : The pressure on employers to justify providing health benefits or to prove the value of health investment has never been greater. Many employers have resorted to cost shifting to employees to dampen the impact of health care costs on their companies or have avoided health investments, believing they don't deliver a return. Both strategies come with significant risk to employees, their dependents and the company's business performance. This article provides a framework for employers to better understand the full impact of workforce health and well-being on bottom-line costs and the opportunities for connecting workforce health and well-being to top-line business performance metrics. Application of the principles presented in this commentary can help human resources/benefits personnel better understand the broader business impacts of their workforce health and well-being strategies as well as equip them to have a more meaningful role in workforce strategic planning.
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Making Sense of the Evolving World of Benefits Administration.
Weiler, Ross D.; Benefits Magazine; v54 no2 pp 38-45 Feb 2017; journal article

Availability : International Foundation of Employee Benefit Plans
Abstract : Employers have many options in benefits administration technology, including private exchanges.
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Mental Health and Substance Abuse Benefits Benchmarked.
Held, Justin; Benefits Quarterly; v33 no1 pp 68-70 1st Qtr 2017; journal article

Availability : International Foundation of Employee Benefit Plans
Abstract : In August 2016 the International Foundation surveyed members to examine the various types of mental health and substance abuse benefits organizations provide to their employees and participants. The survey received 344 completed responses, with 247 coming from U.S. respondents and 97 from Canadian respondents.
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Conversation With Ian Manovel.
Bergstrom, Kathy; Plans & Trusts; v34 no6 pp 34-35 Nov-Dec 2016; journal article

Availability : International Foundation of Employee Benefit Plans
Abstract : Ian Manovel discusses steps Australia has taken to control drug prices and improve health, and how they might apply in Canada.
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What's Working: New York City Health Care Savings Update.
Levitt, Claire; Benefits Magazine; v53 no10 pp 14-16 Oct 2016; journal article

Availability : International Foundation of Employee Benefit Plans
Abstract : Halfway through a four-year effort, New York City and its 144 municipal unions are on track to save $3.4 billion in health care costs so that the city can continue to offer free health care coverage to 1.25 million employees, retirees and dependents.
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Dental Benefits: A Standout Option.
Wilson, Dennis; Benefits Magazine; v53 no9 pp 50-54 Sep 2016; journal article

Availability : International Foundation of Employee Benefit Plans
Abstract : Both employers and employees consider dental benefits important. This article discusses some of the factors a plan sponsor should consider in choosing a dental benefits carrier.
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Are You Paying a Huge Price for the Opioid Drug Abuse Epidemic?
Paralkar, Sadhna; Flick, Eileen; Benefits Magazine; v53 no8 pp 14-19 Aug 2016; journal article

Availability : International Foundation of Employee Benefit Plans
Abstract : Millions of health plan participants are addicted to or misusing opioid painkillers, leading to suffering, deaths and huge costs. Plan sponsors can take steps to try to protect themselves and participants.
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Collaborative Employee Wellness: Living Healthy With Diabetes.
Hovatter, Joan McGarvey; Cooke, Catherine E.; de Bittner, Magaly Rodriguez; Benefits Quarterly; v32 no3 pp 41-45 3rd Qtr 2016; journal article

Availability : International Foundation of Employee Benefit Plans
Abstract : Innovative approaches to managing an employee population with a high prevalence of type 2 diabetes mellitus can mitigate costs for employers by improving employees' health. This article describes such an approach at McCormick & Company, Inc., where participants had statistically significant improvements in weight, average plasma glucose concentration (also called glycated hemoglobin or A1c) and cholesterol. A simulation analysis applying the findings of the study population to Maryland employees with a baseline A1c of greater than 6 percent showed that participation in the program could improve glycemic control in these patients, reducing the A1c by 0.24 percent on average, with associated cost savings for the employer.
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Benefit Trends: Greatest ACA Challenges? Reporting and Disclosure.
Mrkvicka, Neil; Benefits Magazine; v53 no6 pp 9-10 Jun 2016; journal article

Availability : International Foundation of Employee Benefit Plans
Abstract : More than half of organizations (53%) responding to the International Foundation's 2016 ACA survey view reporting and disclosure issues as their biggest ACA challenge. More than two-thirds (69%) say the financial impact of reporting and disclosure requirements is significant.
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A Baker's Dozen of Practical Ways to Reduce Medical Claims Costs.
Ryan, Daniel W.; Stephens, Ryan T.; Benefits Magazine; v53 no5 pp 14-19 May 2016; journal article

Availability : International Foundation of Employee Benefit Plans
Abstract : Many of these suggested administrative actions for health plans require only small changes but have the potential to generate big savings.
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Is a Private Exchange Strategy Right for Your Organization?
Weiler, Ross; Matousek, Sarah Bliss; Benefits Magazine; v53 no4 pp 32-38 Apr 2016; journal article

Availability : International Foundation of Employee Benefit Plans
Abstract : Before deciding whether to send employees to a private exchange to choose health insurance and other benefits, an employer should understand whether it's the right move--and, if so, whether it's the right private exchange.
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Employee Benefits Survey: 2016 Results
Held, Justin; Mrkvicka, Neil; Stich, Julie; 70 pp 2016; survey

Availability : International Foundation of Employee Benefit Plans
Abstract : Results of the fifth comprehensive benchmarking survey conducted by the International Foundation. Includes data on pension and retirement plans, health care benefits and other benefits, such as life insurance, work/life benefits and time off, for three distinct sectors in the U.S.—corporations (including professional service firms), public employers and multiemployer benefit plans. Responses were gathered from members of the Foundation and the International Society of Certified Employee Benefit Specialists during 2016.
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Quick Look: Reactions to ACA Cadillac Tax, Reporting.
Benefits Magazine; v52 no12 p 10 Dec 2015; journal article

Availability : International Foundation of Employee Benefit Plans
Abstract : As the 40% excise tax on high-value health plans (the "Cadillac" tax) gets closer--it is set to take effect in 2018--many plan sponsors are figuring out whether their plans will trigger the tax and when, as well as how to avoid it.
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Benefit Considerations for Part-Time, Temporary and Seasonal Employees.
Zolna, Gladys; Benefits Magazine; v52 no11 pp 42-47 Nov 2015; journal article

Availability : International Foundation of Employee Benefit Plans
Abstract : Excluding part-time, temporary and seasonal workers from health and retirement plans is sometimes used to cut costs but can backfire with unanticipated complications. The Affordable Care Act mandates health care coverage for full-time employees, requiring careful tracking of hours for all workers. Regardless of the calculation method used, this is an administrative burden with complex rules. Retirement plans face complicated coverage testing rules and may not exclude part-time, temporary and seasonal workers if they meet eligibility criteria for age and service. Instead of saving resources, imposing tighter eligibility requirements on part-time, temporary and seasonal workers will lead to higher administrative costs and effort.
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What if ACA Excise Tax Isn't Repealed?
Kaplan, Edward A.; Benefits Magazine; v52 no11 pp 30-35 Nov 2015; journal article

Availability : International Foundation of Employee Benefit Plans
Abstract : The Affordable Care Act (ACA) imposes a 40 percent excise tax on generous medical coverage. This Cadillac tax is intended to lower health care overutilization and excessive tax-free compensation, seen as holding back growth in wages and the broader economy. In 2018 the tax will apply to benefits valued over $10,200 for single coverage and $27,500 for family coverage and is the obligation of the plan sponsor. Among the objections to the tax are that the cost of benefits depends heavily on geography and occupations. Plan sponsors will be forced to cut costs in various ways, potentially affecting all members. While it is hoped that a legislative fix will be found, sponsors should not assume it will be postponed or repealed. They should measure their exposure and cost trends, look at cost-cutting strategies, model the effects of certain changes and consider strategies in collective bargaining negotiations.
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Catastrophic Medical Claimants After ACA's Removal of Annual and Lifetime Limits.
Siemers, Ryan A.; Benefits Quarterly; v31 no4 pp 46-53 4th Qtr 2015; journal article

Availability : International Foundation of Employee Benefit Plans
Abstract : Since 2014 the Affordable Care Act (ACA) has prohibited all annual and lifetime dollar limits on health benefits. Uncapped costs for catastrophic claims and expensive specialty drugs are the responsibility of employers who self fund health benefits, and their occurrence is likely to increase as the norm for reasonable and customary charges ticks higher. Solutions vary by employer size. Most self-funded sponsors with 5,000 or fewer covered individuals already use stop-loss insurance, and large plans with 10,000 or more should consider it with additional reserve and margin. Laser-free renewal and a renewal rate cap are desirable. Employers should also consider dividend contracts and captive insurance, including pharmacy in stop loss and aggressively managing administrative costs. Resorting to full insurance should also be a consideration.
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Delivering Participant Value in an ACA World.
Shaw, Dee; Benefits Magazine; v52 no10 pp 20-25 Oct 2015; journal article

Availability : International Foundation of Employee Benefit Plans
Abstract : Participant value in a health care plan is not simply cost management but improved quality and cost effectiveness. A six-pronged approach can attain multiple goals, starting with administrative audits on medical and pharmacy claims, high-cost claims, dependent eligibility, out-of-network services and stop loss efforts. Strategies focusing on benefits include cost transparency for informed consumers, value-based design, outpatient preauthorization and use of private insurance exchanges. Plans limited to retirees avoid some Affordable Care Act (ACA) requirements. Other strategies that build participant value are geared toward eligibility, networks and special programs for decision support, second opinions and technology including telemedicine and administrative applications. Provider payment models that promote value-based care and accountable care organizations further boost participant value. Two case studies illustrate results from implementing certain strategies.
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