Boardroom

What you need to know

What is a Consumer Driven Health Plan (CDHP)?

Communication and planning are extremely important for the success of your consumer-driven health plan. Getting the right people involved in the education/communication process is essential. Focus on the three principles of the foundation of CDHP.

Communicate the plan’s philosophy of transparency, responsibility, and opportunity to your employees as well as what the plan covers and how. In every communication, focus on the direct effects these principles will have on your employees. Keep the points outlined below front and center in all your communications and educational meetings—staying on message is critical to implementation success because it helps your employees speak the same language.

TRANSPARENCY

Awareness

The first step toward becoming knowledgeable on any subject is accepting that you may not immediately have all of the information. It is no accident that consumers don’t know how much health services cost. Insurers and providers keep them in the dark because their contracts prohibit full disclosure of how and what they are paid.

Let your employees know that they have been in the dark regarding healthcare. When they realize that important information is not being shared with them, they will start asking questions that most insurers and physicians aren’t used to answering. Your employees will want to know their alternatives. You can inform them that the CDHP solution creates awareness, and that the plan encourages the full disclosure of all treatment options, costs, and fees.

Information

Once employees are aware that there are gaps in their knowledge, they will want to know more about healthcare costs and how their personal situation can be better managed. The explanation of benefits (EOB) form which employees receive from their insurance company is the document that will help them better understand the cost of healthcare services and encourage them to verify the services they received. Tell them that the EOB will not only detail the costs of their healthcare expenses, it will also break down each expense into its individual components, illustrating how much money goes to the hospital, the doctor, and the pharmacy. Members won’t have to make a special request to access this information—it’s an integral step in the healthcare process. An EOB will be issued for each medical service they access, so they will always know the full cost of their care.

RESPONSABILITY

Increasing knowledge

With knowledge comes responsibility. When your employees understand that they have the power of choice, they can take the time to review their options and make more informed decisions. Reading the EOB carefully and understanding what it says is one way consumers can inform themselves about their personal medical expenses. There are many ways that an individual can become more engaged in their healthcare choices and take steps to change the way they live their lives and interact with the healthcare system.

Resources

Cost comparison tools such as federal and state healthcare cost web sites can be trustworthy sources. Many health insurance companies offer nurse help lines, which is another valuable resource for employees that will help them to save both time and money. Nurses can provide much of the same information and knowledge a doctor would, but the telephone service normally costs your employees nothing because your carrier offers it as a value-added service.

Learning how they can improve their personal health in order to reduce their reliance on health services is also crucial to the plan’s success, and may encourage your employees to change negative habits. These simple tools are probably news to most people, so build awareness of them into your communication plan.

Considering alternatives

Encourage employees to choose less expensive medical care whenever reasonable. Someone with a broken arm should go to the hospital, but someone who’s twisted their ankle should probably ice it for a day or two, keep it elevated, and try to stay off their feet. If their ankle is still sore and swollen after a few days, they should see a doctor, but it’s important to take alternative measures first. These measures are likely to save them the few hundred dollars it would cost to have a doctor give the same advice, or to fill a prescription for a painkiller when an over-the-counter drug would suffice. Healthcare cost and quality depend on where you live, who you are, and what is known about your condition and will factor into your decision-making process.

Improving health and wellness

Learning how your health directly impacts your healthcare spending can be a major wake-up call. Employees should be encouraged to think about how they can improve their health through diet, exercise, and stress management. Health improvement plans that are determined for them won’t work—they must decide where their health needs the most improvement, and what sorts of initiatives will inspire them to make meaningful changes.

OPPORTUNITY

Reducing healthcare costs and saving money

This is a major benefit of CDHPs and should be highlighted throughout the communication and education process. Employees can use their healthcare account as a vehicle for the tax-favored payment of healthcare services. The more they live by the CDHP philosophy, the more value or equity they can build in their CDHP by spending wisely. By becoming informed, taking advantage of alternate treatments for minor health issues, and staying in good physical shape, they are more likely to have value or equity left over at the end of each year, which rolls over each year and builds over time. This built-in incentive creates a significant financial opportunity for CDHP members.

Becoming healthier

Aside from the financial benefits of improving one’s health, there are also the obvious health benefits. By taking advantage of this unique value proposition, your employees can change their lifestyles and become healthier, stronger, and more productive in every area of their lives.

Contributing to the greater good

Although it’s compelling to think about the personal advantages of CDHPs, it is equally important to remind employees about the big picture. CDHPs are a solution that helps consumers personally and positively impact one of the biggest expenses (usually second only after payroll) every employer has—a real threat to the financial health of most organizations.

Coaches' Takeaway

Communication and planning are critical—getting the right people involved in the communication and education process will determine your level of success.

Tools & Resources

CDHPCoach’s Storage Facility, where the Coach has organized and compiled a vast amount of tools and resources for you to access.

Library

Housed here are key components and information within the book, Bend the Healthcare Trend which was the impetus behind the CDHPCoach.

Boardroom

What you need to know