Communication essential in controlling health care costs

In every business there are times that challenge each of us to rise to the occasion and do our best to meet the demands placed upon us.

Our world has definitely become more chaotic, to say the least. With regard to health care, the demands are diverse, requiring both immediate decisions and long-term strategic planning. It is important to remember that the demands of health care affect not only the business of health care, but how we do business and the lives of our employees and their families.

The challenge for employers is determining how to get control in today's chaotic health care environment; how to obtain and use the information, technology and experience available to them to manage their costs while assuring performance, quality and satisfaction; and how to do all of this while keeping the bottom line above the red line. The key is to find a way to transition from reactive activities and to well-planned, but flexible, strategies.

Easier said than done.

Continued price increases

Health care costs are, indeed, expected to continue to rise some analysts say by as much as 50 percent throughout the next five years. This bottom-line impact on employers especially in the current economy requires they give top priority to containing health care expenditures. Adding to this challenge is the knowledge that their employees and their communities expect and yes, even demand that the quality of health care is not sacrificed in the process.

A recent survey of 600 national em-ployers showed that more than half felt their employees don't understand their health care strategy.

Getting the message out

Most companies don't have the luxury of an excess of personnel and time to devote to employee/family communications. They do the best they can with what they have. However, these same companies must find ways to get the message out to their employees about their health care and its inherent costs, problems, concerns, and how they are trying to address those issues. Active participation in the "utilization and solution" is key to a company's success in controlling its health care costs.

Many companies have indicated that they see themselves being "legislated out of providing health care." Why? Because with few exceptions, mandated coverage increases the cost to provide coverage. Others have noted that they will drop health coverage if they are required to assume the liability for coverage determinations.

Meanwhile, health care plans are cost-shifting more and more to their insureds, increasing their premiums, deductibles, and overall out-of-pocket expenses.

Health care information management is an important tool that improves many decision-making processes. "Report Cards," for instance, provide comparative indicators of levels of hospital and physician care and services based on data and consumer surveys.

Another resource is the Internet, in-cluding those sites and vendors that offer health care advice and information. While they should never replace a physician, utilizing these services could re-duce the number of "excess" office visits. Taking advantage of online expertise could prove to be a welcome alternative for many companies.

Medical technology will continue to advance, with pharmaceuticals leading the way. The dilemma faced by employers is that the "old" drugs are being discarded in favor of the newer albeit more expensive ones. The physician has the responsibility of educating the consumer on the continued appropriateness of older and less expensive drugs.

Health care construction in our local community constitutes some of the big-gest projects going on right now. While many may question the legitimacy of this type of construction, facilities do become outdated quickly because of technological advances and the desires of the consumer.

Health care financing is, indeed, a wild card. The predicators of politics, legislative impositions, economic and marketplace forces, and consumer utilization all have an impact, directly or indirectly, on the monies available from any health care plan.

Obviously, from an employer/employee perspective, understanding, cooperation and even compromise must be reached to assure the stability of those health care plans.

Managed care continues to evolve, with an increased emphasis on choice with responsibility. Health care plans are no longer arenas of unlimited subsidization.

In this regard, the "plan-pays-all," provider-restrictive health maintenance organizations are giving way to more open plans and greater provider access. In return, consumers (e.g., employees and their families) are expected to bear the inherent cost.

Relationships

Physician relations with their patients will evolve pretty much along the lines of the patients' health care plans. In that respect, with the consumers bearing more of the cost of their care, they will expect more time, energy and support from their health care providers.

New programs will continue to be initiated and promoted by employers in an effort to stem the rising tide of the health care costs. Their goals will be to stimulate greater consumer and provider responsibility while promoting and influencing better health outcomes and productivity.

Employers will become more innovative and creative, giving greater consideration to utilizing Internet services, including "ask-the-doctor" programs and e-commerce, complementary alternative medicines and care, disease and condition management programs, and wellness initiatives.

In the employer/employee relationship, there is nothing more personal to an individual than health care. Employers recognize this and seek to effectively manage their health care investment while preserving the value of health care benefits to current and future employees.

(Gordon L. Kinne is president of Med-Pay Inc.)