Healthcare IT Interoperability, EHR interoperability, Hospital Interoperability

Value-Based Care News

Member Engagement is Key for High-Deductible Health Plan Success

Member engagement can help beneficiaries understand the value of high-deductible health plans and explore utilization.

Member engagement creates high deductible health plan value

Source: Thinkstock

By Thomas Beaton

- Payers and employers who offer high-deductible health plans (HDHPs) to attract low-cost members may need member engagement strategies to generate higher value for these beneficiaries.

Member engagement is critical for HDHP success because low premiums aren’t enough to keep members satisfied, says Jeff Oldham, Senior Vice President of Global and Institutional Markets at Benefitfocus, believes that.

Oldham suggests that the health insurance industry is experiencing a large shift where consumers are questioning their health insurance return on investment. He argues that this was not the case when it came to insurance shopping in previous decades when employer groups were the primary entities responsible for providing health insurance.

“Americans were not shopping around insurance markets as they would for anything else that they purchase in their life: refrigerators, cars, houses, and things of that nature,” Oldham said. “If someone is looking buy a high-cost product these days, one can get proper decision support online. A person can look at reviews, prices, and things of that nature.”

Value started to become a concern for employees once employer-sponsored plans responded to recent trends in healthcare spending. Employers are designing health plans with more member responsibility and want members to use healthcare services in a cost-effective manner.

READ MORE: How Payer Philanthropy Can Address Social Determinants of Health

Jeff Oldham, Senior Vice President of Global and Institutional Markets at Benefitfocus Source: Benefitfocus

“These changes, of course, were an attempt to manage this healthcare trend of overindulgence in healthcare utilization,” Oldman said. “For example, if a consumer is purchasing something, and they have no idea about costs or the quality or a product, then as a result someone is not going to use a product correctly.”

Driving HDHP value requires engagement that teaches members about the financial responsibilities associated with health plans.

Members may enroll in an HDHP and not realize the commitment they have unintentionally created to their overall health and financial well-being, Oldham warns. An employee may simply see a low premium and not realize that they’re responsible for high out-of-pocket costs.

“Employees enroll in high-deductible plans and all of a sudden they see deductibles of $4000 or $5000,” Oldham said. “And these employees might not have the financial or healthcare literacy to understand how they can effectively seek out the healthcare services they need.”

READ MORE: Patient, Provider Engagement Drives High Health Plan Performance

Employers and health plan professionals must also create positive changes in employee saving habits. A growing number of Americans have less than $500 in their savings accounts, according to Oldham, and may need to develop the financial management skills to get the most value out of an HDHP.

Oldham found that adding a health savings account (HSA) into an HDHP is a highly effective tool for developing patient fiscal responsibility.

HSAs pairings are valuable additions to HDHPs because they are a tax-advantaged portable account that encourages smart saving.

“An HSA is very similar to a 401(k) in that members can deposit funds and see their contributions grow over time,” Oldham said. “Contributions also transfer year-to-year, unlike a free savings account (FSA), and the savings move with a person if they change employers.”

Oldham found that employers can successfully teach members to contribute to an HSA, especially in younger member groups. Benefitfocus data revealed that millennials enrolled in an HDHP have increased their HSA contributions by 20 percent from prior years after receiving education about how HSAs work.

READ MORE: What are the Pros and Cons of Consumer Directed Health Plans?

Employers could increase HDHP enrollment rates among their employee groups by targeting benefits education to individuals during open enrollment periods.

Oldham suggested that this is a peak opportunity for engagement, since many employers and payers will see a high volume of people shopping for health plans. Tailoring communications about HDHP benefits and sending communications through digital channels like email and text messaging enhances open enrollment outreach.

Payers and employers should also strategize HDHP member engagement year-round to make sure that members are constantly aware of benefits like an HSA, Oldham said.

“An employer can't assume that someone is going to work through a 30-minute open enrollment online application and then, suddenly, know what an HSA is or how to use it,” Oldham said. “Benefits education requires perpetual ongoing communication and different methodologies of communicating.”

Employers should proactively analyze employee claims data to help members understand where they should save or spend on healthcare services.

Oldham found that employers can define value for members by analyzing claims within HDHP populations. Specifically, he suggests that a claims analytics platform may help employers gather year-round information to identify an employee’s expected out-of-pocket expenses and needed HSA contributions based on medical spend.

“By estimating out-of-pocket costs for the next 12 months, employees can now have a much better understanding of their medical spend and if they should have contributed more or less to an HSA.” Oldham said.

“There is proof that if the communication platform, the enrollment process, and the ongoing public-service announcement-like attention to communication work together, then employees will fully understand value,” he concluded.


Sign up for our free newsletter:

Our privacy policy

no, thanks

Continue to site...