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5 Ways for Mid-Sized Employers to Fight the Death Grip of the Health Care System

The death grip on employers by the health care system continues.  Here are five ways to try and loosen the grip.


  1. Self-fund your health plan.   This could be numbers one, two and three on this list.  Without self-funding you receive very limited, if any, data and without data there is no way to understand where your costs are coming from.  Or if your rates are truly fair.  There are alternative ways of being self-insured that are less risky than traditional methods like level funding and captive arrangements.  For smaller employers in VT (less than 50 employees), unfortunately, this type of financing may not be an option because of a lack of access to data.  However, there are still ways for smaller employers to take back some control – think health reimbursement arrangements.
  1. Actively manage your health plan.   While no employer I know loves the fact their organization is in the health care business, the fact is employers are indeed in this business now.  The huge expense has dictated this reality.  Organizations are generally quite good at managing expenses, except when it comes to health care.  We often just cross our fingers at renewal time because it all seems so overwhelming and complicated.  Organizations need to start thinking differently and invest in measures to manage those costs – think incenting people for using lower cost providers, domestic medical tourism and directly contracting with pharmacy benefit managers.
  1. Get educated and get involved.  There is an opportunity for employers to band together and share health care best practices.  And to get educated on the drivers of health care costs to their organizations so that they can start attacking those costs.  Employers also have an opportunity to band together and get involved in the legislative process, regardless of political affiliation, because no employer is immune from the impact these rising costs are having on their organization and their employees and their families.  There is a lot happening on the health care reform front – see the ACO efforts in Vermont.  As major payers in the system, employers have the opportunity to have a voice in the process.
  1. Engage employees.   Health care benefits are valued greatly by employees.  Employers have the opportunity to better educate and engage their employees in the efforts by creating a “we’re all in this together” mindset.  The more educated employees are, the more opportunity exists to try and control costs.  This does not mean avoiding care.  In fact, it’s the opposite – employers should want more care, particularly at the primary care level.
  1. Innovate.  There are some interesting things happening in health care.  New players are emerging to disrupt the current system.  Employers can start thinking about their own ways to disrupt the system.  Perhaps owning a shared clinic for primary care and health coaching.  Or directly contracting with a primary care network.  Or implementing an advocacy program to help employees and their dependents to navigate the system and guide them to high quality care at the best price.

None of this is easy.  And, again, no