Transforming Your Health Plan

The beginning of a new year often brings new ideas and initiatives for employee benefit teams. Those ideas and initiatives are centered around controlling healthcare costs and giving employees an affordable health plan.

Healthcare costs associated with musculoskeletal (MSK) conditions can greatly impact an employer’s overall healthcare spend. Musculoskeletal health relates to the well-being of an individual’s joints, bones, and muscles. MSK conditions can be caused by several issues such as overuse, injuries, sprains, fractures, and poor posture and is often associated with the workplace. Workers in the manufacturing industry are especially prone to MSK injuries from performing repetitive motions such as:

• Prolonged standing
• Repetitive tasks
• Heavy lifting
• Awkward postures

MSK conditions are one of the top cost drivers for a self-funded health plan, oftentimes outpacing spend for cancer and cardiovascular disease. How can self-funded employers tackle this issue? Direct contracting arrangements give employers the ability to establish a more direct and financially beneficial relationship with providers. It gives employers and employees a lower cost option without compromising quality, it improves price transparency, and can lead to healthier outcomes.

We will continue to see an increase of direct contracts and narrow network options to combat the rising costs of healthcare. While direct contracting is a feasible solution, it’s important to have the right partners on hand. Here are some best practices you want to consider:

• Navigation team able to direct employees to low-cost, high-quality facilities.
• Data analytics to compare market options.
• Coordination with the stop-loss vendor.
• Creating network expansion with other providers.

Musculoskeletal conditions aren’t going away. How you deal with them as an employer can help create a positive impact for your health plan and your employees.