Cost Sharing Trend To Continue In 2007
Each year, we look at our book of business for small group plans in Minnesota to identify emerging trends. Our goal is to give you some perspective on how your sales success fits into the big picture and where additional opportunities may lie.
‘Traditional’ HMO benefit offerings are on the decline
Just three years ago, most employers offered rich health benefit packages and carried most of the cost burden. Now, small employers are skimming the fat off benefits to reduce cost. Employers are adopting deductibles and increasing them over time, as well as raising copays in an effort to contain costs. More importantly, members are bearing more and more of the overall cost of health care.
The benchmark $15 copay, once the gold standard, is now a rare offering – especially among new groups. Over the past three years, that number has dropped from 33% in 2004 to just 6% in 2007. Renewing groups have dropped from 63% to a new low of 28%.
Mass migration to deductibles
We’ve also seen rapid adoption of deductibles with both new and renewing small groups. A higher percentage of new groups tend to offer deductibles, jumping from 43% to 73% in just three years. Renewing groups have accelerated their adoption of deductibles at an even greater pace, jumping from 10% to 53%. The adoption of increasingly high-deductible plans is an indicator of the continuing trend toward HSAs.
Putting the Findings to Work
You and your clients can reference these findings to make more-informed health benefits decisions. Use the factors in the EZ Portfolio Pricing Guides to discuss these trends and the corresponding options for your clients and prospects.
With this trend data, you can help clients gauge where they stand relative to the employment market in terms of health benefits value and cost-sharing measures. This could help them justify the changes they are considering in plan structures, such as adding deductibles, offering higher deductibles or increasing copays.
You can also use these finding to help clients establish a plan for a steady migration toward future HSA models, with incremental increases in deductibles and clear, proactive communications to manage employee expectations.
As the health-cost burden shifts to employees, you can help soften the blow by giving them tools for cost planning, advocacy and support, highlighting cost-reduction strategies, such as consumerism, generic drug programs, wellness and disease management.
For more ideas to leverage these findings, please contact your HealthPartners Sales Executive.
HEADLINES
We’ve Got You Covered – Nationwide
 It doesn’t matter where your clients’ employees live, work or travel – we’ve got them covered! Our national alliance with CIGNA gives members access to more than 470,000 providers and 4,800 hospitals nationwide. Members can search for those providers quickly and easily online at healthpartners.com.
The alliance also increased our membership by approximately 25,000 members with the addition of several large groups. Plus, HealthPartners began serving approximately 75,000 CIGNA members in the HealthPartners network.
To support national network discussions with your clients, we’ve developed a new sales flyer for your use.
To learn more please contact your HealthPartners Sales Executive .
HealthPartners Ranks No. 1 For Customer Satisfaction
HealthPartners is the top ranked health plan in Minnesota for customer satisfaction according to an independent survey of 200,000 households. The survey by the National Research Corporation is the largest assessment of customer satisfaction in the nation. Top ranked health plans are determined by member satisfaction measured in the annual NRC Healthcare Market Guide® study, which surveyed households in the contiguous 48 states and the District of Columbia.
"To make smart health care decisions, consumers need information about cost, about quality and about customer experience," said Scott Aebischer, senior vice president of customer service. "This national survey is an important tool in giving patients information about health care that has long been available in most other industries," he added. The study measured consumer satisfaction in seven areas: overall satisfaction, willingness to recommend a plan, online tools, customer service, complaint resolution, plan communication and enrollment process.
Last month the National Quality Forum awarded HealthPartners the National Quality Healthcare Award, its highest honor for improving health care quality and public reporting.
So remember when you’re helping clients select a high-quality health plan, suggest a recognized leader. Suggest HealthPartners.
View article from BusinessNews.
Medicare Coordination of Benefits For Small Employers
Do you have clients with employees who are turning 65 and becoming Medicare eligible? If so, here’s what your clients need to consider if their employees elect to remain on the employer group plan.
We offer two 65+ rate bands on the employer group plan, however, we do not ‘assume’ eligibility. To ensure the employer is charged the appropriate amount, we need the following documentation for verification purposes when the member turns 65 years of age:
- From the member: A copy of the Medicare card showing they have both Medicare Parts A and B.
- From the employer: A letter verifying a payroll of 19 or fewer employees (total, full and part time)
We have received numerous questions on this issue, so please share this with your clients. Employers will find this information in the underwriting assumptions of renewal rate pages.
To learn more please contact your HealthPartners Sales Executive.
 Congratulations to Steve Warner of Warner and Associates who won a mountain bike at the MAHU Sales Congress held February 1, at the RiverCentre in St. Paul. If you didn’t have a chance to stop by our booth, we showcased our Healthy Discounts program. This value-add program provides members with great discounts on eyewear, health clubs, fitness equipment, weight loss programs – at no additional cost to employers.
View our new Healthy Discounts flyer for employers or visit Health Resources on healthpartners.com.
New Generic Drugs Add Up To Savings
In 2006, generic use reduced member drug cost by almost $35 million – are your clients up-to-speed on what’s available? Over-the-counter (OTC) generics are FDA-approved, safe, effective and generally cost 30 to 80% lower than brand-name equivalents.
In fact, we estimate that our drug costs will decrease by more than $10 million annually with the recent availability of simvastatin, a generic version of the cholesterol drug Zocor®. With simvastatin available OTC at $13 per month, members no longer have to pay $85 for Zocor. When you consider that Zocor is the second leading prescription among HealthPartners members, that 90% savings per Rx really adds up!
In the upcoming year, patents are set to expire on other widely used brand name drugs including Ambien®, Norvasc® and Zyrtec®. Your clients will appreciate the related cost savings — and so will their employees!
For more information on generic drugs, visit healthpartners.com/pharmacy or the FDA Office of Generic Drugs.
To learn more please contact your HealthPartners Sales Executive.
HealthPartners Brings Disease Management In-house
In April, HealthPartners will administer disease management programs in-house – including those for diabetes and coronary artery disease. The programs, which benefit about 26,000 members, enhance programs currently offered by an outside vendor.
“This in-house program furthers our commitment to be patient/member centered and it leverages our expertise in health improvement as an integral component of supporting members in managing their chronic condition,” said Nico Pronk, vice president of health and disease management.
The programs will be administered by HealthPartners Health Behavior Group in collaboration with other departments including IS&T, Health Informatics and Case Management.
To learn more please contact your HealthPartners Sales Executive.
The consequences of too little exercise are everywhere. Obesity and related chronic illnesses are spreading at an alarming rate and significantly affecting worker productivity and health care costs. One in four adults is obese. Obesity-related health problems account for 12 percent of our national health care budget and cost our society $13 billion annually in expenses and lost productivity. The situation has become so severe that the International Congress on Obesity recently called obesity as big a threat as global warming and bird flu.
Our Frequent Fitness and GlobalFit programs help members get healthy. Encourage your clients to promote our Frequent Fitness and GlobalFit programs.
Members have access to more than 250 facilities and that number is growing daily! New clubs for 2007 include:
- Anytime Fitness – Becker, Big Lake, Brainerd, Brooklyn Park, Coon Rapids, Little Falls, Maple Grove, St. Francis, Zimmerman
- Central Square Community Center – South Saint Paul
- Forest Lake Health Club – Forest Lake
- Lake Crystal Area Recreation Center – Lake Crystal
- Life Time Fitness – 25 Twin Cities metro locations
- Mill Street Fitness – Rushford
- New Brighton Community Center – New Brighton
- Princeton Health & Fitness – Princeton
- Sioux Falls Family YMCA – Sioux Falls, South Dakota
- Superior Balance and Fitness – Superior, Wisc.
- The Workout Center – Waseca
- Unity Health and Fitness – Eau Claire, Wisc.
- Uplift Guided Fitness for Women – Woodbury
- Vital Fitness – Howard Lake
- Workout 24/7 – Cannon Falls, Red Wing
- YMCA – Fergus Falls
Network Updates
We’re committed to providing access to the providers your clients demand – nationwide. In the past few months we’ve focused on provider growth in North Dakota. No matter where your clients live, work or travel, we’ve got them covered. Recent additions include:
Medical – North Dakota
Ashley Clinic, PC – Ashley
Ashley Medical Center – Kulm, Zeeland
Gackle Clinic – Gackle
Unity Medical Center/Grafton Family Clinic – Grafton
Kulm Clinic – Kulm
Napoleon Clinic – Napoleon
Rolla Clinic, PC – Rolla
Southwest Medical Clinic – Bowman
Wishek Clinic – Wishek
Medical – Minnesota
Allina Medical Clinic – St. Michael
Family Health Medical Clinic – Farmington, Lonsdale, Northfield
St. James Health Services – Saint James, Comfrey, Trimont
Dental – Minnesota
Artistic Smile Dental Center – Sartell
Baudette Dental – Baudette
Bruce A. Bohnsack, DDS – Cokato
Bridget L. Fensholt, DDS – South Saint Paul
Donald F. Garon, DDS, PC – Maple Grove
Family & Cosmetic Dentistry, LTD – Saint Paul
Ann E. Jennen, DDS – Saint Paul
Knutson & Huxford, DDS, PA – Owatonna
Salute Dental – Woodbury
Shakopee Dental, PLLC – Shakopee
Westland Dental – Plymouth
Zumbrota Dental – Zumbrota
Medical – Wisconsin
Castleberg Clinic, SC – Durand
Dental – Wisconsin
Midwest Dental –Baldwin
William R. Powell, DDS, SC – Menomonie
Try out our new search function so see just how easy it is to find a network provider quickly and simply. Provider Search.
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