Beware of Facility Fees

healthMembers would be well advised to keep an eye out for a new wrinkle in provider billing – facility fees, resembling resort fees often tacked on to daily room charges at upscale hotels. These fees, being charged by some hospital-owned clinics in addition to the charge for physician services, are said to be the result of hospitals acquiring more and more physician practices. They are also one more reason to look closely at provider billing.

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Student Loans and Standing Desks

appleFinancial wellness, standing desks and other wellness strategies are high on the list of benefits trending upward in 2018. According to the Society for Human Resource Management, a growing number of organizations are offering programs to help employees improve their financial well-being. Some companies are providing debt counseling and help with repayment of student loans. Standing desks are becoming very popular, with a growing number of companies offering them to employees as a new wellness benefit.

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How many times has your company changed its health plan in the last 5 years?

EBSO Benefits, an independently owned Third Party Administrator, helps employer groups self-fund their health benefits, thereby giving their clients an opportunity to reduce administrative costs, increase plan flexibility and expand the services they offer to their employees.

More importantly, EBSO is leading the way in a new phase of employee healthcare by helping employer groups take control of their healthcare plan. And taking control means more than self-funding. It means really managing the plan, doing some heavy lifting and shaking things up when what was commonplace is no longer working.

One example EBSO is proud to reference is that of a Midwest-based food processor that has not only stabilized costs for its 700+ employee group but seen the cost of its self-funded health plan drop by approximately 8 percent over the past 4 years. There’s no magic involved – taking ownership of the plan and managing it each and every day has made the difference. New steps have also been taken over time, like adding on-site clinics and contracting directly with high value providers for certain procedures.

While change came slowly at first, the pace quickened once everyone bought into the reality that the status quo was no longer acceptable.

As their TPA, we partnered with the employer to lead the way. Actively managing the plan and navigating care demonstrated to members that the days of simply pulling out an ID card and paying a co-pay were over.

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As shown, navigating care in a self-funded environment can achieve high quality, affordable healthcare over time. Employees value the many resources available to them, such as an online benefits portal, mobile apps and day-to-day support. They also learn to share in the responsibility.

If moving from carrier to carrier isn’t working out well for your company, it’s time you discovered the freedom, flexibility and control that self-funding with an independent TPA can offer. Contact EBSO and learn more today.

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Workers Retiring Later

boomersThe Society of Actuaries reports that nearly one in five Americans in their early 70s are still working. A big reason cited is that the age at which people can claim full Social Security benefits is currently 66. With actuarial tables showing that a 65-year old male can expect to live an additional 20 years, working longer has become a necessity, since retirement may very well last far longer than previously anticipated.

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Redefining High Blood Pressure

healthAccording to new guidelines being published by the American Heart Association (AHA) and the American College of Cardiology (ACC), high blood pressure is now defined as readings of 130 mm Hg and higher for systolic blood pressure or 80 and higher for the diastolic measurement. As the first update to the U.S. guidelines for blood pressure detection and treatment since 2003, these new measurements are intended to encourage earlier detection, prevention and management of high blood pressure.

While estimates are that high blood pressure diagnoses will rise by 14%, the hope is that the vast majority will be counseled about lifestyle changes rather than receiving prescribed medication. Often referred to as the “silent killer” because there are no symptoms, high blood pressure accounts for the second largest number of preventable heart disease and stroke deaths, second only to smoking.

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Pregnant Workers Receive Accommodations

Pregnant-WorkerBeginning in April of 2018, employers in Massachusetts will need to provide reasonable accommodations to pregnant employees, including measures to prevent discrimination against those pregnant workers who request an accommodation. Some of these accommodations will include allowing more frequent or longer breaks, modifying seating or other work-related equipment, temporarily transferring pregnant employees to a less strenuous or hazardous position and providing private non-bathroom space for expressing breast milk. According to the Pregnant Workers Fairness Act, employees must be notified of these rights, in writing, beginning January 1, 2018.

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Your Phone May Be Smart, But Is It Clean?

While your cell phone can carry your valued business contacts, treasured photos and more, it may be carrying plenty of germs as well. In fact, clinical microbiology experts told Time magazine recently that a cell phone can carry 10 times more bacteria than most toilet seats!

What can you do to protect yourself? Keep your phone out of the bathroom, use microfiber cloths designed to clean your phone and most important – wash your hands since basic hygiene will always help protect you and others who may share your phone from time to time.

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Seeking a Second Opinion

second-opinionHealth policy researchers at Mayo Clinic recently found that only 12% of patients who sought a second opinion for a complex medical condition at Mayo Clinic received confirmation that their initial diagnosis was correct and complete. This should be reason enough to begin educating employees about the benefits of second opinions and how to get them. Common concerns expressed by patients include a fear of offending their physician, a feeling of urgency to begin treatment and of course, concern that their health plan may not cover the cost of a second opinion.

Whether you use employee newsletters, printed handouts and posters or a lunch and learn, it is important to let employees know that most doctors welcome a second opinion and they should never be afraid to ask their physician how much time they can take to obtain a second opinion before making a decision on treatment. Make sure members know if they have a second opinion benefit and consider offering an incentive for taking an active role in health management.

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Empowering Employees: Big Talk, Little Action

telemedicineTelemedicine offers a lot of potential for everyone – added convenience for busy families and lower costs than a traditional office visit. But as helpful as this service can be, it will only make a difference if it is used.

Low utilization is not unique to telemedicine. It’s a common problem with many new, well designed and well-intended health care services. Encouraging plan members to actually use new offerings is a challenge for employer groups, large and small. And while utilization is often higher in self-funded health plans, all employers need help turning talk into action. Here are a few ideas to consider:

It’s all about them – With health care consuming more of everyone’s income and attention, we all have a vested interest in our benefits. And while wonderful tools like telemedicine keep coming to the table, you need to look at these offerings from your member’s perspective rather than your own. Talk with your employees; ask if a service will help them and listen to their feedback. If it can add real value to your employee’s lives, utilization will follow.

Talk about health, not cost – Research indicates that when it comes to their health and wellbeing, there are many things members would prefer to hear about than fees and costs. A majority are interested in improving their health. It takes time, but focusing on current health risks and personalizing communications as much as possible will help members want to get more engaged.

Educate to empower – Transparency tools and online portals are no different than other modern advances. If people don’t understand them, they will never catch on. Like telemedicine, unless employees understand how to use it and when they can use it, they will never realize the benefit of having an experienced, board certified physician, with access to their medical records, available to help them 24/7.

While it seems that other new disruptive innovations, such as Alexa, catch fire overnight, they do take time. Since your employee communication budget likely pales in comparison to those driving consumers to Amazon, talk with your TPA about new ways to zero in on the needs of your employees. Doing so can lead to increased utilization and a happier, healthier workforce in 2018 and beyond.

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