Workplace wellness programs are not always beneficial for companies looking to cut their healthcare costs. This article focuses on five methods to reduce employers’ healthcare costs.

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Five Effective Methods for Companies to Reduce Healthcare Costs
Most of the companies in the U.S have been implementing several initiatives to
develop an efficient health care plan for their full-time employees so that they can
receive affordable coverage (with payment not more than 9.5% of their salary) as
insisted by the Affordable Care Act. The latest CNN report cites the opinions of
America’s famous healthcare experts Tom Emerick and Al Lewis about cracking
healthcare costs. According to that report, Workplace Wellness programs can’t
reduce the healthcare costs as they are supposed to have done. The savings are very
less even if we consider the participation of both committed employers and
motivated participants. An article published by the Journal of American Medical
Association also asserts that visiting doctors frequently for more tests, as advocated
by most of the wellness programs, is simply a waste of money. The report puts forth
five initiatives to cut healthcare costs rather than opting for state health insurance
exchanges or penalties as alternatives to wellness program.
Curb Unnecessary Health Checks
It is a bad practice to persuade your employees to go for unnecessary health checks
even as a part of the wellness program. This will increase the medical spending and
lead to over-treatment which may prove hazardous to individuals. Frequent
biometric screenings is a perfect example for that. The unnecessary tests, biopsies
and surgical procedures generated from this screening are ineffective and cost
around $1 million. Emerick and Lewis say that you need to screen 4,000 people
incurring a cost that exceeds $1 million to prevent even one $50,000 heart attack.
Moreover, the false diagnosis rate in the case of cancer screens is very high. The
National Heart, Lung, and Blood Institute even opposes unwanted biometric
screenings as it results in over-treatment.
Fire Health Care Consultants
Healthcare consultants who helped to implement the programs to reduce healthcare
costs and failed can’t be trusted any more. The failure signifies the fact that they
may not have evaluated the pros and cons of the programs thoroughly. Fire such
consultants and employ new consultants. They will evaluate the programs more
efficiently. The cost will be reduced as well.

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Spending money for health insurance brokers is also a very good option. Insurance
brokers can help employers find suitable health insurance for their employees.
They will check for better plans and premiums and negotiate with the employers. The
companies can thus find a better deal which can cut their healthcare costs. Apart
from that, they can help employers settle benefits issues and assist them in
employee enrollment.
Conduct Eligibility Audits
If you audit the claims submitted by your employees against the insurance policy,
you can ensure that the claims are paid only to the employees who are actually
eligible for the health benefit. You may feel that knowing who are the people eligible
to have which claims paid seems like Health Insurance 101 and would bring no
savings. But, if you get support from professional medical billing companies which
ensure 100% contingency-based audits, you can review every portion of the claim,
eliminate serious mistakes and reduce inaccurate costs. In this way, you can save lot
of money that you may otherwise spend unnecessarily.
Negotiate with Prescriptions Benefit Manager (PBM)
Prescription Benefit Managers often hide their profitability with rebates, low or
unrealistic direct fees, implementation allowances and other contractual clauses.
Therefore, it becomes impossible for the employers to estimate per-drug markup of
PBMs and adjust the healthcare costs accordingly. It is better to negotiate that
markup with PBMs directly.
Better Care for Employees with Unpreventable Health Conditions
Normally, a small percentage of employees generate large percentage of claims on
account of continuous health needs. But, if you focus your wellness program on the
80% that generate just 20% of the claims, it means you are neglecting the outliers
who have health conditions that were not preventable. Wal-Mart, the retail giant
offers free travel for their employees to find destinations across the country which
specialize in treating the particular health condition and thereby cut health costs
significantly. The facilities you offer should be such that your employees can get back
to work soon. Hence, focus only on medical destinations that ensure (and agree to
get paid for) positive results.
About OSI
OSI is a multi-specialty medical billing service provider based in Tulsa, provides end-
to-end medical insurance verification to help healthcare facilities to improve their
bottom line. For more information regarding our medical billing outsourcing services,
call 1-800-670-2809 or make use of our free billing analysis