Regardless of your position on health care reform, recent legislation will change the way we operate our businesses. Small companies will have to determine whether they want to grow and thereby become responsible for additional requirements under the new laws. Companies will need to determine if they want to add wellness programs to their benefit packages because of the laws’ incentives in that area. Executive leadership will have to decide whether paying penalties for non-compliance will be cheaper overall than the cost of changing their existing health care plans. Existing physicians must assess their business model to determine its sustainability, as well as its ability to meet an increasing demand for patient care. Educated consumers will have to decide whether they are willing to see a mid-level care provider, such as a nurse practitioner or physician assistant, immediately or wait longer so they can see a doctor. Commercial health insurance and the government-sponsored health care plans will need to determine how costs will be constrained. Everyone will be impacted by the changes to health care. Some of the change is good, while other changes will require a new strategy if your company is to cope effectively.
In a recent article of The Economist, the author wrote of the challenges caused in Canada by prescription-drug spending. The Canadian government spends 46% of their entire budget on health care, the greatest portion of which is used to cover the cost of prescription drugs. As a result, one province, Quebec, has added a health tax to its 2010 budget, so its citizens will share the burden of the spiraling health costs anticipated for the aging baby-boomer generation. The Canadian model, on which much of the new U.S. health care reform is based, indicates that increased access to health care in the U.S. will ultimately result in more prescriptions being written to care for the sick. Everyone agrees the new health care reform measures still do not encourage proactive wellness care but rather continue the model of ‘sick care’. Sick care means writing prescriptions to treat illnesses. What does this mean for U.S. executive leaders? It means you need a strategic plan! Whether you build the plan with internal resources or hire an outside business and strategy consultant to assist you, you have to make a plan for how you will navigate these complex issues.
As we look at the Canadian model, what lessons can we learn so as to act proactively? For one thing, we know our insurance premiums must be “affordable,” so it’s important to know the cost of your current insurance plans. Other actions to consider could include the following:
- Conduct audits to determine only the appropriate people are getting coverage. For example, make sure ex-spouses have been removed from the company’s health plan. If your employee presented a divorce decree, make sure your company isn’t still paying the company portion of premiums.
- Examine the trends within your existing plan prior to making changes. For instance, what services are most commonly used by your employees?
- If it isn’t already being done, assign someone in your company to monitor claims. It is unfortunate but true that many healthcare providers submit claims incorrectly.
- Most importantly, actively listen to your staff. They can help you understand the pros and cons of the existing plan and most likely can help you identify better ways to control costs. Ask the staff what they want in a wellness plan. Often the most important strategies will come from your own staff.
You already have a full plate trying to operate a company in the current economy while preparing for future legislation. One of the most devastating things a leader can do is to stop looking ahead and manage reactively versus proactively. Our Canadian neighbors have dealt with some of these issues for years. Look, listen, and learn from their experience. Be proactive now and prepare your company for a stronger future.