A healthy workplace

How to sort through new care options for workers

November 02, 2008

Your bosses aren't serving you chicken soup just yet, but during this open enrollment season you'll find they're taking other creative steps to make sure you don't get sick.

They might bribe you with gift cards or cash so you fill out a questionnaire to assess your health risks. They might pick up the full cost of certain prescription drugs to make sure you stay on them. Some large employers are even adding on-site medical clinics to make it easy for workers to visit a doctor or fill a prescription.

This push toward preventive care isn't the only trend you'll see during open enrollment. As in past years, you can probably count on higher premiums, deductibles and out-of-pocket costs. Benefits consultant Hewitt Associates predicts the average employee will see annual health care costs go up to $3,826, an 8 percent increase from a year ago.

And you may find you have fewer plans to choose from, a move by employers to gain negotiating leverage with insurers.

When your enrollment package arrives, make sure you read it carefully and choose a plan to fit your needs. About 60 percent of workers don't do this, instead defaulting into whatever plan they chose in the past, says Sara Taylor, Hewitt's annual enrollment leader.

This can be risky given that many employers are making changes this season. You could end up with inadequate coverage that costs you more, Taylor says.

The most noticeable changes could be your employer's eagerness to keep you healthy. Companies figure if they can coax you to take care of yourself or to seek medical treatment early when you need it, you won't develop serious - and expensive - health problems later.

"The health care system in the country has historically taken care of things when things go wrong. ... Plans were geared toward that," says George Lane, a principal at benefits consultant Mercer. "Employers have come to realize that the best way to manage costs long term is to get ahead of the curve and prevent some of those things happening."

The economy, though, is working against employers. Recent surveys indicate that many workers are letting health care slide, often blaming the weak economy. Nearly half of respondents to a recent Kaiser Family Foundation survey said a family member had skipped taking pills or cut back on needed medical care in the past year because of the cost.

Here are ways employers are trying to nudge you to better health and keep costs down:

On-site medical clinics:

Many years ago, companies often kept medical professionals on staff to take care of minor injuries or illnesses in the workplace. McCormick and Northrop Grumman in Maryland still do.

Others eliminated those posts to cut costs. Now, large employers are discovering they can save money by opening health centers at the business site, says Andrea Baer, a senior consultant with Watson Wyatt Worldwide.

Clinics usually handle screenings, immunizations and minor illnesses. At some, you can fill a prescription or get physical therapy.

It gives employers some control over the cost of these services, Baer says. And clinics improve productivity because workers aren't taking time off to visit a doctor across town.

A Watson Wyatt survey of more than 450 large employers this year found that nearly one-third have or plan to build an on-site clinic by 2009.

Erickson Retirement Communities in Baltimore County started rolling out employee clinics at its communities a year ago. It now has four and expects to have 11 by the end of next year.

The company figured healthy employees will lead to better service to residents, says Dr. Craig Thorne, medical director for employee health and wellness. And Erickson saw that other employers saved money with clinics.

Studies show that for every $1 spent on a clinic, a company over time saves $2.50 to $4 through lower premiums and a reduction in absenteeism and other health-related costs, Thorne says.

Thorne says a clinic's annual cost is $120 per worker. Workers pay $10 or $20 per visit. Three clinics opened last year have handled more than 2,000 visits.

Lockheed Martin has had medical clinics at its facilities for decades to deal with health and occupational safety matters. But the defense manufacturer opened up a wellness center in August to promote health and preventive care at its Bethesda headquarters. By the end of next year, its 27 medical clinics also will be transformed into wellness centers.

Confidentiality was a concern, and Lockheed took extra precautions to protect employees' privacy, says Bill Bonk, Lockheed's director of health and wellness.

"Trust is the most important thing," Bonk says. "If we lose the trust, we might as well close the doors."

Even if an employer doesn't add a clinic, more are making sure that their plans cover visits to easy-access medical clinics within retail outlets, Baer says.

Health risk assessments:

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