It’s preferable to stop a fire from starting than it is to stop the flames from spreading, or to undo the damage that they cause. Prevention is naturally a primary goal for healthcare providers, who strive to keep patients from becoming sick and/or getting sicker. But self-insured employers benefit from this branch of healthcare too. Though it’s hard to say definitely if preventive medicine will help you dramatically slash costs, embracing prevention has lasting benefits for all involved.
What Preventive Medicine Looks Like
First, it’s important to understand what we mean when we talk about preventative medicine. It’s a catch-all term, encompassing a huge range of measures and treatments designed to avert disease. In medical terms, preventive measures fall into one of three categories.
Primary prevention occurs before disease begins. These measures are designed to prevent symptoms from developing. Immunizations are a common example of primary prevention. Secondary prevention involves treating symptoms or risk factors to prevent a condition from progressing. These measures should identify diseases in their earliest stages; mammograms are an example. Finally, tertiary prevention seeks to slow or stop the progression of an existing disease. Pharmaceuticals and rehabilitation are often used as tertiary prevention.
The Case for Preventative Medicine
For self-insured employers, preventative medicine is a powerful resource. Avoiding high-value claims is a primary goal for these employers, and preventing diseases from starting is naturally in a patient’s best interest.
Unfortunately, a self-insured employer can’t be guaranteed that preventive medicine will minimize its costs because it’s really tough to measure the financial impact of preventive medicine. It’s a category that encompasses so many different kinds of services and treatments, and different types of preventive medicine have different cost-saving power. Unsurprisingly, tertiary prevention is often more expensive than primary or secondary prevention. That makes sense: these measures are used when someone is already sick and are generally administered in a healthcare setting.
Still, it’s really hard to quantify exactly how different prevention efforts translate to savings, especially when they’re community based. (Say you build a company yoga studio to help workers destress—even if you track who uses it, how will you know for sure whether that investment had a direct impact on your health spending?)
So it’s useful to keep in mind that even when preventive services aren’t cost-saving, they may be cost-effective—that is to say, they might not save you money but they’re an effective use of your resources. If a mammogram detects that a woman needs a biopsy, for example, those services will cost the employer a great deal less than treatment for an advanced case of breast cancer.
Another thing to keep in mind? For self-insured employers, preventative measures are especially beneficial because employees who stay healthy, stay at work. Keeping your workforce healthy is critical for maximizing productivity and minimizing turnover. Hopefully too, employees will recognize the investment your company is making in providing access preventative medicine that helps them to stay healthy and will be loyal to your organization.
What Self-Insured Employers Can Do
Many preventive measures are outside the self-insured employer’s purview; determining what’s appropriate in terms of secondary or tertiary prevention is generally between a patient and their medical providers, since these decisions are based on an individual’s private medical records. But many of the conditions that are responsible for high value claims are triggered or complicated by high blood pressure, obesity and stress—factors that primary prevention can significantly control.
Self-insured employers can’t get overly involved in their employees’ health, but they do have a key role to play here. One of the problems with preventative medicine is how underutilized these benefits are. In 2015, only 8 percent of Americans 35 and older received all their appropriate preventive services. Self-insured employers are empowered to connect their workers with the resources that will help them prevent future diseases. That might mean educating employees about the preventive benefits that their coverage provides. It could mean changing workplace policies to make it easier for workers to make it to medical appointments. Some employers introduce company-wide wellness programs or offer perks like healthy break room foods or discounted fitness memberships.
Finally, self-insured employers have to understand exactly what benefits they provide before encouraging their employees to embrace preventive medicine. Assessing your coverage also lets you identify areas for improvement, and guarantees that you can authoritatively communicate with employees about the plan.
Stop Loss Insurance, Inc. is always here to help you understand your options as a self-insured employer. We want to work with you to manage your costs and protect your employees. Contact us with questions today.