4 Hacks for Lowering Health-Care Costs While Improving Employee Health

Complying with the Affordable Care Act means new health insurance premiums for smaller businesses but innovation offers hope of manageable costs and a healthier workforce.

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By Tor Constantino


Opinions expressed by Entrepreneur contributors are their own.

According to a recent survey conducted by the National Small Business Association, 58 percent of business owners have little or no understanding of the impact of the Affordable Care Act (ACA) on their business.

Despite that fact, beginning next year businesses with more than 100 full-time employees (defined as working 30 hours per week or more) will have to comply with ACA or face a tax penalty, while businesses with more than 50 full timers will have to comply in 2016 or face similar assessments.

Whether you agree or disagree with healthcare reform, it's still the law of the land and there is a collective benefit to keeping employees healthy and active. That's the reason why employers originally got into offering health insurance in the first place---the realization that it was a good benefit to offer because they wanted to keep employees on the job.

However, navigating through the nexus of employee wellness, insurance coverage and profit margin maintenance is often challenging and confusing for non-health experts. To help, the IMS Institute for Healthcare Informatics recently published a report titled Harbingers of Change in Healthcare. Packed with actionable projections on a range of healthcare issues, including ACA, the report serves as grist for the following 4 Healthcare Hacks for Business Owners.

Related: How Your Smartphone Is Becoming Your Doctor

1. Technology

Recent announcements by Apple, Google and Samsung to develop healthcare offerings provide clear indications of a melding between technology and personal wellness, according to Michael Kleinrock, director of the IMS Institute and co-author of the report. He says, given the near ubiquity of smart phones, smart business owners need to factor employee technology into their health plan decisions.

"Businesses are going to want a health plan that has mobile healthcare apps or that empowers employees to securely access their health records at their convenience," said Kleinrock. "The patient experience of managing their health and wellness, with mobile devices is something that more and more patients want---and employers don't have to pay extra to get it. You just need to be mindful of it as an available option during insurance plan selection."

2. Prevention

The easiest and least expensive healthcare hack for an employer is to make sure that all employees get a wellness checkup every year, since ACA allows for free wellness visits for employees and their dependents. Anybody who wants a wellness checkup only has to make their physician's office know the nature of the visit when making the free appointment.

"If an employee has not been to the doctor in 10 years and has an underlying health condition---if they wait until it's acute, it will cost more to manage. Specifically, it'll cost the patient more from a clinical treatment perspective and cost the employer in lost hours, productivity, replacement and training expenses---prevention is in everyone's interest and it's a cornerstone of ACA," said Kleinrock.

Related: Prioritizing Health Can Help You and Your Business

3. Convenience

Under the ACA reform, there are a variety of minimum requirements or service options that insurance providers must have in place to be a legal health plan. One healthcare hack to consider asking about from a potential insurance provider is "a nurse navigator" hotline, which is completely different than an on-call nurse from your physician's office.

"Very few physicians know the exact reimbursement rates they get from insurers so they don't know the exact out-of-pocket amount the patient with ultimately have to pay for a procedure. The insurer's nurse navigator will have a much better idea," said Kleinrock.

"More and more insurance companies have a qualified nurse on the other end of a phone line---available 24/7---the nurse navigator works for the insurance company to help your employees navigate questions regarding covered treatment options, available procedures and how much those things may cost."

Kleinrock says having ready, reliable, easy access to valuable health information is invaluable for both employees and employers alike.

4. Create a culture of health

Beyond those healthcare hacks, various studies -- as well as common sense -- have found that individuals who take responsibility for their personal health and behaviors tend to live longer and have a better quality of life overall.

Employers can leverage that fact with the easy-to-implement healthcare hack of creating an active culture of health within the workplace.

"There are a variety of low-cost benefits generated for your employees and your business if you help them engage in healthy activities," said Kleinrock.

"Smart businesses allow employees to volunteer in charity bike rides, or they sponsor a team to run in a 5-K fundraiser for leukemia research or choose to be a named sponsor for an event to fight breast cancer or diabetes. While participation in these activities helps employees emotionally and physically, such events also help remind employees that they work at a company that has a culture of responsibility and health, all at a very low cost to the employer."

According to Kleinrock there are several factors beyond cost that business owners need to consider when it comes to healthcare.

"While cost is important, there have to be other healthcare mechanisms that business decision makers need to keep in mind to ensure that they choose appropriately to manage their healthcare expenses, as well as the health of their employees, because ultimately the employees drive the health of the business," said Kleinrock.

[Disclosure: Tor Constantino is not employed by the IMS Institute for Healthcare Informatics, but he does work for its parent organization.]

Related: What 3 Companies Are Doing to Keep Employees Healthy

Tor Constantino

Former Journalist, Current PR Guy (wielding an MBA)

Tor Constantino is a former journalist, consultant and current corporate comms executive with an MBA degree and 25+ years of experience. His writing has appeared across the web on Entrepreneur, Forbes, Fortune and Yahoo!. Tor's views are his own and do not reflect those of his current employer.

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