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Renewing Health Care Plans: Some Questions to Ask

By Phil Britt | Oct 11, 2017

As the annual renewal season for health care plans approaches, trustees should ask themselves if they're offering the best cost-effective plans that provide their members with comprehensive coverage solutions. By reviewing what has been offered in the past and possibilities for the new season, providers can provide better plans, better coverage and engage members in their own health management while ensuring all stakeholders have secure access to critical health care information.

Complimentary, Coordinated Coverage

Do current offerings feature a complimentary blend of services? Different health care providers may spot health issues early, for example, an eye exam can uncover evidence of diabetes, high blood pressure and other issues. Similarly, dentists and other specialists may notice health care problems before a member has his or her annual physical. Athena Health noted that their findings may never be communicated to the primary physician — even if the member is told of his or her condition — if there's no method of sharing test data and other pertinent health care findings. Additionally, The Wall Street Journal pointed out that shared data leads to better patient outcomes and lower costs.

Member Concerns, Desires

What do members want from their health care plans? While they may want eye care or dental care, they may feel that these options are too expensive. If there are strong comments one way or the other, trusts can take that into consideration as offering is designed for the upcoming year.

Additionally, by providing members with an online forum to discuss their health care coverage concerns, ask for simple polling data — e.g., do you see an eye doctor once a year? — and ask for free-form comments about health care issues that concern the member. This not only helps the member become more engaged, but from his or her answers, trusts can provide links to authoritative articles on specific topics such as weight management, diabetic diets, pain management techniques and the best ways to manage certain chronic conditions, among other topics.

According to an article in Managed Health Care Executive, by providing members with authoritative health care articles, you can better involve them in low-cost ways of managing their own health, such as better diet and weight management.

Data Security

Another question to ask: Is member data secure but shared by different stakeholders — primary physicians, specialists, pharmacists, patients, etc. — to ensure the patients have the health care plans that best meet their needs? Without robust, well-tested security of the data storage and retrieval system, there's a high risk of data compromise and of patients' private health care information being compromised. Such a compromise leads not only to regulatory fines and potential risks for the patients, but a lack of trust in a health care provider.

Citing a report from the Ponemon Institute, Becker's Health IT & CIO Review explained that the per-breach cost for the health care industry is $402 per record. So, a health record system that's fully vetted in terms of security is essential.

By starting early to get as much feedback from members as possible, considering different coordinated coverage and working with a trusted partner with robust security, funds can offer plans to members providing the coverage they want at a price that makes sense for both parties.