Designing Valuable Benefits Means Understanding the Population

As the cost of healthcare continues to place a greater burden on employers, some are redesigning benefits and providing new access to care in ways that improve employees’ health and, ultimately, drive down costs. Panelists at the National Alliance of Healthcare Purchaser Coalitions' Leadership Summits highlighted the ways their companies are customizing care and benefits to meet the needs of their employees.

Sherri Samuels-Fuerst, RN, vice president of total rewards at Sargento Foods Inc, explained that people want to work for someone who cares about them and supports them. During her 25 years at Sargento, the health and well-being strategy of the company has transformed from what was essentially a spirit committee.

When the MinuteClinic was taking off, Samuels-Fuerst worked to start an onsite health and wellness center. With locations in rural areas, the onsite clinic mainly started out of necessity.

“Our [primary care physician] coverage in our very narrow network was not inclusive enough to take care of all our employees and their family members,” she said. “So, thus the reason for the onsite health and wellness center,” which is available to not just employees, but also dependents between the ages of 2 and 26 regardless of whether or not they are on the company’s health insurance.

The center offers comprehensive services with a medical director who oversees nurse practitioners, personal trainers, a health coach, phlebotomist, and more. The center is used for population health management, including risk identification, chronic condition compliance, and prescription adherence.

According to Samuels-Fuerst, Sargento has seen engagement and utilization grow and with that there has been progress on employee health. Body mass index, glucose, and blood pressure all went down for employees.

To show that the company actually cared about the health of its employees, it set Healthy Sargento 2020 Goals, modeled off the concept of the government’s Healthy People 2020. The company has a goal to keep the healthy healthy, have people manage their chronic conditions, drive engagement in offerings, and achieve high satisfaction.

Sargento is already considering 2030 goals, such as having at least 65% of the population have a preventive and primary care visit claim; closing medication gaps in care for hypertension, hyperlipidemia, and asthma; and having at least half of depression services provided by a specialist.

“…We are very rural, and we don’t have the opportunity to really have a lot of specialized services,” Samuels-Fuerst said. “So, we’ve really got to take care of our own…”

While Sargento has to implement services to meet the needs of its rural population, American Eagle Outfitters Inc (AEO) has a different employee population, which is much younger. Tammy Fennessy, director of benefits, explained that approximately two-thirds of her full-time employees enrolled in the company’s health plan are millennials.

“So, we’re in the education space,” she said. “We’re trying to teach those that are really getting on healthcare for the first time in their lives how to use it.”

In addition to being young, the majority of employees are female; those taken together mean “we’re a birthing center; we have a lot of babies,” she said, which means the company spends a lot of time trying to enhance those benefits.

Another big concern for the workforce is physical therapy and chiropractor needs, and AEO is trying to avoid surgery right away for people who have pain.

The company has moved to value-based care by implementing free second-opinion services and decision support. It has also created some partnerships around fertility management and support in building a family.

There are also incentives available for employees, such as $400 to engage in surveillance decision support at least 30 days before getting surgery, a well-being program with a raffle to win a trip to Disney World for using health coaches, lifestyle management programs, and more.

Amgen has yet another different population to treat because the patients who use the drugs that it develops are often colleagues or the dependents of colleagues. The company took steps to ensure that its benefit design supported value for the plan and the plan beneficiaries, and it did so by asking those who had the means to pay more for their healthcare.

“We established medical premiums based on salary, and we also established out-of-pocket maximum limits also based on salary tiers,” explained Vincent Brigandi, director of US benefits strategy at Amgen.

The money it took in was reinvested to help participants by putting the money into a co-pay tier to make drugs, not just those by Amgen, more affordable. The early results of this change to the plan have been encouraging, although Brigandi admitted they are very early and that even Amgen has trouble getting data to review. The company saw that adherence of participants was greater than that of peers.

Next, Amgen is looking to better understand the participant data and create partnerships to understand how plan design changes impact other populations.

While quality of care is important, Brigandi mentioned that data on quality are not accessible just yet, which can be challenging. People are still getting quality data through word of mouth because they are still most comfortable talking to an advocate who is a peer rather than someone who works in the benefits department.

“…The winds of change are coming. People are demanding transparency,” he said. “We are not there yet, but I think over time it will come.”