Risk Insider: Mike Mascolo

ACA Reform: Time to Get Comfortable With Uncomfortable

By: | June 22, 2017 • 3 min read
Mike Mascolo is the Employee Benefits National Practice Resource Leader at Wells Fargo Insurance, with expertise in funding arrangements, provider network evaluation, clinical health/wellness strategies, benefits administration technology and consumer engagement designs. He can be reached at [email protected]

When it comes to health care reform, I hear one constant question from employers these days: What’s going to happen and when?

Unfortunately, I don’t have the answer.

It’s normal to prefer getting answers, even if that answer is painful. For example, according to research, people who were given the choice between receiving an immediate, definite shock would choose to be zinged, rather than have only a small possibility of a shock to come later without warning.

I can relate. Earlier this year, I was recruiting a high-potential new employee who had offers from other firms. I did all I could to make our offer as attractive as possible, and was waiting for the candidate’s final decision. I came to the point of needing an answer, even if it was to accept another offer over ours, just to get on with Plan B to move forward. The delay and inaction was bad for my business.

Uncertainty around the Affordable Care Act reform is similar. It’s ambiguous and confusing. Many of my clients are stuck in this grey space—somewhere between complying with existing laws and anticipating the unknown.

Instead of focusing on the unknown, however, companies should stay focused on what’s within their control. It’s easier said than done, but making a mindful effort to focus on the ‘now’ truly helps.

When it comes to health care reform, I recommend employers do the same. Stay in the ‘now’ by focusing on a three key strategies.

Engage millennials. Seventy five percent of employers are concerned about retention rates with millennials, yet only 28 percent of companies plan to make benefit-offering changes this year to accommodate them.  According to the American Psychological Association, millennials are more prone to experience anxiety and financial stress than any other generation. Potential solutions for millennials include tuition-forgiveness incentives, financial planning programs (such as tailored apps) and mentoring programs.

Instead of focusing on the unknown, however, companies should stay focused on what’s within their control.

Review prescription drug costs. Costs for pharmaceuticals have risen for the past few years, and that trend is anticipated to continue through the remainder of the decade. Employers should review current benefit design/pharmacy data and revisit current pharmacy benefit manager (PBM) contracts to ensure that the most aggressive unit cost and appropriate-use strategies are in place. Businesses can also ask their current PBM about what measures are in place to review providers that may have opioid prescribing issues.

Explore adding voluntary benefits. While the pressures and uncertainty of healthcare legislation can make it challenging to add new employee benefits, voluntary benefits allow companies to add value without adding direct costs. Businesses choose which benefits to offer based in part on the company’s demographic profile; employees simply pay for the products they want.

Voluntary benefits can help improve employee retention, reduce employees stress and increase productivity. They help companies become employers of choice, prepare for uncertainty, address the challenges of the new health care environment, and manage costs. These benefits allow organizations to add flexibility, employee choice, and even portability to their benefits menu while addressing the needs of a diverse workforce.

Despite the uncertainty surrounding ACA legislation, employers have the opportunity to positively engage their workforce and evolve benefit programs to meet needs of their employees. Most importantly, employers should consult with an employee benefits professional to help navigate the changing landscape of health care.When all else fails, there’s always therapy. Maybe even shock therapy!

More from Risk & Insurance

More from Risk & Insurance

4 Companies That Rocked It by Treating Injured Workers as Equals; Not Adversaries

The 2018 Teddy Award winners built their programs around people, not claims, and offer proof that a worker-centric approach is a smarter way to operate.
By: | October 30, 2018 • 3 min read

Across the workers’ compensation industry, the concept of a worker advocacy model has been around for a while, but has only seen notable adoption in recent years.

Even among those not adopting a formal advocacy approach, mindsets are shifting. Formerly claims-centric programs are becoming worker-centric and it’s a win all around: better outcomes; greater productivity; safer, healthier employees and a stronger bottom line.

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That’s what you’ll see in this month’s issue of Risk & Insurance® when you read the profiles of the four recipients of the 2018 Theodore Roosevelt Workers’ Compensation and Disability Management Award, sponsored by PMA Companies. These four programs put workers front and center in everything they do.

“We were focused on building up a program with an eye on our partner experience. Cost was at the bottom of the list. Doing a better job by our partners was at the top,” said Steve Legg, director of risk management for Starbucks.

Starbucks put claims reporting in the hands of its partners, an exemplary act of trust. The coffee company also put itself in workers’ shoes to identify and remove points of friction.

That led to a call center run by Starbucks’ TPA and a dedicated telephonic case management team so that partners can speak to a live person without the frustration of ‘phone tag’ and unanswered questions.

“We were focused on building up a program with an eye on our partner experience. Cost was at the bottom of the list. Doing a better job by our partners was at the top.” — Steve Legg, director of risk management, Starbucks

Starbucks also implemented direct deposit for lost-time pay, eliminating stressful wait times for injured partners, and allowing them to focus on healing.

For Starbucks, as for all of the 2018 Teddy Award winners, the approach is netting measurable results. With higher partner satisfaction, it has seen a 50 percent decrease in litigation.

Teddy winner Main Line Health (MLH) adopted worker advocacy in a way that goes far beyond claims.

Employees who identify and report safety hazards can take credit for their actions by sending out a formal “Employee Safety Message” to nearly 11,000 mailboxes across the organization.

“The recognition is pretty cool,” said Steve Besack, system director, claims management and workers’ compensation for the health system.

MLH also takes a non-adversarial approach to workers with repeat injuries, seeing them as a resource for identifying areas of improvement.

“When you look at ‘repeat offenders’ in an unconventional way, they’re a great asset to the program, not a liability,” said Mike Miller, manager, workers’ compensation and employee safety for MLH.

Teddy winner Monmouth County, N.J. utilizes high-tech motion capture technology to reduce the chance of placing new hires in jobs that are likely to hurt them.

Monmouth County also adopted numerous wellness initiatives that help workers manage their weight and improve their wellbeing overall.

“You should see the looks on their faces when their cholesterol is down, they’ve lost weight and their blood sugar is better. We’ve had people lose 30 and 40 pounds,” said William McGuane, the county’s manager of benefits and workers’ compensation.

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Do these sound like minor program elements? The math says otherwise: Claims severity has plunged from $5.5 million in 2009 to $1.3 million in 2017.

At the University of Pennsylvania, putting workers first means getting out from behind the desk and finding out what each one of them is tasked with, day in, day out — and looking for ways to make each of those tasks safer.

Regular observations across the sprawling campus have resulted in a phenomenal number of process and equipment changes that seem simple on their own, but in combination have created a substantially safer, healthier campus and improved employee morale.

UPenn’s workers’ comp costs, in the seven-digit figures in 2009, have been virtually cut in half.

Risk & Insurance® is proud to honor the work of these four organizations. We hope their stories inspire other organizations to be true partners with the employees they depend on. &

Michelle Kerr is associate editor of Risk & Insurance. She can be reached at [email protected]