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Consumer-Driven Plans: Don’t Let Fear of Employee Backlash Deter You

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Making the decision to adopt a high deductible health plan (HDHP) can feel overwhelming to Human Resources professionals. It is easy to assume employees will hate the benefits, resent management and cause lots of drama before ultimately quitting. While these assumptions have some level of validity, employers can sometimes underestimate adaptability of their workforce. Being ready for the resistance and equipped with the resources that employees will need can help HR implement consumer-driven plans that motivate rather than frustrate.

First, we need to acknowledge that people hate change; it is part of human nature. Resisting change is normal. Anxiety and stress typically occur no matter what the change. Even positive changes can have this effect. Resistance to change is not a sign of failure or an indicator that the wrong decision was made. Opposition is a normal human emotion in response to change.

So how do you help employees understand the benefits of changing to a HDHP? Consumer-driven plans are going to challenge employees to understand benefits in a new way. Let’s compare and contrast a PPO and HDHP.

  • With a traditional PPO, an employee goes to the doctor and receives a prescription for a test, bloodwork or medication. They paid their $20 copay and continued on their way. They trusted that what they were told they needed they needed, that the claim submitted was right and that if it wasn’t someone would catch it.
  • When an employee transitions onto a consumer-driven plan that entire process changes. They must transition from a passive patient to a participatory patient. Every visit, every procedure, every prescription, every claim hits the employee’s pocket so employees have to participate in their care. They need to ask questions about why tests are needed, what alternatives exist and what facilities are in their network.

Employees won’t naturally know that they can question a doctor’s order, so HR needs to have training and educational meetings to teach consumerism. These trainings should focus on mock doctor visits, claim processing procedures and show cost comparisons between different providers and drugs. During the meeting be sure to talk about some mistakes with coding and how preventive visits should be handled. Equip your employees with information so that they can be better consumers.

Information is power with consumer-driven plans. Be sure to give them tools so they can start evaluating their costs independently. Provide employees with tools that help them to do side-by-side comparisons of the same procedure from facility to facility.

When you first roll out consumer-driven plans the goal is to keep the information simple so that employees can absorb it. Make yourself available for one-on-one questions and to help with claim issues. Let them know they have a resource to support them. Ask your insurance providers and brokers to be resources with claim resolution issues. Let the employees know that taking an active role doesn’t mean they are on their own. Continue to develop their knowledge and to provide them with tools that make them effective consumers.

The whole goal behind consumer-driven plans is to find a way for employers to continue to offer comprehensive benefits that take care of their employees’ needs. Employees want benefits and will use them effectively when they are equipped to do so. Rest assured, they will adapt to the change with time, the right resources and effective communication.

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