Scott MacStravic Ph.D.
I noticed the other day an online promotion for a webcast called “The C-Suite’s Guide to Employer Relationships,” sponsored by the publication HealthLeadersMedia.com. The announcement noted that: “For decades, hospitals have been separated from the true purchasers of healthcare – employers – by payors. While health plans are still firmly in the middle, leading hospitals and employers are finding innovative ways to create relationships with each other. For hospitals, these relationships are an opportunity to attract more patients and extend their services beyond traditional need-based care. For employers, a direct line to the hospital’s c-suite creates a dialogue for reducing the high cost of healthcare.”
It mentions that hospitals can use employer relationships to “…convince employers to insist your hospital(s) be include in their payor’s network” and to “…sell health risk assessments to employers as a way to help lower their premium costs.” It notes that health risk assessments can enable hospitals to “…aggregate data from the assessments to help you plan for your service lines’ needs.” And relationships with employers can help hospitals “…develop lasting customer relationships with a group of paying, insured consumers.”
While hospitals have had opportunities to develop relationships with employers ever since both have existed, they are often not the best of pals. Hospitals have offered VIP suite accommodations and executive health programs to business executives, i.e. premium level, luxury treatment and health management for them, when they wish. But few hospitals are in the occupational health business, or doing much to help employers control their most worrisome source of labor costs – sickness care/insurance for their employees and dependents.
There is a good reason for not helping with this problem – it represents the main source of revenue for hospitals, sickness care, and the best source of profitable revenue for them, with government programs constantly seeking to cut payments. Indeed, the advantages cited above reflect the superiority of insured employees as patients, but employers lose whenever their covered employees or dependents use hospitals’ services.
The HealthLeadersMedia.com program does mention that health risk assessments (HRAs) are logical places to start such a relationship. But HRAs are only the start, and of something big and threatening to hospitals. They represent the first step in what are becoming almost universal efforts -- among employers who think of their employees as valuable assets, at least – to improve the health of those employees. Employers are now investing in a wide range of proactive health management initiatives based on HRAs of their employees and dependents.
And these initiatives are aimed explicitly at reducing employee/dependent sickness, sickness care, and overall sickness-related productivity losses. And since the greatest productivity losses tend to come from chronic diseases, employer initiatives typically focus on reducing the incidence of such diseases, while managing existing diseases to reduce the crises, complications and worsening thereof. If successful, such efforts could dramatically reduce the use of hospital care by employer-insured patients, leaving them dependent far more than ever on the generosity of CMS.
The option hospitals have, of course, is to partner with employers in addressing employers’ biggest problem – the total costs and damage to their performance caused by preventable or manageable illness and injury. Since employers’ total costs and damage amounts to multiples of sickness care costs, per se, these partnerships could easily result in significant, profitable revenue from preventing and managing illness injury to make up for any losses in revenue from treating sickness. Lacking that, partnerships that benefit only hospitals are both unlikely and hardly worth the name.
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