Health plan decisions reverberate through organizations, influencing their financial trajectory and resiliency of employees. While business leaders agree that strategic decision-making is paramount to success, they often neglect to apply it to their health plan strategy — despite health benefits being among an employer’s top-three expenses. 

It’s perplexing, given that self-funded health plans built on claims data consistently yield affordable, high-quality healthcare that attracts and retains top talent. 

Passivity stagnates organizations. Every decision has consequences. Opting for hands-off health insurance with a big-box mega-carrier may seem like an effortless solution. However, this decision relinquishes control to an entity without any incentive to achieve savings and quality goals — to the detriment of the entire organization. 

Read more: Step away from the status quo to win big for employer clients

Often mistaken for security, passivity toward your client’s health benefits delivers costly consequences, including:

Pill rationing and delayed care

Skipping doses, pill splitting and avoiding doctor appointments cause chronic diseases to mushroom out of control. Over time, minor health problems become catastrophic emergencies, costing employers more in the long run as healthcare expenses spike and productivity plummets.

Medical debt

Up to 41% of Americans struggle with medical debt, exacerbating underutilization and adding stress that compounds disease.


For 67% of Americans, medical debt snowballs and eventually crushes their financial stability.
Proactive employers and their advisers know that inaction leads to missed opportunities and underappreciated threats. In contrast, doing something — even taking a small step — generates forward momentum. Imperfect progress begets high-quality healthcare at the lowest possible price, while feedback and outcomes clarify future decision-making. 

Read more: In benefits and healthcare, the cost of inaction is unaffordable

Strategic decision-making builds confidence within the employee populations you serve and demonstrates a commitment to value-centered health benefits. Not only are employees the driving force behind their organization, they’re the driving force behind every effective, affordable health plan. Workers trust their employer and benefits adviser to curate a data-driven health plan customized to their needs. They rely on you to help them navigate the choppy waters of the healthcare industry, so their benefits genuinely serve their best interests. 

Making impactful decisions requires partnership with properly incentivized, client-focused experts well-versed in the nuances of seizing control of a health plan and its data. Once in motion, continuous monitoring protocols gauge the efficacy of a health plan’s policies, procedures and programs. Ongoing refinement ensures that health benefits align with the workforce’s evolving needs.

Strategic decision-making is not just a buzz phrase; it’s a systematic approach to investing in healthcare that yields the most optimal outcomes. At its core lies an understanding of the power of choice, human behavior and effective communication. Employees want autonomy, especially concerning their health. Help them navigate the complex U.S. healthcare maze so they can easily choose high-quality, lower-cost providers.

Read more: Advisers need to scrap autopilot mode when it comes to open enrollment

Employees often gravitate to healthcare solutions that appear beneficial on the surface but prove risky, unnecessary, or overpriced when a patient advocate pulls back the curtain for them. In partnership with a trusted adviser, employers are responsible for providing value-steering resources to strengthen members’ decision-making.

The age-old debate in behavioral psychology persists: Is offering rewards (the carrot) or penalties (the stick) more effective in influencing behavior? The truth is, they’re two sides of the same coin. In essence, a carrot is just a stick painted orange. How you frame it makes all the difference in the world.

Ultimately, we’re all human, and the best motivator is the “what’s in it for me?” So, clear, tangible and convenient health benefits paired with low- or no-cost copays promote value-minded behaviors that cultivate your client’s most significant savings. Effectively communicating what resources are available, how to easily access them and worthwhile incentives for desired behaviors empowers healthcare consumers to go the extra mile for affordable, high-quality care.

Read more: 3 health benefits misconceptions to rethink for a more secure future

Ongoing, multilingual and multimodal (email, text, signage, video) communication about plan resources, such as patient concierge, second-opinion services or manufacturer-assistance programs, help members engage with the healthcare process.

Promote consumerism by reminding members of the financial incentives for sourcing high-quality, lower-cost providers and medication. Employees are natural shoppers, so nurturing value-minded healthcare decisions increases utilization, which translates to employer and employee savings.

What are you waiting for?

Data-driven decision-making speaks volumes about an employer’s values and commitment to curating health benefits that genuinely serve the best interests of the workforce. It paves the way for exceptional benefits that attract and retain the best talent. 

Be sure to help your clients start with the proactive decision to embrace imperfect action, then refine and use the savings to innovate. 

As you help them take that first step and continuously strive to improve, you will help clients build trust and loyalty that resonates throughout their organization, thereby securing employees’ health and protecting the organization’s health.


By admin