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Employers test health care effectiveness


DALLAS—A pilot project that launched this week will help nine employer members of the Dallas-Fort Worth Business Group on Health more effectively tailor their benefits to better address worker health and productivity while also lowering overall health care costs.

The Texas Health Strategy Project is one of five initiatives announced in May by the Washington-based National Business Coalition on Health as part of the American Health Strategy Project, which intends to help employers use data from multiple sources to develop and implement value-based insurance designs. Such designs remove barriers that might prevent employees from receiving necessary health care, such as preventive screenings and maintenance medications.

While the Texas project is under way, the four other projects involving other coalitions—the Midwest Business Group on Health in Chicago, the Oregon Coalition of Health Care Purchasers in Portland, the Pittsburgh Business Group on Health and the Virginia Business Coalition on Health in Virginia Beach—are in various stages of deployment.

Until now, most employers setting up value-based insurance designs have relied primarily on medical claims data, which may or may not provide a complete picture of health risks lurking in their workforces, said Marianne Fazen, executive director of the Texas group.

In addition to medical claims data, employers participating in the American Health Strategy Project will collect data on family medical leaves, pharmaceutical and prescription drug utilization, short- and long-term disability claims, workers compensation claims, employee assistance program usage, disease management and employee demographics, Ms. Fazen said.

Pfizer Inc., which is financing the project, will analyze the data provided by each employer and devise a matrix that each can use to identify the health risks unique to their employees and redirect their benefits programs to address them, Ms. Fazen said.

The goal is to complete the analyses by year-end so the participating employers can revamp their benefit designs for the 2012 plan year, she added.

The project then will continue for three years so the participating employers can monitor how well their newly implemented value-based benefits designs are working, she said.

“Our major goal is to be able to improve the health of our employees and their families and to have a more cost-effective health care plan,” said Janie Britton, human resources business partner at Interstate Battery System of America Inc., a Dallas-based employer participating in the Texas Health Strategy Project.

Other participating employers are Archon Group L.P., Brinker International Inc., city of McKinney, City of Mesquite, Energy Future Holdings Corp., the Federal Reserve Bank of Dallas, Haggar Clothing Co. and Triumph Group Inc.'s Triumph Aerostructures unit.

Although Ms. Britton said she receives “a lot of claims data from our insurance provider, broker, health risk assessments and disease management programs, it's really hard to interpret,” which is why the matrix will help determine what changes need to be made to Interstate Battery's health plan to achieve those goals.

Interstate Battery, which provides coverage to 2,900 workers and their dependents, has had a consumer-driven health plan in place for five years using a health reimbursement arrangement funding single coverage at $600 and family coverage at $1,200 annually.

In addition, Interstate Battery covers wellness and preventive benefits at 100%, awarding points to employees for completing health risk assessments, annual physicals and exercising at least 12 times per month. Under the program, employees use the points to purchase prizes, Ms. Britton said.

This real objective behind the American Health Strategy Project is to provide “the proof of concept” that value-based insurance designs can improve the health of the population served while also lowering health care costs for employees and employers, Ms. Fazen said.

“The intent is to help employers understand value-based benefit design is more than just waiving copays,” Ms. Fazen said. “It will give employers the tools and a model to collect data from multiple different sources” that will enable “a picture to emerge of what the health risks and costs really are in their workforces.”

For example, the matrix will give employers a better idea of what diseases are most common among their employees and dependents, she said.

Eventually, the data from the nine employers, which collectively cover approximately 60,000 individuals, will be aggregated to enable employers throughout the community to perform benchmarking to see how they compare with others, Ms. Fazen said.

The participating employers represent a cross-section of public and private self-insured and fully insured employers in the Dallas-Fort Worth area, including those in the manufacturing, retail and hospitality industries.