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August 25, 2020

Doing Well While Doing Good

By Josh Smith

It is possible to keep your health benefit costs down without shifting the financial burden to your employees. We’ll show you how.

As your organization begins to receive health plan renewal rate notices, you’re likely planning and thinking about how you’ll cover these expenses while still maintaining strong benefits for your most valuable resource — your people. Without your people, your organization couldn’t do its vital work, which makes offering them meaningful healthcare benefits incredibly important. Yet, healthcare costs keep rising and your organization needs to remain financially solvent to keep serving its mission. It’s a double-edged sword. How do you balance the financial well-being of your organization with the personal well-being of  your people?

In the struggle to offer benefits while reining in rising healthcare costs, employers have very few tools at their disposal, which is why many resort to shifting costs to their employees. In fact, the average deductible among covered workers for single coverage in the U.S. nearly doubled from $836 in 2009 to $1,655 in 2019. 1

While this strategy may help the organization’s bottom line, it does not help (and may even harm) those covered by the plan. And in non-profits, like congregations and ELCA-affiliated organizations, this strategy is in direct opposition to their social teachings. Cost-shifting is off the table for these organizations — and frankly, it should be for most organizations. Why? Because there’s a better way.

That better way begins with the premise that health benefits aren’t just for caring for the sick, they’re also for preventing people from getting sick — in other words, keeping people healthier. There are many ways for health plans to do this (which I’ll detail in upcoming blogs), but when executed well, the result is both improved employee well-being and improved financial well-being for your organization. This isn’t a theoretical, untested idea — it’s what we’re doing.

At Portico, we design benefit solutions that help control healthcare costs by improving health outcomes. We start by looking at how we can help our plan members live healthier lives, then we create programs that encourage them do so. The result? Healthier people who have lower healthcare costs — a win for the individuals covered by the plan, the sponsoring organization, and for their mission. Three years into the launch of new programming, we have the evidence that this approach works:

Meaningful Engagement

  • 45 minutes: average amount of time members spend on wellness platform (40% higher than platform’s average book of business) 2
  • 46% of members with diabetes enrolled in diabetes management program (compared to 30% for the program’s average book of business)

Better Clinical Outcomes

  • 46% reduction in likelihood of days with a hypoglycemic reading for diabetics 3
  • Overall reduction in readmissions, urgent care, and ER visits
  • 11,502 pounds: Collective amount of weight lost by members; representing a risk reduction in diabetes and other chronic diseases that put a strain on healthcare budgets representing an 85% reduction in projected 3-year disease risk factors

Strong Financial Outlook

  • 4% average annual rate increase – consistently below national average 4

Price Stability Through Effective Plan Management and Innovative Program Design

High Satisfaction 

  • Various vendor-partner programs have achieved Net Promoter Scores that significantly outpace most healthcare benchmarks, while competing with consumer-friendly brands like Netflix, Apple, and Amazon 4

In future articles, I’ll discuss in detail how Portico leverages data to create personalized programs that improve well-being and drive down healthcare costs. Today, I hope you leave with the idea that it is possible to do well while doing good.

1 2019 Kaiser Family Foundation Employer Health Benefits Survey
2 Livongo Program 2020 Business Update, June 2017-April 2020
3 Omada for Prevention Population Overview, August 2020
4 Plan Performance Review, Quantum Health, Jan-Dec 2019
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Josh Smith

Josh is a strategic and innovative benefits professional willing to challenge the status quo. In his time at Portico, he led a transformation in health plan design with innovative offerings that empower members and the organizations they serve to more effectively control costs and improve outcomes.

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