Alternative Health Insurance Models

With insurance costs sky-high and reform questionable, other insurance options are popping up and become first choice for more people. Most families struggle to afford $700-$2,000 average monthly payments, sometimes paying more for health insurance than their house.

Diane, for example, is totally disgusted and very typical insurance shopper. At 27, she has a good job, lives in a decent apartment, and is finally getting her life settled. But, her job doesn’t offer health insurance, so she’s left alone to pay for it on her own.

Like many other young professionals, she’s faced with a huge decision:

Nearly $1,000 a month for health insurance she will barely use or go without.

But, if she ever ends up in the hospital, she could be faced with a lifetime of crippling hospital bills.

Facing this kind of dilemma is a daily struggle for millions of people and families throughout the US. Including mine. We went through a job transition and chose to go without health benefits for half a year. My wife and I had three kids in middles school at the time but with no stable income we just could not fathom paying almost $1,500 a month for COBRA benefits.

Different Ways Around Health Insurance

Like millions of other people in the United States, we’re looking at various ways of affording hospital bills without having to resort to high-cost healthcare. It’s not an easy choice, because some of the options do not cover extended hospital stays or treatment for diseases and some only provide discounts.

But, these are the options I want to make people know and use because they work. 

The uncertainty in the health care economy prompted a resurgence of alternative health insurance models people are flocking to by the millions. No longer fringe movements, many of these models are now standards in certain areas. 

You can also find more details on these alternative insurance models in my book Health-Wealth for You: 11 Steps to Save Big & Live Healthy throughout Part 3.

Health Savings Accounts

Many employers are opting for Health Savings Accounts (HSA) for their employees. These are specific employer-provided savings accounts that set aside a certain amount of the employee’s paycheck and/or employer contribution for the sole purpose of helping pay for medical bills. 

These became a much more popular option as insurance premiums skyrocketed. Employers began choosing higher deductible plans and setting up HSAs to offset the deductible. When employees paid for their medical care, the health savings account reimbursed them.

Will This Work for Me?

If your employer offers insurance and an HSA, most financial advisors will encourage you to contribute significantly to the HSA. It helps offset costs and used for many services such as nutritionists, massage therapists, and alternative medicines.

Some banks and credit unions will allow you to set up an HSA without your employer under certain conditions. This works very well for the self-employed or for those whose company does not offer health insurance.

Cost Sharing Community Models (CSCM)

One of the next steps away from traditional health insurance is having cost-sharing models that prioritize the use of virtual doctor’s visits, apps and technology, and remote monitoring. Many CSCMs help their members by offering discounted services, especially for patients who are paying cash.

Sedera Health is one program. Members of Sedera Health self-pay for the health care costs, and Sedera helps negotiate what the patients will pay. This bill negotiation process can significantly reduce the cost of many standard and emergency procedures. It’s also excellent for people who take a small number of regular prescription medications. Similar models exist for dental and vision programs. 

I regularly speak to organizations and businesses that want to offer their employees options to expensive and complicated insurance programs. Personally, I am a member of Sedera through a cost sharing model called Fit Health. If you’re going to explore this cost-saving measure in your workplace, please visit http://wearefithealth.com//drluke to learn more.

Will This Work for Me?

For people who are in general good health and do not often need to see the doctor, a CSCM works very well. It can significantly reduce your costs for health insurance. As new regulations are taking place and basic, emergency only insurance begins to re-emerge, the cost-sharing model will become more popular.

Faith-Based Cost-Sharing Models

Faith-based cost-sharing models are becoming more popular in the Mid-West to the West Coast of the US, although they are available through most religious organizations. Membership is usually limited, having to be part of the organization’s faith, and members are often required to live by specific standards. However, if this option is available to you through your church organization, it’s an option that can benefit you in the long run.

Most faith-based models have members pay a regular monthly due to a community account. Then, as members incur medical expenses, they apply to this community account for reimbursement. Members take a slight risk of not being reimbursed, depending on the status of the fund, but usually gain their money back.

Will This Work for Me?

If you belong to a faith-based community that offers these programs, it is worth your time to investigate how large fund typically is and what the repayment policy is. Currently, there are hundreds of faith-based cost-sharing models throughout the United States and well over a million people belonging to these groups. They are successful at helping people with bills and costs. Christian Care Ministry gives a great break down of their service and how it would work for you.

Value-Based Insurance Design (VBID)

VBIDs are specialized health care tactics that prioritize high-value, proven procedures.  This model emphasizes shopping around for the best value for specific procedures, not always the lowest cost.

Because the provider of this type of insurance requires prices and clinical outcomes to be specific and transparent, patients can choose between different providers and procedures. Because the rates, co-pays, and cost of the patient are available for review, healthcare costs are driven down with the right type of choices.

For example, the company Walmart has chosen the VBID for many of its procedures. When it comes to knee problems, Walmart fully supports its employees opting for knee replacement surgery. However, they’ve negotiated with various institutions to provide high-value services for the lowest cost. Employees can choose to use Walmart’s selected facilities, often with minimal co-pays, or other facilities with a higher co-pay. For some people, it’s a natural choice, but for others, they may have to travel a significant distance to use a preferred facility.

In Episode 21 of my podcast Dr Luke’s Waiting Room, Doctor Bill Hennessey, founder of Pratter, Inc. created a tool for companies to know how much they spend on various procedures at different facility. It helps people price shop and know the real value of their surgery. 

Will This Work for Me?

If you’re part of this type of system, it can save you money. You’ll have to do more work before procedures to choose the most cost-effective and highest value treatments. In the long run, for higher-priced services, it can save significant amounts of money.

Private Membership Programs

As insurances are driving up the clinic cost of many routine medical procedures and requiring extra personnel to submit insurance claims, many of these small clinics are opting out of accepting insurance altogether. For some, they face the choice of abandoning insurance or going out of business.

So, many created their own third choice: they’re offering a self-pay membership program. This is one insurance option that I support and belong to.

These membership programs offer a set number of services for the members to take advantage. Many of these programs charge a fixed monthly fee and provide routine health checks, urgent care visits, minor in-office surgeries and procedures, and other accessory medical needs. Membership to many of these doctor’s offices ranges from less than $50 per month to several hundred.

And it’s not just small doctor’s offices that are offering the service. Larger hospitals are also exploring this option and may be able to provide a broader range of services. Most of the time, the doctor’s websites will inform you if a membership option is available.

Will this work for me?

For most people in decent to good health, this is a very reasonable alternative to health insurance. People can get the routine medical care they need, the prescription medications, and minor procedures.

Catastrophic Health Insurance

With all the options available, and with changing regulations, catastrophic insurance may become an option in the near future. Coverage that supplies just emergency medical treatment, lengthy hospital stays, and extensive surgery, without providing any routine care, may become an option again.

If you choose an alternative health insurance model, be sure to have funds set aside for emergency care. Most alternative models do not cover emergency care, although they are perfect for routine care.

With the rapidly changing landscape of American health insurance, we can only guess where things will go. Remember, in the last decade, we’ve seen insurance costs rise nearly 1000%, force everyone to have insurance or be fined, take medical procedures they won’t ever use (maternity), and have over a thousand different regulations enacted and redacted. 

We can only wait and see what the future will hold. Taking control of your Health-Wealth maybe the only secure financial decision you can make.

Surgery in Mexico, Spain, and Canada: What you really need to know before going out of the country for surgery

In part 1 of this two-part series discussing traveling to get medical care, or medical tourism, we discussed the considerations for traveling within the United States for routine medical care. In this article, we talk about going to other countries to obtain medical care.

Yes, you can leave the country, see new things, and fix a problem at the same time. Many times, you’ll save thousands.

You’ll find the most common procedures people seek out are dental surgeries, cosmetic surgery (breast augmentation and reduction tops this), fertilization treatments, hair implant surgery, cardiac surgery, cancer treatment, and holistic treatments. But there is a lot more to the decision to look elsewhere for more affordable, quality care.

Why Leave The Country for Medical Care?

Over the past ten years, more and more people are leaving the United States to obtain healthcare, prescription medications, and elective surgeries than ever before. Patients Without Borders shows that the medical tourism industries in Mexico and Canada have increased every year over the past ten years.

Very few regulations exist to govern leaving the country for medical care. Often, your doctor at home may not recognize the work done if you leave the country. Standards vary in different places, so you have to be careful about where you choose.

It’s not all bad news, however. For the most common elective surgeries, like knee surgery, many people find they save money by going to a different country. For example, in 2012, a person could travel to France ($700), obtain a hip replacement surgery ($12,000), and spend two weeks recovering in a grand hotel with meals delivered ($5,800) for half of what it would cost to obtain hip replacement surgery in the US ($42,000).

Pricing has changed and become more obscure, so more current figures are challenging to obtain. Sometimes, the correlation isn’t even comparable. For example, for fertility and cancer treatment, US doctors are limited as to what they can recommend and prescribe. However, in Europe, dozens of natural treatments work together. Several cancer centers base their treatments on minimal chemotherapy and place emphasis on detoxification, herbal supplementation, and other traditional modalities.

Imagine going to a resort to obtain a fertility treatment, relaxing and taking care of yourself, rather than forcing your body into submission with powerful medications. Can you see why some people choose this route?

Sometimes, paying out of pocket for an out-of-network provider, or traveling out of the country sometimes is less costly than the deductible and out-of-pocket costs of sticking with your local doctor. Of course, you do need to factor in what the insurance pays, but you won’t know that real cost until you get the bill.

Finding Quality Surgeons in Foreign Countries

Two top organizations exist to help patients find quality physicians and high standards of care. Patients Without Borders and the Medical Tourism Associationwere both established to provide regulations and requirements for the doctors and facilities the handle the increasing medical tourism.

So many people in the United States are shocked at the standards that exist in foreign countries in both good and bad ways.

For example, in the famous Harry Potter movies, the medical facilities were filled with long rows of beds. While the atmosphere the movie suggested this was set up sometime in the early 1900s, many Americans who find themselves in need of hospitalization in the UK find this is actually normal, standard care. Private rooms are only now becoming more popular in Europe and Asia.

On the opposite end of the spectrum, Japan has increasingly modern and private facilities. Their cleanliness practices and respect for privacy outshine the strictest American standard.

So, who decides what good quality of care is?

Facilities reviews by Patients Without Borders and the Medical Tourism Association meet specific standards for cleanliness, professionalism, and success rates. Beyond that, you need to ask the following questions:

·      Do the doctor and staff speak English, or your native language, fluently? If not, will a translator be available? If not, may I bring my own?

·      What are your requirements for follow-up care?

·      What do I need to do before the procedure?

·      How many nurses or systems will you be using?

·      What can I expect at your facility?

·      Can I talk to some of your previous patients? Especially those who came from out of the country?

·      What will happen in an emergency?

The doctors who have higher standards of care will gladly provide this information. Nearly every practice that takes in medical tourism patients has a website that highlights their facilities. Of course, it’s always your right to leave any of the facilities up to your standards.

Risks and Concerns of Leaving the Country For Surgery

Additional concerns arise when looking at foreign facilities, especially one that you don’t have the opportunity to visit before you make your appointment.

First, you have to talk to your doctor to see if you’re healthy enough to travel. You can’t go away if going away is going to cause more problems.

Certain medical conditions preclude traveling, flying, or long-distance car rides. Many blood conditions, bleeding disorders, and clotting factors prevent airplane travel. Additionally, many types of surgery will require you to stay grounded because of the risk of blood clots. In the case of hip surgery, you may be required to remain an extra 2 to 6 weeks in a foreign country because of this risk.

As we discussed earlier, standards around the world are not the same as they are in the United States. In some cases, they’re much better. In some cases, we would question the safety of the facility.

Make sure all your doctors have available allof the information about various prescription medications you take. In some countries, that information is not accessible, or the drug may be unknown. Doctors in foreign countries might not understand the mix of prescriptions you’re on, which could cause dangerous interactions.

On top of that, you may be prescribed medications in foreign countries that are not available locally. In Germany, doctors have thousands of herbal and alternative medications available that are banned in the US (but are often sold as supplements). If you don’t check before surgery, you could be without a part of your recovery treatment.

This is the grip the pharmaceutical companies have on the doctors and hospitals. Between controlling what the doctors see for new treatments and lobbying in Congress and the FDA, they were able to get thousands of supplements, herbs, and other alternative medicines banned. Now, doctors aren’t aware of over half of the medical knowledge that exists in the rest of the world!

You can learn more about these historical trends leading to skyrocketing healthcare costs while decreasing services in my book Health-Wealth for You: 11 Steps to Save Big & Live Healthy.You’ll also find money-saving tips for the most common medical procedures and visits.

Every country has vaccine requirements that you must follow before you’re able to travel to that country. In some cases, that means you need a certain number of vaccines administered in a specific time frame. In other cases, having received a vaccine, such as a flu vaccine, actually may prevent your entry into another country or prevent you from acquiring the medical services. (Were you ever told that the flu vaccine requires you to avoid medically compromised individuals for two weeks after getting the shot?)

Finally, specific medical procedures have been restricted in certain countries. Recently, the UK prohibited elective surgeries for over 20 different standard surgeries, among these includes our example of hip surgery, breast reduction, and surgeries to reduce reproductive pain. Some facilities may accept you on a cash-only basis and allow you to get the treatments that natives cannot. However, you’re more likely to be passed over in favor of local patients.

Steps To Consider Medical Tourism to Save Money

As you begin to look at the various options for traveling to another country to obtain medical services, keep in mind a series of questions, make sure this is the correct decision for you. Additionally, be sure to discuss the options with your regular physician. They may have concerns specific to your medical needs that would be beneficial for you to ask the new facility.

If your doctor is against you traveling for medical treatment to another location in the United States or even out of the country, be sure to listen to the reasons why. Some doctors may take offense do you traveling to obtain the surgery, while others may have justified concerns. You will have to decide if your doctor is looking out for your safety.

Here’s a list of questions that you need to answer fully before seeking out medical treatment in a foreign country.

·      Are you healthy enough to travel?

·      Can you speak the language or will you have an interpreter?

·      Is it something your doctor would support?

·      How will you handle recovery and follow-up appointments?

·      What will your loved ones and family do during this time?

·      Are you protected from theft and violence?

·      Is this a vacation or medical trips?

Finally, keep in mind the cost of the treatment. Since your insurance will not be covering the medical aspect, you may be expected to provide payment before the procedure. Very few foreign hospitals or doctors will bill you for service.

On average, you can expect to spend $4,000 to $6,000 per visit to obtain simple medical procedures. This can include travel costs, food, and lodging. These costs increase dramatically as you have family members traveling with you, or you have to leave employment to obtain the medical procedure. Having enough savings to cover your medical costs and time off of work is essential.

Unlike obtaining medical procedures in the United States with your approval of your doctor, you may not be able to receive the Federal Medical Leave Act (FMLA) benefits. Employers may see this as a voluntary cosmetic procedure and may not approve the time away from your job. Remember, FLMA requires paperwork to be submitted by your doctor to obtain benefits. Without your doctor’s support, you have no support.

“In the past few years, Americans are definitely more willing to go overseas and now appreciate that there is quality there,” said Jonathan Edelheit, the chief executive of the Medical Tourism Associationtold the New York Timesin 2013.

In the coming years, we’re going to see more travel to foreign countries and around the United States to obtain specific services. There are many reasons for this, including the decreasing number of doctors, health insurance costs, the exorbitant price of running a hospital, and increasing specialization.

If you choose to leave the country or even your state to obtain medical procedures, be sure to have all of the details that we discussed in these two articles before making your final decision. It can save you money to travel to obtain medical procedures, but there are many logistics you have to look at.

Dr. Josh Luke is a hospital CEO, celebrated keynote speaker, award-winning Futurist, Founder of the not-for-profit Health-Wealth and author of the book series including Health-Wealth: Is healthcare bankrupting your business? andHealth-Wealth for You: 11 Steps to Save Big & Live Healthy (both Amazon #1 Best Sellers). Dr. Luke delivers engaging and entertaining keynotes that teach audiences simple concepts on how individuals and companies can save thousands on healthcare. For more information, please visit www.DrJoshLuke.com

Preventing Unnecessary Medical Care 5 Steps To Helping Your Employees Become Engaged Health Care Consumers

The days of trusting your doctor to take care of all of your health care is over.

Between doctors used to Medicare paying everything (which lets them over-prescribe and over-charge) and medications and health insurance cost going through the roof, the only option to save money on health insurance is to engage your employees into make smarter choices.

You need to become partners in this fight!

In my book, we discuss multiple different apps, services, and cost-saving measures that will help you reduce your insurance costs and save your employees some money. See Health-Wealthfor Youfor more information.

The first step in saving money…

Getting your employees to become Engaged Healthcare Consumers.

Being an EHC means your employees know what’s going on with their health. They make informed decisions about medical tests, treatments, and prescriptions, and look outside of the traditional allopathic medicine community for alternative medicines.

It’s about personal responsibility – take care of yourself and your family first!

Imagine being able to talk with a doctor and get all of the options available to you, not just what your insurance will cover. Imagine being able to shop doctors, procedures, and medicine like you would for shoes or a new TV.

As new legislation comes through by executive order and Congress, people will be able to make informed choices and save money. But, like everything else with the government, it’s going to take time to implement, sometimes years.

We want to save money right now.

Start taking these steps to help your employees become Engage Healthcare Consumers. When they see the cost savings, it will be easier to implement bigger and better strategies with their full cooperation. And, some of these will help save you thousands of dollars on your health care costs.

1.    Discuss Health Insurance Premiums with your Employees

You and I both know that for every employee you insure, it cost you between $1,100 and $1,500 per month. How much are you having your employees contribute? 5%, 10%?

Chances are, your employees have no idea how much their insurance plans cost. All they’ve seen is the deductions out of their paycheck and the deductible at the office. And those keep going up – creating resentment.

It’s time to be upfront with your employees and let them know the actual cost of their health insurance. Discuss the different plans and the different costs, and you can get your employees on your side.

They may even have suggestions you haven’t thought of yet!

2.    Provide Apps & Services Directly

In my book, we discussed several services and apps designed to help people take charge of their medical care.

One of the apps you can provide your employees is called Calm. It helps people with frustrations, emotional upsets, and provides basic counseling. When you provide this app to your employees free of charge, they can engage with low-level counseling that will save hundreds of dollars in insurance costs.

Another option is paying for life coaching, massage therapy, and other holistic medicine out of pocket. Healthy, happy employees work harder and cost less. Providing free 10-minute chair massages from a licensed massage therapist costs significantly less than an insurance claim for a wrenched back.

In 2005, a study showed that back pain sufferersneed $2,580 more in medical care per year and nearly 80% of all people will suffer back pain. Plus, time off, lost labor, and reduced productivity cost you money.

Compare that to a 10-minute chair massage once per week costing $520 per year. It may save you over $2,000 per employee!

3.    Discuss Your Employees Health Issues (Legally)

Imagine if you knew your employees had a potential health problem before they caused problems? What if you could make a few minor changes and reduce them taking time off, visiting doctor after doctor, and driving up insurance costs?

It’s illegal to ask about employees medical conditions prior to hiring unless it interferes with their work and safety. It’s also a touchy area legally to discuss it after they’re hired.

But, if you ask them to share with you any medical problems to resolve right now, you may be able to work through some of them, make adjustments, and provide a better working environment. Just be sure to let them know that it is not a requirement they do so.

Pregnant and breast-feeding women have one of the most significant challenges in today’s workplace. The top discrimination lawsuits are from pregnant women over some really ridiculous reasons..

Let’s take for example a woman who is pregnant with her first child. She will see a doctor every couple of weeks, need more frequent bathroom breaks, and may require a different chair to accommodate her growing size and ability to move. For most businesses, that’s a really easy solution and makes you and the new mother happy.

If you start a dialogue with her early on in her pregnancy, you can communicate different services you can offer to help manage her needs during pregnancy long before they become a complication.

By being open and honest about your employee’s needs and what you can do, you avoid bad feelings and potential lawsuits.

4.    Provide Options for HSA, Alternative Medicine, and Self-Care

The fastest growing area in healthcare is Complementary and Alternative Medicine. Set to exceed $10 billion in out-of-pocket payments, people are taking full financial responsibility for different healthcare options, like massage, acupuncture, and supplements.

Massage therapy is the largest provider of alternative medicine. It’s also one of the easiest to get and cheapest to provide. As Ken Lee, owners of Kenneth Mark Mobile Massage, who specializes in taking massages to the people homes and offices, says: “Employees love massage day [from their company]. It give them a chance to de-stress, reset, and even just a few minutes in the massage chair can make their day better. A clear headed and refreshed employee returns to work feeling renewed.”

Your various options for self-care go way beyond just massage. You can provide a Health Savings Account for your employees to use for nutritional services, supplements, and other medical expenses not covered by your insurance. Not only is this a benefit for your employees, but it’s also the tax write-off for you.

5.    Negotiate with Local Doctors and Hospitals for Direct Pay Care

A growing alternative to traditional insurance is negotiating payments directly with doctors and hospitals. You pay for a certain amount of services or have a set fees for services to pay the doctor directly. By eliminating the headache of insurance paperwork and delayed payments, you can get significantly lower costs.

For one of my clients, we recently negotiated with a large health system to cover basic medical care, routine appointments, and some of the most common surgeries their employees obtained and ended up staying close to $3 million a year in insurance costs.

I don’t think you need to be a large company to save this money. Small businesses of all sizes are negotiating with different providers for services of care. If you would like more information, please call or email me directly.

Conclusion

The top principle of lowering your healthcare costs is getting your employees engaged. This means you need to talk with them and let them know what is going on with their health insurance and various costs. You need to get your employee to take responsibility for their health and work as partners to save money and time.

Engaged Healthcare Consumers are healthier, harder working, and save themselves and you money.

3 BIG TIPS ON TELLING YOUR EMPLOYEES ABOUT HIGHER HEALTH CARE COSTS

I’m going to lay out a scenario. By the time we get to the end of it, you tell me, does it sound familiar?

Your health plan needed to change, it was just getting too expensive.

Your new plan is still more expensive, but not as expensive. You don’t have any more funds for it, and you’ve got to raise costs for your employees.

You struggled and struggled to figure out how to save money and not put this extra cost on your employees.

You’ve laid awake at night worrying about what they’re going to say, what they think, and how to get out of this. What’s this going to do to their families? It’s an annual ritual.

Now, you have no choice; you have to let them know their health care premiums are going up.

Because how you inform your employees is critical to the happiness and longevity of your company as a whole.

Morale and water cooler talk change.

The story of the modern business owner isn’t exactly easy these days. At least once a year, we have to review our healthcare plan, figure out the best way to keep costs reasonable, and what to do when costs are not reasonable – which has become the norm.  In fact, let’s face it, prices are not even rational or justifiable anymore.

Despite what the media says and what many employees believe, as business owners, we don’t want to put these costs on to our employees. It’s difficult enough to make ends meet, without having to pay the extra fees for healthcare, especially with the year-over-year rate increases we’ve experienced in America for the past 20 years.

But, what choice do we have?

We have to tell the employees that their health care premiums are going up again. The business can’t sustain the cost of health insurance without the employees paying more; either the employees pay more, or there won’t be jobs available.

Let this guide help you take a little bit of the pain away from telling your employees. By involving them in the conversation, you can minimize resentment, get them on board with some healthy practices, and build better relationships that will benefit not only your insurance costs but also your bottom line.

Before anything else, you need to have this conversation with your employees ASAP. The sooner they know about the premium increase, the smoother they can adapt to the higher costs.

And by having a conversation with them, you’ll be able to get their agreement that this was the only choice you had. And maybe by listening to their feedback, you’ll get some ideas that might save everyone a little bit of money.

Breakdown of the Cost of Health Care

Over the past 30 years, insurance, billing providers, and doctors have done an outstanding (for them) job of disguising the cost of treatments, lab tests, surgeries, and prescriptions. Unless someone has paid out of pocket for these procedures, nobody truly knows what they actually cost. The billing department of most doctor’s offices and hospitals have created such confusing processes that even attempting to understand billing paperwork can be exhausting. The fact is it’s almost impossible for most Americans to even confirm what procedures or tests truly cost any more.

Perhaps this is why in 2018, the government passed a law that hospitals, doctors, and health providers must provide customers with their costs in advance as well as post them online. However, many providers still do not share this information with patients unless the patients specifically ask.

Most people know the cost of insurance and the amount of their co-pay, but that’s it. And this distorts reality. Learn more about that in “The 6 Words that Killed Health Care”. What are those six words? Here is a hint: don’t be conned into believing that your insurance pays for the rest because ultimately, you do.

So, insurance companies spread out the cost of health care to employers. What you, as the employer, have to pay can be a hidden cost. That reality is that by purchasing insurance for your employees, you are contributing over $1,000 a month per employee for their health care.

In 2016, the family plan health insurance was $18,142 billed to the employer, according to the Kaiser Family Foundation. This rose 5% to $19,616 in 2018, and there appears to be no end in sight. But, your workers only see about $5,547 of that cost, and you cover the rest.

Tell your employees this figure. Let them know the cost per employee, and what you pay so they can have their insurance. There are a few of your employees that won’t believe this number is that high, but most will be surprised.

Take notice of as many reactions as you can. Who among your employees understands your predicament? Nurture these people; they have the potential to become allies. Who is in complete denial? These people will need to be talked to separately to soothe over bad feelings.

This process is what I call converting your employees into EHC’s – Engaged Healthcare Consumers. Becoming an EHC is a process and requires each employee to commit to the process on their own time. The sooner the better for all. During your discussion, compare healthcare cost to your total operating budget and profits. In many cases, health care is one of your highest expenses.

Deductible versus Premiums

Most people will be concerned about what gets taken out of their paycheck and what deductible they will have. This was probably the hardest decision you had to make. Do you choose a higher deductible plan or a higher premium plan? You’ll never be able to satisfy everyone.

Be sure to explain the plan you chose for your employees. Are vision and dental included? Tell them why or why not. Let them know how much extra it would cost for a lower premium plan or lower deductibles, or even better prescription coverage.

Deductions for healthy employees

By now, you should have already checked with your health care plan to see whether there are deductions for healthy employees, age brackets, and frequency of use. Generally, many insurance plans will give you a rate reduction for healthier employees. Employees who do not smoke, drink often, or use their insurance often tend to have lower premiums.

Take a look at your workforce. What’s the general health? Be sure to share with your employees that the healthier they are, the lower the health care costs. You can help them become healthier by starting several of the programs we have listed below.

Working With Your Employees

This is where you will want to get input from your employees. Find out what they want, and how much they’re willing to work with you to get the best benefits at the best price.

If you can get to the last of these three steps—working with your employees to answer their questions—then you are well on your way, as they have started the process of becoming an EHC, and may be well on their way down that road already. In my next column, I will share several specific tactics that can be offered or discussed with your employees once the cultural shift has begun and you see signs of Engaged Healthcare Consumers throughout your workforce.

Dr. Josh Luke is a celebrated speaker, award-winning Futurist, LinkedIn Influencer, a faculty member at the University of Southern California’s Sol Price School of Public Policy, and author of Health-Wealth: Is Healthcare Bankrupting Your Business? 9 Steps to Financial Recovery. Drawing on his experiences as a hospital CEO, Dr. Luke delivers engaging and entertaining keynotes that teach audiences simple concepts on how individuals and companies can save thousands on healthcare. 

Sick At Work: Reducing Employee Absenteeism

Four steps to reduce employees missing work when they’re not sick

When one of your employees is sick, you know the hard cost for paid time off. You planned for it, and you know your employees will use it. Just you know there are days that they aren’t sick, but want to have fun (don’t you wish you could do that).

But, there’s a less quantifiable, but insidious burden upon your company that comes when your employees take time off without getting paid. They do it for many reasons, no more sick/vacation time, mental health days, or couldn’t get time scheduled off. These unpaid days off, as reported by Forbes, cost U.S. companies more than $227 billion each year in lost productivity or missed deadlines.

Your sick day policy needs to be flexible in this economy to accommodate the changing lifestyle of your employees and produce the most effective and loyal workers.

Causes of Absenteeism

Surprisingly, the number one cause of employees missing work is not because they are sick. It’s because they have to take care of family members. More people would instead try to work while sick, than rest up properly. We’ll cover more on this below.

The number of sick days and how often a person misses is highly dependent on gender. Women will miss working more often to take care of kids and ailing parents than men. This is true in nearly every type of employment and executive level.

Young children being home sick from school requires a parent’s care, and young kids get sick often. As women and men start having families in their late 20s to mid-thirties, this absenteeism will hit your core workforce.

However, age makes a difference. Older workers are less likely to take time off from work, according to a 2005 survey by The Commonwealth Fund, than workers ages 19 to 29. Younger workers may take “Mental Health” days, a concept workers over the age of 40 may not even know about.

Of course, your employee being sick plays a significant role in your bottom line. But, you may be surprised to learn why.

Working while sick or “Presenteeism,” as coined by a report in the American Journal of Public Health in 2012, found the food services industry had an increased risk of injury and public health potential disaster. DM Norton et al. found that nearly half of all foodborne illness outbreaks in restaurants come from employees working while sick.

Along with the potential of spreading the illness, sick employees at work have reduced output, shorter tempers, and are ill longer. Plus, the work your sick employee isn’t doing falls onto other workers who are not ill, making them less productive.

Other reasons for missing work include not being able to find transportation, not being able to find facilities to care for children or aging parents, doctor’s appointments, and the mentioned trend of taking mental health days.

4 Ways to Reduce Absenteeism

In every company, you should be tracking the reason your employees give for taking time off. Once you have the data, you can provide the facilities and support for your employees that will minimize absenteeism and promote a good, healthy working environment.

Both of the books in my Health-Wealth series offer more than a dozen different tactics on how to reduce absenteeism in the workplace. Here are four examples:

On-Site & Near-Site Health Clinics

Many larger companies are hiring doctors, nurses, and medical staff to provide a small, urgent care clinic right in their main building. These urgent care clinics are often free, open during all working hours, and operate under the same strict HIPAA regulations found in other doctor’s offices. Many companies utilizing on-site or near-site clinics are also converting to a Direct Primary Care model.

Your employees benefit with better access to health care, reduced illness, better regulation over medications, decreased insurance cost, and reduced absenteeism.

The Direct Primary Care (DPC) model reduces costs further. DPC resembles a subscription plan or country club membership. One flat fee is paid to the doctor, and your employees can obtain as many services as they need. The DPC doctor benefits from a steady, guaranteed income, your employees benefit from the doctor being more concern with your employee’s health than insurance, and you benefit from saving money on insurance costs. Coming soon, another article will explain how you can implement this system.

The most significant hurdle facing these health clinics is the right to privacy. These doctors are required to operate under HIPAA regulations, precisely as if they were in a formal doctor’s office. You need to reassure your employees that these offices will not share medical information, nor can visits to the clinic be tracked.

If your facility is not large enough to support a doctor and full nursing staff, consider partnering with a small, local clinic or urgent care center that your employees can visit with minimal or no cost. For many of the smaller doctors offices, a monthly retainer for helping treat your employees is more profitable for them than to continuously bill insurance.

Health clinics also play a role in helping employees live healthier, which reduces illness and time off. Obesity, diabetes, high blood pressure, and pain management are issues that a health clinic can incorporate as part of a wellness program. Healthier employees are more productive, take less unpaid time off, and generally remain with the company longer.

Family Support Services

Missing work to take care of a sick child, manage snow days, or attend after-school activities is commonplace, especially among women. Instituting child care facilities to take care of young children can be often profitable when compared to lost productivity due to missing work.

Some examples of family support services include child day care, senior care, and after-school programs. Some urgent care facilities in office allow children to attend, helping reduce the need for parents to take time off for their child to see a doctor.

Ride Share/ Car Pool Support

Employees who are late or need to miss work because they don’t have adequate transportation are rising in numbers. The Millennial culture is beginning to reject the use of individual automobiles and are demanding public transport be more available. However, public transportation systems are lacking in many areas, especially where newer office complexes are being built.

Fortunately, several enterprising organizations are providing transportation for those without. Uber, Lyft, Hyre, RabbitTransit, and many others are providing personal transportation and group transportation in a customizable and confidential way. Consider contracting with a local mass transit organization or group of individuals to help your employees arrive at work on time.

Additionally, some organizations are providing company vehicles or bonuses for individuals willing to carpool or pick up other employees. One large cast metal production plant in northern Pennsylvania offers specific individuals $250 in bonus each month to pick up three other employees and arrive on time. Since implementing the program, this company reported nearly all late arrivals started being on time and missed time at work dropped by over 50%.

Health-Wealth Focused Mobile Applications

The not-for-profit Health-Wealth organization and the two books in the series recommend some mobile apps to help corporations and employees better manage their health and save money. In our next article, well go into these topics a bit deeper, add a few, and show you how to incorporate them into your health care model. Here are a few to look into:

– Telehealth – Apps like Teladoc and Lemonaid Health put you in direct contact with a doctor via phone or video chat. This chat costs significantly less and sometimes saves a trip to the emergency room or doctor’s office.

– Disease-specific counseling – Managing health issues like diabetes, high blood pressure, and obesity works best when working with a coach or counselor. Canary Health’s diabetes prevention program and monitoring apps help doctors adjust medications, provide warnings of problems, and can provide meal planning.

– Women’s Health – Some women are embarrassed by specific problems, especially if their doctor is male. Speaking to a female teledoctor, such as Teladoc or ReadyDoc MD, or a coach can help provide guidance and understand for sensitive issues. Certain apps that monitor blood pressure, menstruation (Glow app), and mood swings can identify problems before they interfere with normal, daily life.

– Stress and anxiety – The most significant trend in mental health is texting apps with a trained professional. For a minimal fee, you can talk to a coach, psychologist, or counselor about health, stress, depression, or any relationship issue. Usually, these monthly fees are 75-90% less than a single counselor session and provide better, faster service. 7 Cups provides 24/7 service.

Making Sense of It All

The Health-Wealth Not-For-Profit education division offers an interactive exercise for corporate benefits teams to assist them in starting the cultural shift to get employees to convert to Engaged Health Consumers.

You have to take an active interest in your employees and learn why they miss work. Then, you can take proactive steps to give them the support they need to be the present, hard workers you need.

Becoming Engaged Healthcare Consumers

Originally Appeared on Forbes.com

Premiums are going up and your employees aren’t happy. If you’ve taken the steps in part one, you started the discussion on why your employee’s health care costs are going up. You’ll know who is now thinking about health care in a whole new way and who wants to stick to the old way of doing things.

It’s your duty to your employees and business to encourage Engaged Healthcare Consumer (EHC) behaviors. We have several tips and ideas to implement in the book, Health-Wealth. It’s designed to help you understand why prices keep jumping up and how to save costs on your health care spending. The Health-Wealth not for profit education division offers an interactive exercise for your corporate benefits teams, to assist them in starting the cultural shift of converting employees to EHCs.

Additionally, you can assist your employees to be more responsible by having them read Health Wealth for You, 11 Steps to Save Big & Live Healthy. This follow-up is for your employees to start saving money on their own health care costs.

Now, let’s take a look at a few of the suggestions.

Health Savings Account (HSA)

More insurance plans and companies are implementing HSAs. These are accounts that employees and employers contribute funds to, usually tax-free. These plans can be used for any health or medical expense. For example, many employees use it to pay deductibles and prescription costs. Other people may use it for massage therapy, nutritional services, or other wellness product.

One of the more significant benefits of HSAs is you as the employer can contribute to this account. Depending on your business model, your contributions can also be tax deductible.

Explain to your employees why you’re contributing to HSA rather than getting them a lower deductible. The reduced employee contribution and the HSA can offset the cost of the higher deductible for many employees.

For the younger generation, Generation Y and Millennials, HSAs can help pay for services not covered by the insurance companies. For healthier individuals, they may not fulfill the deductible no matter how high or low. An HSA makes more sense.

Higher Pay Vs. No Health Care

Depending on the size of your company, you may fall into a bracket that you may not need to offer health insurance at all. In some cases, these companies will opt to pay their employees significantly higher wages and/or contribute to large HSA.

For some companies, the cost of government fines for not providing insurance is lower than the cost of health insurance. Be sure to know your legal responsibility before choose not to offer coverage.

Gym Memberships, Weight Loss Programs, & Other Incentives

Before purchasing any new health insurance, talk to the wellness advisors to see if there are any discounts for healthy employees, wellness plans, and other incentives. Many insurance plans are helping to lower deductibles and premiums when employees take advantage of weight loss programs, gym memberships, and insurance sponsored wellness plans.

For example, most insurance companies have nutritionists on staff to help with weight loss, dieticians to help with diabetes and blood pressure control, pain management specialist to help people avoid painkillers and other opioids, and health coaches the help people feel better and be more active.

You should also help your employees to quit smoking, avoid recreational drugs, and reduce their alcohol intake. Because premiums are built upon risk factors, lowering the risk factors in your employees can help lower your overall insurance cost. Many people who smoke and abuse mind-altering substances, like alcohol, genuinely desire to get rid of their addiction but don’t have the support in place. By offering that support, you help your employees be healthier, more productive, and lower your insurance premiums.

Some insurances offer discounts when you hold a health fair for your employees. Usually, local businesses and health offices will volunteer to set up a table and give out free information during these fairs (many come for the free lunch). It’s a chance to talk to potential new patients for these health businesses.

Telehealth & Remote Monitoring Services

Nearly all insurance companies now offer some form of telehealth or the ability for the insured party to contact a doctor via phone or video. Many doctors can diagnose, prescribe, and treat a patient without ever having to see them in person. These services usually are significantly reduced in price, often being less than a standard deductible.

These services are an especially important step in the treatment of chronic and lifestyle diseases. For example, heart disease requires frequent check-ups. Patients who can monitor their blood pressure and diet at home can use electronic links to automatically submit the information to the doctor. Medications can be adjusted as needed, and a wellness coach can be consulted virtually to help with lifestyle techniques. Patients who visit a doctor every three months can reduce this frequency to once a year.

Overall, patients have better and faster access to doctors and medicine via telehealth.

There are several other examples of how an employer will save in the book Health-Wealth, such as how to save money on prescriptions, choosing center-of-value hospitals, and much more.

Navigating Negative Feedback

We all know you’re not going to make everybody happy. No matter which plan you choose, how low the deductible, or how small the premiums, someone will find faults with your choice.

This resistance is especially true when it comes to having to talk to your employees about raising their insurance costs.

There are three basic steps you can take to reduce the impact of negative comments and help all of your employees understand your position and the inevitable rate increase.

Listen to constructive negative feedback

There’s a significant difference between listening to constructive feedback and allowing people to rant and rave. Tell your employees you welcome calm input and are willing to have a conversation about what’s happening with the insurance. However, do not allow your employees to fall into the trap of venting their frustrations with no purpose.

Listen to constructive negative feedback

Yes, we know we listed this twice. It’s that important. Once you know you are getting valuable feedback, listen to it thoroughly without interruption. Ask questions if you don’t understand something. Once your employee has finished their feedback, summarize and repeat back to them what they said. Then, ask them if that is their concern and if you missed any significant detail.

Once you have your employee’s feedback, it is up to you to decide what to do with it. If it is something that will help you lower your costs and benefit your employees, you should work with your employees to implement the process. If it is something you cannot do or will end up costing too much of your profits, explain to your employee why it is not a good idea.

Share the feedback you receive and your response

If one of your employees has a complaint, chances are many more do and are unwilling to come forward. By not sharing, resentment can fester.

When you share the negative feedback and your response to it, you help address many problems that could potentially arise in the future and resolve them before they ever become a problem. It also shows your employees that you are willing to listen and consider their concerns.

Will this solve all the problems? Probably not. Insurance premiums will likely continue to rise over the next few years.

Many changes came to the healthcare system in a very short amount of time. The rising cost of healthcare and insurance left many people choosing to opt out of the system entirely, placing a more substantial financial burden on to doctors and hospitals, which eventually get passed through to the insurance companies and back to the people.

While we can’t change how the insurance companies work, nor beat the health care system, communication with your employees can help them understand why the costs are going up so much.

My Employees Want Alternative Medicine: How do I do it?

A funny rumor reached HR this morning. It seems that an employee has these funny circular marks, almost like bruises on her arms and shoulders. It’s also known this employee just began dating again, and bruises raise red flags.

Walking into the break room, and, behold, there are those marks. Yet, the employee is glowing about how wonderful her massage therapist is and how the cupping relieved her shoulder pain. You remember the employee had several doctor’s appointments over the past couple of months. She lost time at work, had lower productivity, and just wasn’t happy.

Now smiling, the employee looks at you and asks “Why isn’t cupping covered by our insurance? I know another massage therapist was, but the guy that fixed me isn’t!”

Do you know what cupping is? You didn’t know your insurance covered massage therapy to begin with!

Cupping therapy can be described as an ancient form of alternative or functional medicine in which cups are placed on the skin for several minutes to create suction. Cupping therapy is used to address pain, blood flow issues, for relaxation and as a type of deep tissue massage.

Still talking, it appears the doctors covered by your insurance didn’t have the solution, other than surgery. But this alternative medicine seems to have restored her mobility, happiness, and health.

More and more of your employees are seeking out alternative medicine to fill in these types of gaps.

In all the years I’ve been teaching companies about saving money on health insurance, alternative medicine is one of the most requested and sought out therapies not covered by insurance. Of course, there are ways around this little problem, one example of which will talk about later.

Let’s first take a look at some of the ways your insurance companies treat alternative medicine, and how you can include it in your employee’s benefits.

Why Insurance Doesn’t Cover Alternative and Integrated Medicine

Every insurance company has different views of what constitutes complementary and alternative medicine (CAM). Most are based on consistent treatments, scientifically predictable results, and measurable change.

Only a few of the nearly 200 different registered alternative medicines have the legal and scientific basis to prove these kind of results.

That’s not encouraging, wouldn’t you say?

Let’s take herbal medicine, for example. Practitioners of herbal medicine strongly oppose licensing and legal restrictions. Therefore, few insurances cover an herbal practitioner or the cost of prescribed herbal supplements.

The devil is in the details. With herbal medicine, there are several distinct schools of practice, including Traditional Chinese Medicine, Ayurveda, and Western Herbalism. Even within these schools, various practitioners use different herbs in different ways.

Which one is right? And do you want to government to decide that for you?

When the government steps in and starts dictating who has the legal right to practice herbalism, it passes these regulations to the insurance company. What if the legal right to practice is limited to Traditional Chinese Medicine? That means every other Ayurveda practitioner, home-based herbalists, and Western Herbalists now find their businesses and livelihood suddenly illegal.

This happened with the doctors and nurses we know today. In the early 1900s, the American Medical Association set out to formalize education and create standards for doctors. It sounded great until we learn that big businesses, such as the Rockefellers, had a hand in dictating the type of medicine that would be promoted would be pharmaceutical based, therefore increasing their profits.

Because it became illegal to call oneself a doctor from any other school of medicine other than the approved ones, millions of doctors went out of business, and whole strains of medical treatment either went underground or extinct.

The resurgent of complementary and alternative medicine is the revival of many of these techniques that survived the original medical purge. Just like the risk of licensing herbal practitioners, these alternative medicines need to remain unlicensed and passed down traditionally to stay viable.

Because it isn’t profitable or legal to test some of these alternative medicines, studies don’t exist to show it works, has measurable results, nor can the practitioner predict the outcome.

Today’s medicine and the insurance that pays for it is based on metrics. If it can’t be measured and replicated, you can’t predict weather at will work for somebody else. And without the ability to predict results, the insurance company loses money.

What Alternative Therapies Are Covered By Insurance? And which ones aren’t…

But, not all alternative medicines are entirely devoid of proof. Increasingly, massage therapy, naturopathic medicine, chiropractors, and a select few other practitioners have made it onto the list of alternative treatments commonly covered by insurances.

You’ll need to check your specific insurance plan to discover which alternatives are covered and if a particular practitioner is covered. Here’s a list the ones commonly covered:

  • Acupuncture
  • Aromatherapy
  • Ayurvedic Medicine
  • Biofeedback Therapy
  • Chiropractic
  • Gym Memberships
  • Hypnotherapy
  • Massage Therapy
  • Naturopathic Doctors
  • Nutritional Consulting
  • Traditional Chinese Medicine

We don’t want you to limit your choice of alternative medicine just because your insurance will cover it. Remember, if insurance and licensing regulations constrain practitioners, they may not be able to provide the type of care you need, even if it doesn’t cost you a penny.

Also, many practitioners choose not to take insurance because of the paperwork, delay in payments, and headaches.

Private HSA for Alternative Medicine Use

Another lifetime ago, health savings account were privately created by individuals for their own health needs. People specifically put away money “just in case.” Today, many employers are going back to that mindset and creating Health Savings Accounts (HSA) for their employees.

HSAs can be used to help save money on any health-related items including things that are usually not included in insurances. Things like specialty massage therapy, diet nutrition, reiki, herbal medicine, supplements, and many other less common form of treatments can be selected and then paid with the HSA.

Your workers stay healthier when they are more involved with making the decisions of their healthcare rather than letting it up to the insurance companies. Healthier employees are more productive and take off less unpaid sick time.

More productive employees mean a higher profit margin for the company and less turnover.

Integrating Alternatives – What You Need To Know

Working with your HR department and opening discussions with presidents and owner of the company helps reinforce the necessity of including alternative medicine and HSAs into the budget. Even if these options aren’t implemented in the current year, repeated requests will help include stipends in future years budgets, benefiting the health of your employees.

I help a lot of different companies open the lines of communication to lower health insurance costs, including starting HSAs and reducing the cost of insurance. Many of these changes come down to your employees’ requests being heard and the demand for health savings accounts. In cases like this, the squeaky wheel really does get greased.

Based on statistics from the National Institute of Health 38% to 50% of all people are using some form of alternative medicine right now. If your employees are asking for more options, they will get them. So, think about this, if another company offers health insurance with alternative medicine coverage, would your employees leave you for them?


Dr. Josh Luke is a keynote speaker, award-winning Futurist, faculty member at the University of Southern California’s Sol Price School of Public Policy and author of Health-Wealth: Is healthcare bankrupting your business? 9 Steps to Financial Recovery. Drawing on his experiences as a hospital CEO, Dr. Luke delivers engaging and entertaining keynotes that teach audiences simple concepts on how individuals and companies can save thousands on healthcare. For more information on Dr. Josh Luke, please visit www.DrJoshLuke.com.

 

Dr. Josh Luke on Forbes, Simple Tips to Save Thousands on Healthcare in 2019

Originally appeared on Forbes.com

Apple, Amazon, Google, Walmart, and Tesla are among the global brands that made significant changes in 2018 to start curbing corporate and employee healthcare costs for the company and employees. 2018 shaped up to be the year that many American businesses and families declared war on out of control healthcare costs by seeking out more affordable options. Those companies, employees, and families are now being rewarded by seeing thousands in savings already.

Health insurance and benefits are the second highest expenditure behind payroll for most American businesses. For individuals and families, healthcare is likely the fastest growing expense year over year, even as each dollar buys less care as benefits are being reduced! Has your company or family declared your tipping point on out of control healthcare costs? If not, now is the time and this article will provide a few simple starter ideas on where to begin in 2019!

Simple tips to save thousands on healthcare in 2019:

For Individuals and Families

There has been rapid growth in cost sharing plans whose premiums can be 60% less than traditional insurance. Many are familiar with faith-based cost sharing plans such as MediShare (Medishare.com) that have been providing a more cost-efficient alternative to Christian members for years. The key to cost sharing plans is that the plan is not regulated by the Department of Insurance and members pay significantly less in premiums. Members pay cash prices to doctors on the day of appointment and later seek reimbursement from the provider, and also have no guarantees that major claims will be reimbursed. There is a “leap of faith” factor involved.

For those who are not comfortable joining a faith-based cost sharing program, there has been rapid growth from individual providers like Sedera Health (Sedera.com) that allows non-faith-based organizations to create their own product. One of the more unique but rapidly growing groups that offer a program through Sedera is Fit Health (WeAreFitHealth.com). Fit Health simply asks that members commit themselves to living a healthy lifestyle and in return are included in a group that is offered significantly reduced premiums and share of costs.

You and your family can join a cost sharing plan on your own. Many corporations have begun offering a $200 monthly allocation toward an employee’s cost sharing plan as an alternative to traditional insurance as well.

For Employers

Employers are auditing every dollar they spend on healthcare to identify how to slow down the constant, excessive growth in healthcare spending year over year. The goal is to conduct a full review of all expenses related to providing healthcare benefits to employees. Account for every dollar and measure its impact.

While many employers rely on brokers or benefits advisors for this purpose, there is little incentive for your broker or advisor to do an honest review as their compensation is based on the amount your company spends. The fastest growing option nationally that is yielding immediate results is a not-for-profit effort named Health Rosetta (healthrosetta.org). It’s a full bumper-to-bumper review of every dollar your company spends on healthcare and provides tactics and alternatives to reduce spending as much as 50 percent.

Because Health-Rosetta is a non-profit and their results have been immediate, they have seen rapid growth as an alternative to relying on your traditional broker or benefits advisor for this type of audit.

For Individuals and Employers

There has been quite a bit of media attention given this year to companies dedicated to helping Americans eliminate medical debt. The two best-known organizations, both not-for-profits, solicit donations from corporations, events and individuals, and allocate those dollars to pay down outstanding healthcare costs. RIP Medical Debt (RIPMedicalDebt.org) has received a lot of national media attention after a church in Texas donated $100,000 to eliminate outstanding medical debt. Although RIP’s website states that they “cannot currently forgive the debt of targeted individuals,” a separate company known as HLTHE (HLTHE.com) does allow donations that go directly to individuals. The organization recently re-branded to HLTHE after helping individuals with medical costs for years under the brand Pink Firetrucks (pinkfiretrucks.org).

For example, if your company or event wanted to make a tax-deductible donation to HLTHE of $25,000, that donation could be allocated directly to your employees. Any employee who creates a wallet could then use those funds to pay down personal medical debt for themselves or family members.

For example, if a colleague at work is diagnosed with Cancer, your company could host an event or solicit tax-deductible donations from employees that are contributed directly into the HLTHE wallet of that individual who was diagnosed and turned into HLTHE cash. That individual is provided a debit card that can be used to pay down medical debt.

If your company or family has had enough of hyper-inflating healthcare costs, these simple tips will help you save thousands in 2019.


Dr. Josh Luke is a former hospital CEO, acclaimed speaker, healthcare futurist, and best-selling author of Health-Wealth with ForbesBooks. Learn more at health-wealth.com.

Dr. Josh Luke on Forbes, Will Obamacare’s Medical Record Requirement Be the Biggest Bust in History?

Originally published on Forbes.com

Let’s flash back to 2010. It made so much sense that any healthcare reform act would include a mandate that required hospitals to aggressively implement electronic medical records (EMR) so patients could finally have access to their own personal health data.

There wasn’t much push-back from either side of the aisle on this condition known in the Patient Protection and Affordable Care Act (PPACA) as “meaningful use.” After all, the information age was upon us yet hospitals were still photocopying records, charging patients for the copies, and telling the patient they needed to come back in 72 hours to retrieve the records. Hospitals frowned upon the process as it usually symbolized a potential lawsuit on the horizon.

It seemed that Americans as a whole were united that meaningful use was a positive step to empower the patient to be involved and educated in their own health management. But one year went by and then three or four, and, despite the threat of penalties for missing implementation deadlines, the hospital industry lobbied successfully to limit these requirements to implementing components of the EMR that helped them maximize revenues.

The top three EMR vendors became so powerful, it was not uncommon for them to pass up on opportunities to work with small and midsized hospitals and health systems. I know, as I was one of the CEO’s who was told, “You’re not big enough for us to justify working with you.“ What about those big hospitals that did work with these top vendors? They were often boot-strapped for years and unable to fulfill other priorities as a result of the cost allocated to their EMR implementation. It was a highly publicized nationwide epidemic for many hospitals.

Despite great profitability for the vendors, little was done in regard to making a patient’s personal health record more accessible and most hospitals made almost no progress in the initial five years after PPACA passed. In 2016, as a handful or EMR vendors rose to the top and captured the majority of the core hospital market, Congress called several of their leaders back to Capitol Hill to address the lack of progress and implemented new, heightened expectations around implementation and compatibility.

It makes sense if you break it down into a timeline:

  • Congress requires EMR implementation in PPACA in 2010. The EMR space explodes in 2011 as a result, and hospitals are the sole payer to EMR vendors
  • Despite ObamaCare prioritizing patient access, population health, and staying healthy at home, hospitals had little financial incentive to enhance access or keep patients healthy at home into 2015.
  • Prior to 2016, almost no hospital dollars were spent on EMR vendor software that supported access or population health, and therefore the EMR vendors had little incentive to prioritize these needs as well. Then Congress stepped in by 2016 and asked EMR companies and hospital leadership to focus more on compatibility and access.

 

But in early 2018, just as health systems started shifting their meaningful use priorities toward patient access, a strange thing happened. A few technology companies much larger and influential than those in the EMR space entered the electronic patient record discussion.

Have you ever heard of Apple? What about Amazon or Google?

These companies have a global reach that makes the EMR vendors’ footprint look almost irrelevant. In January 2018, Apple announced a partnership with several major health systems to make patient records accessible on their mobile phones. In that same month, Amazon announced it was partnering with JP Morgan and Berkshire Hathaway to rethink how healthcare benefits are offered to employees. Within a few short months, Google made a number of announcements and key hires as it moved into the healthcare delivery space as well.

While its unlikely Apple, Amazon, and Google will prioritize becoming major EMR providers in coming years, it’s not at all unlikely that this goal is within their long-term plans. More importantly, these global tech giants realize that the EMR is not the most critical information available in the healthcare process. Much more important than the EMR is the HIPPA-compliant, cloud-based parallel that allows patients and caregivers to converse and get educated from their mobile device. Think of a group text, or the Slack Application, specific to healthcare. There are already several effective patient management apps out there. These applications vary in scope, but Stellicare, MeUCare, and LoopdIn are all examples of applications currently available to the consumer that help manage a patient’s sensitive health information.

Remember, in the model of the future, when a patient is hospitalized, more often than not it will be a failure of the population health system. The focus of healthcare in the future is on being healthy at home, which requires self-management and caregiver education. These applications enhance those skill sets. I have lived this personally as my mom is currently in the advanced stages of Alzheimer’s Disease. My family has used a group text to accomplish this, but these new applications not only allow us to opt-in any doctor, pharmacist, caregiver, or family member, they also allow us to download instructional videos and resources.

As a result of this excessive EMR spending, hospitals pass the expenses onto the consumer and businesses in the form of rate hikes and the cost of healthcare in America continues to skyrocket. The meaningful use requirement is no doubt one of the contributing factors to healthcare’s continued hyperinflation.

So here’s the good and the bad of President Obama’s meaningful use experiment: big EMR vendors built up power and influence and, just as it peaked, several companies with much greater influence entered the arena and forced the EMR vendor back to the table to re-prioritize. Depending on how quickly Apple, Amazon, Google, and others enter the arena, the success and livelihood of these top EMR vendors may be on the line. EMR vendors’ failure to prioritize population health software and applications may cost them in the long run.

If Apple, Amazon, Google, and others create more effective means of managing and making accessible patient information and records, will Obamacare’s meaningful use requirements prove to be the biggest waste of billions of dollars in the history of American business? Time will tell.

Dr. Josh Luke is an award-winning Futurist, hospital CEO, two-time Amazon #1 best-selling author, and a member of the faculty at the University of Southern California’s Sol Price School of Public Policy. He is a well-known public speaker on the topic of healthcare affordability and transformation and writes regularly for LinkedIn as The Healthcare Affordability Authority. Visit www.DrJoshLuke.com for more information.

Dr. Josh Luke on Forbes, providing time management wisdom along with other CEO’s

Originally appeared:

https://www.forbes.com/sites/forbescoachescouncil/2018/11/21/15-big-challenges-youll-face-as-a-modern-ceo-and-how-to-solve-them/#679812c1398e

Every leader faces trying times, both internally and externally. Those external factors are often the most difficult to contend with, since they’re outside of a leader‘s control. In fact, the current business climate has generated many shared concerns among managers across the board, regardless of the industry they’re in or type of business they operate.

Below, 15 members of Forbes Coaches Council shared challenges their executive clients are struggling with most today. Follow their advice to navigate these common issues.

1. Making Space For Reflection

My CEO clients know and believe that time and space for reflection and thinking is crucial for clarity and strategic process. And they have a hard time finding the space. Many clients are scheduling space in their calendars and challenging themselves to treat it as a priority just as they do other meetings. – Renelle DarrInSight Coaching & Consulting

2. Navigating And Communicating Constant Change

I haven’t worked with an organization or leader who isn’t struggling with how to navigate change, whether it is in the organization itself or industry overall. The keys to leading change are trust and clear communication. Build trust with your teams by creating avenues for open, two-way communication, not only about the change itself but also timing and impact. – Tonya EcholsThrive Coaching Solutions

3. Making Progress Amidst Chaos

It is so easy to get distracted and be pulled in so many directions when trying to balance creating an exciting future while maximizing results today. Taking the time to communicate constantly and engage your teams in both the excitement of creation as well as the dedication to providing results can ensure that you provide the reassurance and sense of stability an organization needs. – Rose CartolariRose Cartolari Consulting

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4. Staying Ahead Of The Competition

With other companies offering a similar service to yours, how do you stay competitive in a crowded marketplace? Instead of focusing on the competition, get intimate with your company’s unique differentiators and value proposition. Remove yourself from the commodity market that competes on price and quality, and focus on innovating your unique approach, exceptional skills and customer intimacy. – Michela QuiliciMQ Consulting and Business Training, Inc.

5. Finding Talent In A Good Economy

Most of my CEO clients struggle to find good help. It’s the curse of a good economy. In bad times, employees are everywhere. In good times, all the good employees are happily employed and taken care of. You must learn to recruit talent in a good economy. You have to seek out employees because most are happy and not seeking further employment. – Ryan StewmanBreak Free Academy

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6. Overwhelm

Many of my CEO/executive clients seem completely overwhelmed, mostly by problems coming at them 24/7. I teach them prioritization techniques, and I also serve as a “vent buddy” for them. Having a vent buddy is really helpful. It needs to be someone trustworthy and discreet, who will listen, not judge, not try to solve the problems, but just be there for venting. – Gregg WardThe Gregg Ward Group

7. Retaining Top Talent

In today’s economy, jobs (and better-paying ones) are plentiful. Companies need to find ways to engage employees in new ways, and it may be different for each one. Are they mission-driven? Are they vision-driven? Do they thrive on cooperation/teamwork? Understand what drives each employee and create a work experience that matches them. – Adam KipnesCoach Adam Kipnes

8. Building A Strong Management Team

Having a strong management team will have the most impact on any challenge a CEO/executive is struggling with. As companies grow, they often outpace their management expertise. A CEO should focus their time on getting the right managers in place (from internal or external sources), and then have consistent management meetings focused on strategic initiatives and problem solving. – Erin HoffmanCollaboration Business Consulting

9. Creating Safe And Supportive Environments

With everything in the news and the #MeToo era, many leaders are struggling with promoting and maintaining safe and supportive work environments. An easy way to do this is by promoting a simple statement: people first. Then couple this statement with values of how people will work and communicate with each other in a people-first initiative. Make sure to reinforce this through goals and training. – Kristy McCannGoCoach

10. Email Overload

A key to managing time is understanding that your priorities and daily “to dos” must come first. Responding to emails has to wait. Look at it this way: Your “to dos” are your priorities. The emails in your inbox are other people’s priorities. Take care of your business first! We have all sat down just to clear a few emails in the past only to find that we spent an entire day responding to them. – Dr. Josh LukeHealth-Wealth.com

11. Staying Relevant And Professional On Social Media

Many CEOs find it challenging to navigate the world of social media, which is growing daily and here to stay. Being hip and trendy while remaining professional can be tough for some executives. You must learn the dos and don’ts, and you must remember that just because something is effective doesn’t mean it’s professional. – Pasha CarterThe VIP Network

12. Taking Stands On Social Issues

Social issues and business really don’t mix well. However, CEOs are being pressured by stockholders and employees to take a stand on issues like immigration, for example. This is a slippery slope. You can’t please everyone. But you can address issues of those where it matters most — as long as you represent company values. – Randy BlockRandy Block

13. Nurturing A Strong Company Culture

My clients find it challenging to nurture their company culture in the current climate and as their company grows. They are keen on retaining their vibrant, collaborative cultures, so I advise them to capture what that means first. Their clear vision enables them to integrate culture nourishment into operations and continuously evolve. For example, they identify how training and rewards align with the culture. – Kelly Tyler ByrnesVoyage Consulting Group

14. Choosing The Right Opportunities

Forward-thinking CEOs are constantly seeking then filtering opportunities to grow and strengthen their businesses. Which ones are the best ones to pursue? That is the toughest part for them, and frankly for most of us. Learning to say no to opportunities that don’t meet the company’s growth and value criteria is essential, so that precious and finite time is spent on the best opportunities. – Evan RothRoth Consultancy International, LLC.

15. Defining A Legacy

When the economy is hot, executives feel pressure to take larger-than-normal risks to grow the company’s brand. Coupling this with the human needs of personal growth and the service of others, CEOs may take action on deals that don’t align with the company’s mission. I encourage clients to define their personal mission first and find alignment between it, the deal, and the company’s objectives. – Michael S. SeaverSeaver Consulting, LLC