Several years ago, Montefiore Health System in the Bronx was behind the curve when it came to health benefits costs for employees.
In 2011, the average cost for medical services and prescription drugs for an employee of the hospital system was $12,475 a year, or about $500 above its peers in New York City. That amounted to millions of dollars in superfluous costs, William Shanahan, Montefiore's vice president of human resources, said during a session Tuesday at the American College of Healthcare Executives' Congress on Healthcare Leadership in Chicago.
So Montefiore, a self-insured organization, decided to implement disease- and care-management programs to improve the health of employees before illnesses became more serious, and more expensive, problems. The health system also redesigned its benefits plan to ensure more money stayed inside the system, such as making Montefiore hospitals and doctors the preferred providers for employees.
The care management programs spurred Montefiore to look at what social determinants are affecting their employees' health, said Anne Meara, associate vice president of network care management at Montefiore. Nurses, pharmacists, nutritionists and other caretakers used to data to find out which employees were most at risk. Montefiore's care management organization bolstered its staff to more than 900 people.
Montefiore recorded some progress in keeping employee medical spending in check, the executives said. Since 2011, Montefiore's healthcare costs per employee grew only 3.7% annually, compared with 8.5% for other New York-area hospital systems. In addition, employees who participated in some type of program used the emergency department less frequently and were more likely to follow their recommended care.
Like other self-insured organizations, Montefiore also increased what employees had to contribute for their monthly premiums. At almost 13%, employee contributions are still below other New York-area hospitals, Shanahan said. Executives instead attributed most of the controlled costs to actively engaging employees who had chronic health conditions.
“It's not enough to just ratchet up cost-sharing,” Shanahan said.
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