Understanding Integration: What have other employers done?

We continually publish case studies that track the steps that employers take in integrating their employee benefits as part of our employer profile series.

Recently, we summarized the experience of 11 employers in Getting to Benefits Integration: Lessons from Employers That Implemented Health &Productivity Management.

From that summary came the following significant findings:

Results:

• Minimizing disability provides employers the greatest opportunity for savings. Several initiatives report as much as 40% to 50% in disability savings. Employee satisfaction is the second most frequent result, with generally positive responses here, too. Medical cost savings are less frequently sought as employers take care not to seek medical cost savings if it increases disability.

 

• Few programs promised savings going in, despite the belief that savings would result, because sponsors couldn’t document baseline costs. Instead, employers relied on enhanced employee satisfaction and improved healthcare goals to get approval to go forward.

Process:

• Rather than tear down benefits silos, employers commonly drew claims management best-practice functions from each benefit program into a central case management unit. For most, traditional silos continue to perform insurance contracting, administration and plan design.
• Most initiatives begin with a pilot. The pilots test integration initiatives and develop reliable data on potential cost savings to justify full rollout. Some programs used the savings realized in the pilot to pay for system-wide rollout.
• Almost all initiatives provide a single contact for claims reporting. Employees aren’t required to choose the "correct" program in which to report a claim, supervisors are relieved from the role of conduit for notices to other involved units and case managers can begin assisting employees, physicians and supervisors in healing and return-to-work.
• Most employers modify their benefits plans to remove disincentives to return to work. In some programs, employees saw this as a take-away from integration, provoking strong communications efforts to explain the positive elements of the programs.

Data:

Most initiatives found ways to create management databases and reports without replacing legacy systems. Preexisting databases and data systems weren’t consistent or linked across benefits silos prior to integration. In the new program, existing information systems often are linked through bridging systems or supplemented with new front-end data collection programs. Full data warehousing usually is left for later stages.

Our case studies (and the summary) follow employers’ integration progress through four basic steps: Development, Initiative Design, Launch and Evaluation. Within each of those four steps is included the following detail:

Development
• Goals
• Motivators
• Process
• Organization

Initiative Design

Launch
• Pilot
• Communication
• Education
• Measurement & Metrics

Evaluation
• Savings
• Satisfaction

We add case studies continually. Later in 2002, we will publish a summary of the experience of four employers in implementing the first several steps, including getting the support of senior management, putting the design process in place and designing the data and measurement system to determine success.