In 2013 HelloWallet moved to a full replacement high deductible health plan. While much has been written about the various pros and cons in making this decision, including the timing, for us it was simply about the responsibility of participating in the swing into consumerism. The existing three party model – payer (employer), provider (health system) and consumer (employee) – no longer works, economically speaking, with the spreading US obesity epidemic; which continues to drive healthcare costs up while the overall health of the population continues to get worse.
Instead, our approach to the conversion was was to dive right in instead of slowly making the change. Here are 3 lessons we learned from our transition:
- Support and help your employees through the transition
The first phase of high deductible plans has been centered around plan design. This is not a surprise given the economic incentives to fit health insurance plans into health savings account qualified models (an IRS governed activity). But this is like tossing your young child into a pool and expecting nature to teach he or she to swim. You need floatation devices, a paddle board or, at a minimum, encouraging parental words and a steady hand in the shallow end of the pool. Instead the health system assumes a level of fluency among the consumer base (back to the swimming analogy, perhaps a fundamental understanding of the principles of buoyancy by the three year old). But this is not reality, and the supplemental materials published by the traditional health provider incumbents are often not sufficient to bridge the knowledge and behavior gap. The good news is with the emergence of companies like Castlight (CAST), RxREVU, ZocDoc and others providing consumers more user-oriented accounts of what to do and how.
- Perfection is not the goal
The most important decision is the one to take action, and with the right approach and intent your employees will forgive the mistakes. Which is good because there will be many. HelloWallet approached this as an iterative design. We listened to employees and providers in the space and adopted a glide path approach by funding health savings accounts on day 1, and providing match dollars similar to the conventional wisdom around 401(k) plans. Both of these went a long way in communicating the partnership everyone was taking. We will make additional tweaks this year and likely in the years after as more consumer facing tools are introduced in the market, but it was enough to recognize this was a journey, one fraught with some (emotional) peril.
While HelloWallet is in the employee benefits space and we have a significant portion of our team dedicated to user testing and employee benefit communication (about a quarter of us), we too learned a lot when we experimented with communicating this topic. Goodwill and trust are important elements, with education being the bedrock to both. Most employees understand the world is changing around them, and further, if given the guidance and tools, want to help their employers, and particularly their colleagues, overcome this next challenge. The path forward is through communication. While each message doesn’t need to come from the CEO, it is important to have senior leadership bought in. Executives must walk the walk.
There are many other considerations regarding the technical aspects of introducing health plans, of course, and each day welcomes the release of a new white paper or product offering attempting to chip away at the existing problem. Certainly employers would be forgiven from taking a cautious approach to such an important topic as an employee and their families’ health. However, the current arrangement is no longer sustainable and employers must begin to address the issue as a matter of industry competitiveness. Employees want to help you and your company succeed, but also expect that you are putting them into positions and pr