Lack of Understanding Hampers Value Plan Participation

According to the International Foundation of Employee Benefit Plans Value-Based Health Care second annual benchmarking survey, the main barriers to incorporating a value-based health insurance approach are participants’ lack of understanding and insufficient time to participate, in combination with a scattered workforce.

These and other complexities of administering the value-based concept, such as how to capture variations in prescription copays among workers, may prevent some employers from giving it a try.

Ray Desrochers, executive vice president, sales and marketing of HealthEdge, a Burlington, Massachusetts software company notes that the majority of human resources managers still rely upon software solutions that are 25 years old or more.

“Technology from the 1970s doesn’t work with health care plans in 2011,” Desrochers says. “Health care is rapidly changing, as a result of legislation and innovation, and employers and vendors need a different level of flexibility and more agile software that allows them to customize benefits for individuals.”

Desrochers says new technology solutions that allow employers to align each member’s benefits with a specific incentive program are required to enable many of the wellness plans currently being discussed in the industry. For example, members with diabetes may receive free medications, free physician visits, and other discounted services based upon their compliance with a case management program, and that information has to be trackable.

“Real-time access to information and requirements has to be available to members and physicians for these value-based plans to work,” says Desrochers. “Next-generation web portal technology can be used to seamlessly connect everyone involved in the healthcare delivery cycle, including payors, physicians and members.”