Hartford Business Journal

www.HartfordBusiness.com November 28, 2016 • Hartford Business Journal 9 show that facility offers the best outcome and if employees want the costs fully cov- ered. O'Shaughnessy already sees Hartford area employers sending employees to facili- ties like the Cleveland Clinic. Employers can build their programs so that certain higher-cost services are only covered at key quality health systems, O'Shaughnessy said. Or, employers can allow treatment closer to home, for example, but at lower reimbursement versus 100 percent cov- erage at a facility the employer deems a center of excellence. It's not meant to be a penalty, but a reward for using the facility deemed best quality for that condition, she added. That's already occurring and she expects to see more of it. Mercer also encourages employers to continue using tactics to personalize employees' interaction with health and well-being programs to keep them engaged with their health on a daily basis. About a third of large employers (at least 500 employees) encourage employees to track physical activity with wearable devices and more than half provide employees with a health advocacy service. Some provide a health advocate to help members find the right healthcare provider, compare costs and resolve claims prob- lems, and who will stay in touch through- out a care episode to provide support as needed, Mercer said. On embracing disruption, O'Shaughnessy said, "We're seeing employers do a lot of things that a couple of years ago they would have never done." That goes beyond driving employees to specific facilities for certain condi- tions or contracting directly with health- care systems. More employers are engaging with the hundreds of vendors that have emerged in recent years, from telemedicine to niche services for sleep disorders, infertility, dia- betes and more — vendors who claim their narrow focus benefits patients. "We are seeing this explosion of ven- dors of technology, of creative outside-the- box thinking and we are seeing employers engage with these vendors, wellness vendors for example, where they are driving walk-in competitions, and they are gamifying health care," O'Shaughnessy said. Mercer, though, isn't just working with employers to drive down healthcare costs, she said. "We are now looking at … driving the whole concept of bringing your best self to work," she added. That includes looking at stress, which has a significant impact on health, and addressing the causes of stress, such as financial concerns. "We are now looking all the way at the root cause of financial distress, rolling out solutions to that as a long-term solution and impact driver to health care," O'Shaughnessy said. "And so we have to think so far outside the traditional medical box." Short-term options Among short-term, cost-containment solutions, telemedicine is growing in popu- larity, O'Shaughnessy said. Among large employers, 59 percent offered telemedicine this year, up from 30 percent last year and 18 percent in 2014, Mercer's survey showed. The typical charge for a telemedicine visit is $40 vs. $125 for an office visit, Mer- cer reported. Mercer also is seeing more employers consider spousal surcharges to motivate employees' spouses who may have cover- age available through their own employer to use that instead. Another trend is smoking surcharges, which employers can use to motivate smokers to consider quitting. A smoker can achieve a nonsmoker rate by enrolling in a smoking-ces- sation program, even if they're not successful in quitting. Mercer's survey also shows 61 percent of large employers offered a high-deductible plan, or CDHP, this year, a number expected to rise to 72 percent by 2019. The Phoenix Cos. in Hartford, which is self-insured, is among those offering one. "Phoenix was able to hold down overall employee-benefit costs for 2017 through a combination of plan design changes and direct incentives for employees to switch from a tra- ditional PPO plan to a high-deductible health plan that allows them to establish a Health Savings Account (HSA)," Suzette Louro, sec- ond vice president, corporate benefits for The Phoenix, said via email. "Our employees have been responding positively to the lower upfront costs of the high-deductible plan and the tax advantages they can get from an HSA." Nearly a third of all covered employees in the Mercer survey, or 29 percent, enrolled in a CDHP this year, up from 25 percent in 2015 and 3 percent a decade ago. Part of the move toward CDHPs is to raise awareness about the true cost of what ser- vices and medications cost, O'Shaughnessy said. Employers help by pointing employees to price transparency tools to see costs per provider, allowing them to be smarter healthcare consumers. n any medical restrictions, unless temporar- ily placing that employee in such position would cause an undue hardship. Can an employer deny a request for a leave of absence? Yes. When assessing whether to grant leave as a "reasonable accommodation," an employer may consider whether the leave would cause an undue hardship for the business. If it can be shown that a requested leave would cause a hardship, an employer does not have to grant the requested leave. According to the EEOC, in determining whether providing leave would result in undue hardship an employer may consider the following points: • The amount and length of leave required; • The frequency of the leave; • Whether there is flexibility with respect to the days on which leave is taken; • Whether the need for intermittent leave on specific dates is predictable or unpredictable; • The impact of the employee's absence on coworkers and on whether specific job duties are being performed in an appropriate and timely manner; • The impact on the employer's opera- tions and its ability to serve customers/ clients appropriately and in a timely manner, which takes into account, for example, the size of the employer. n Shel Myers is a partner at the labor and employment law firm of Kainen, Escalera & McHale in Hartford. Healthcare Costs Experts Corner Tons Toys of Wednesday, december 7, 2016 To benefit the Boys & Girls Clubs of Hartford MARQUEE EVENTS & CATERING featuring the gershon fox ballroom 960 Main Street, Hartford Come have your picture taken with Santa! Kids Reception - 4:30 p.m. to 5:30 p.m. Cocktail Reception - 6:00 p.m. to 9:00 p.m. $20 per person or FREE with the donation of one new unwrapped toy! More info at www.hypehartford.com Presenting Sponsor

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