The Ultimate Roadmap to Navigating Your Employee Health Plan

Jun 14, 2023

Do you have a love-hate relationship with your employee health plan? You may consider them a necessary evil, but really, they have the ability to not only take better care of your employees and their families but boost productivity, and morale.

Often, when company leadership thinks about their employee health plan, the core concern is cutting and containing costs. Unfortunately, the focus is not on how an employee health plan can best serve your business, but how you can get it down to the lowest possible cost. 

We understand your concern. Especially in our current economy, businesses are working diligently to cut costs wherever possible, and we know that healthcare benefits can account for a significant portion of your budget. 

It’s important to remember that you don’t have to strip the value of your employee health plan in order to cut costs.

In fact, cost savings and better benefits go hand-in-hand. 

As the time comes to renew your employee health plan or partner with a new benefits broker, it’s critical to evaluate your options. At Totem, we pride ourselves on taking a results-driven approach to healthcare. If your team is in search of the ultimate roadmap to navigating your employee health plan, look no further.

The Ultimate Roadmap to Navigating Your Employee Health Plan

1. Direct employees to primary care physicians

According to Employee Benefits News, “…89% of employees and 91% of HR said it’s important to receive regular primary care, citing benefits like better health, increased productivity, and long-term healthcare savings. However, they found that only one in five workers have a primary care provider.” Only one in five workers have a primary care provider. 

How does this impact your business? When your employees are encouraged to go directly to their primary care provider, you can prevent up to 90% of specialist visits. Plus, when members actively participate in preventative care, they’re more likely to avoid visits to urgent care or the emergency room, saving your plan money.

2. Ensure your employees get the best healthcare possible

What good is an optimized employee health plan if your team is not receiving care from high-quality providers? Your healthcare plan should direct employees to the top providers in their area. The results of this steerage are mutually beneficial – better healthcare outcomes and cost savings for employees and employers. 

The physicians your employees see make a difference. At Totem, we make a point to include incentives for our members, ensuring patients receive excellent engagement with the best doctors. These incentives remove all barriers to care and take better care of your employees and your bottom line.

3. Introduce Centers of Excellence 

Centers of Excellence (COEs) have a lot to offer. When you incorporate them into your employee health plan, you find yourself with more productive employees, increased employee satisfaction and lowered health plan costs.

At Totem, our COE programs are designated multi-disciplinary facilities staffed with the top doctors in the nation. By incorporating bundled pricing and a consensus team-based diagnosis model, you’ll receive the best care for your employees at the best cost for both the patient and the plan. 

4. Prioritize your pharmacy consultant

Not just any pharmacy consultant should make the cut for your employee healthcare plan. Prescriptions and their costs play a major role in the life of your employees. Employee Benefit News states that “over 131 million Americans use prescription drugs, but a poll by medical research organization West Health and management consulting company Gallup estimates that 18 million Americans cannot afford their prescriptions.”

Drug spending continues to impact your employees and your plan. Totem partners with a leading Pharmacy Consultant to help clients save 30% – 40% in annual Rx savings. We create pharmacy solutions that allow for creativity and flexibility when designing formularies, alternate funding programs, specialty drug management and working with pass-through Pharmacy Benefit Managers. 

Navigating your employee health plan isn’t always easy. It takes a tried and true approach that leverages creative solutions to prioritize quality care and cost savings. Trust us, it can be done. By implementing the four key aspects of healthcare listed above, you can deliver on all of your promises – to your employees and your leadership team. 

If you’re interested in learning more about Totem’s approach to healthcare solutions, connect with one of our team members today for a complimentary consultation.

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