PREVENTIVE CARE Your Best Defense Against Costly Claims February 2025
An apple a day may keep the doctor away, but getting annual preventive care can keep risks at bay.
Many employers do not realize the impact preventive care has on their employees and their bottom line. Companies that promote and inspire their employees to use their preventive care benefits usually have one or more success stories that are eye-opening and drive the need for continued promotion and support. Even though preventive care is available for free in many medical plans, most companies are not seeing the benefits of it. Yet, it is one of the most crucial ways to reduce health care risks and avoid catastrophic claims. Preventive care is offered at all stages in life at no cost if the care provided remains within the recommended preventive care guidelines. In fact, a variety of screenings, assessments, vaccines, and tests based on age and sex are required to be free under the Affordable Care Act for most medical plans. Employees have no copays, coinsurance, or deductibles to meet to obtain the care. In addition to maintaining overall health, preventive care uncovers and helps prevent more costly chronic conditions, such as heart disease, cancer, diabetes, and high blood pressure. When employees catch these types of conditions early and manage their health, a company can avoid catastrophic claims and maintain a healthier workforce. Key components of preventive care are having a doctorpatient relationship that ensures continuation of care and having encouragement to be healthy. Employees need a lot of education about their benefits — especially what is free — and incentives to be healthy.
Preventive care is the fastest way to reduce health care risks and avoid catastrophic claims — and it costs $0.
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Case in Point The following case study shows how preventive care screenings coupled with wellness programs can positively impact your workforce and bottom line. • Industry: Insurance Services • Program Type: Third-party Wellness Vendor • Program Style: Outcomes-based (employees); Participatory (spouses) • Funding Strategy: Fully-insured • Length of Study: 5 Years • Number of Employees: 1,100 • Number of Spouses: 220 • Average Employee Age at Start of Study: 48.4 • Average Employee Age at End of Study: 52.4
Four Ways to Optimize Preventive Care Benefits
1. Promote preventive care via regular, customized employee benefits communication.
2. Offer a health and wellness program with employee participation incentives and rewards, such as gift cards or a medical premium discount.
3. Reward employees for completing an annual preventive care screening.
4. Provide benefit programs and services that
address specific chronic conditions, such as diabetes and heart disease.
Worth the Thought When employees understand their benefits, they are more engaged. This often leads to higher productivity and retention, in addition to a healthier employee base. In fact, a comprehensive analysis conducted by Gallup shows that companies with high levels of employee engagement have 25% to 65% lower turnover rates. It pays to engage!
Case in Point
Moving in the Right Direction This employer conducted a 5-year trend survey with a group of 159 participants. After moving from a participatory style to an outcomes-based program, the employer discovered a positive risk movement in many areas, including biometric values and preventive care compliance.
5-year Health Improvements
Start
End
Alcohol Overconsumption
7.5%
5.0%
Mammogram Noncompliance
14.7%
3.9%
Pap Smear Noncompliance
17.5%
16.2%
Colorectal Screening Noncompliance
31.8%
23.0%
Flu Vaccine Noncompliance
41.5%
28.3%
TDAP Vaccine Noncompliance
33.9%
24.6%
Smoking
7.5%
4.4%
No Primary Care Provider
8.8%
2.5%
Uncontrolled Lipids
23.1%
21.5%
Good/Optimal Lipids
38.0%
39.7%
Normal/Optimal Blood Pressure
30.8%
40.3%
Long-term Employees Lead to an Aging Population This employer enjoys a large population of long-term employees, ranging from five to more than 20 years of service. Although biometric values improved for the data group in the 5-year study, chronic conditions remained present, which is common. It is typical for a population’s health to decline over time, but success is defined by showing — and maintaining — ongoing improvements. Employee health education and support to successfully manage their medical condition are highly important to achieve success.
Metabolic Syndrome
Five or more risk factors Start – 1.6% End – 0.8%
Blood Pressure
Controlled hypertension Start – 16.4% End – 18.2%
Cholesterol
Uncontrolled lipid disorder Start – 23.1% End – 21.5%
Incentives and Rewards Are Effective Two core tracks to this employer’s success are encouraging healthy lifestyles and rewarding employees for their efforts. Since its wellness platform reports personal health information and participation rates, the employer can focus on learning opportunities and provide a variety of incentives and rewards to keep the momentum going.
Conclusion Employee participation continues to increase in the employer’s wellness program. Having an active internal wellness committee with champions at every company location, a medical premium discount for wellness program participation, and an ongoing effort to communicate the program’s offerings and incentives to employees and spouses alike are key factors for participation rates.
What We Heard • “This program has changed my life for the best of my health.” • “It’s making me aware of my overall health … I hope my employer continues to care and educate their employees with this program.” • “Since joining the program, I have been determined to get my diabetes under control and maintain a healthy BMI.”
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Let’s Talk About This Our Population Health Management and Day Two Services® teams are available to provide custom preventive care programs, services, and communications that reduce risk and increase your bottom line. If your company is not reaping the rewards of preventive care, learn how Higginbotham can help create a healthier workforce and bottom line for you.
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