Account-based retiree medical plans: what's good for your pension plan may be good for your retiree medical plan

Many of the same forces that caused employers to gravitate toward account-based pension plans are beginning to spark similar changes in retiree medical plans. As medical costs continue to escalate, account-based retiree medical plans offer a new way to manage company outlays, while preserving an important benefit for retirees.     

Managing health care costs in the small business environment

Managed care is bringing down health care costs. But few small business employers find the time to manage their own health, much less that of their employees. Despite time constraints and other factors, small business employers need to embrace managed care. A critical first step is to encourage and support the implementation of important medical management initiatives.     

MNT: an innovative employee-friendly benefit that saves

In an effort to address the rising cost of health care within employee and retiree populations, many large employers are turning to an innovative health care solution: the registered dietitian and medical nutrition therapy and prevention. Research and case histories show the effectiveness of this approach.     

Disease management programs--guidelines for employers

The new disease management programs hold a promise of successful drug maintenance and lower health care costs for participants with certain chronic medical conditions. These programs can benefit both employees and employers, but employers adopting them should take all the steps necessary to bring them under ERISA and to carefully monitor their operation.     

Second opinion programs: continued savings from nonconfirmed surgeries

A second opinion program for elective surgery was one of the first tools utilized by employers to "manage" health care costs. These authors argue that second opinion programs continue to demonstrate their usefulness as part of overall health care cost-management effort.     

Why managed care has gone too far

Managed care has not solved employers' problems with rising health care costs; instead, it has created another set of problems, this author maintains. She suggests steps that employers can take to enhance the quality of health care for their employees and prevent further damage from the excesses of managed care.     

Options available for retirees if benefits are not offered

Employers are increasingly concerned about the costs of providing retiree health care benefits. While they await the details of health care reform legislation, alternatives to plan sponsorship are available.     

Affordable defined contribution health plans can help employers get through challenging times

Defined contribution health plans, modeled on defined contribution retirement plans, seem to be the wave of the future. At a time when employers and employees alike are trying to contain their health care costs, and employers fight to retain their workers, defined contribution health plans can provide solutions for both employers and employees. The health purchasing alliance model has met with success in both the small and mid-size market.     

Retiree health care benefits: a new standard of care

Solving the problem of continually rising retiree health care costs may ultimately require a new type of health care system. By monitoring individual behavior and intervening when necessary to modify potentially harmful behavior, we can reduce the present system's wasteful emphasis on hospitals and drugs.     

Employer-sponsored health plans and experimental medical treatments: life and death cost/benefit decisions

The process of determining whether--and how--to limit coverage for certain expensive, experimental medical treatments is complex and involves social, legal and economic considerations. However, employers do have several options for responsibly containing their health plan costs while meeting their employees' basic health care needs.     

Evaluate and communicate health care benefits

Both employers and employees need appropriate information to make intelligent decisions about health care benefits. For employers, analysis of health care data offers an approach to monitoring quality care and can provide a tool for controlling costs. For employees, an education and communication strategy is probably the single most important factor influencing both program utilization and employee acceptance.     

Depression's surprising toll on worker productivity

Employers need to adopt a broad set of measures to combat depression, which has a serious impact on health care costs and productivity. They should start by conducting an assessment of the various ways depression surfaces and prepare carefully designed responses, involving HR, the EAP, line managers/supervisors, health plan vendors, managed behavioral firms, disability program managers and PBMs, among others. With such an approach, ultimately employers should realize improved medical plan costs, reduced disability expenditures, lower absence rates and enhanced productivity.     

Self-funding health insurance for small employers: is it the right way to go?

Self-funding offers small employers an alternative approach to providing health care benefits for their employees. It may not be appropriate for every small employer but, in situations where it is feasible, self-funding offers employers a way to get a measure of control over health care costs while providing the benefits employees expect.     

Ethics and economics

The author suggests that one way to better manage the burgeoning costs in acute care settings and improve patient care is by the earlier use of ethics case consultations and end-of-life support from ethics teams. This study determined that, in several very diverse clinical scenarios, timely facilitation of meaningful communication and decision making between patients, families, and health care providers can result in the more appropriate use of health care resources. While few of the patients in this study had recorded advanced directives in place, and there was initially a lack of family consensus in some cases, compliance with the ethics team recommendations led to a more appropriate clinical unit placement; and improved family support helped manage the costs of care and focus on the patients' quality of life. The decrease in the use of medical interventions and therapies after ethics consultations was consistent in all cases presented here.     

THE ROLE OF RETIREE HEALTH INSURANCE IN THE EMPLOYMENT BEHAVIOR OF OLDER MEN*

Using data from the Health and Retirement Survey, we estimate preference and expectations parameters of a structural model of the employment and medical care decisions of older men in order to evaluate the role of health insurance. The budget constraint incorporates detailed cost‐sharing characteristics of private health insurance and Medicare as well as rules and requirements associated with Social Security and private pensions. Simulations imply that changes in health insurance, including access and restrictions to retiree health insurance and Medicare, have a modest impact on employment behavior among older males, with the greatest effect on men in bad health.     

Universal Health Care and the Economics of Responsibility

In the American health care system the cost of health insurance is underwritten by all three sectors of the economy: 1) households; 2) employers; and 3) government. However, while costs are shared, responsibility is not. The retreat of private firms and government from assuming a substantial share of the burden of health care costs is based on the presumption that health care is an individual’s responsibility, while the contributions of government and the private sector are basically optional - a matter of benevolence rather than responsibility. The outcome of the current debates over health care reform will depend on this issue of responsibility. Who should pay for health care? Is it a collective responsibility or an individual one? In this paper, we explore the economics of responsibility as it applies to health care. In the institutionalist framework, any reallocation of costs must be driven by an underlying philosophy of shared responsibility.     

What should be done now with retiree health benefit prefunding?

At least in its early stages, health care reform is not likely to signal the end of concerns about retiree health benefits. Employers may want to explore prefunding as a practical approach to the problem.     

Factors Driving German Physicians’ Managed Care Participation

Recent German health care reforms were intended to increase efficiency and quality of medical supply by introducing managed care (MC). Participation of physicians in MC contracts, however, is still limited. This study econometrically identifies factors determining physicians’ MC participation. The data has been obtained from a telephone survey among 500 German physicians. Economic implications of our results regarding future MC development in Germany are discussed.