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Benefits Forecast

Monday, July 21, 2014
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Janet McNichol, HR director at > the Rockville, Md.-based American Speech-Language-Hearing Association and I were speakers < at > both the Human Resource Executive® Health & Benefits Leadership Conference in March and the World Health Care Congress in April. We discuss our experiences in the Q&A below.

Is it fair to say your takeaways from both conferences appear to center mainly around healthcare delivery, including narrow quality-centered networks, hospital safety, medical necessity and evidence-based medicine?

Yes. I'm motivated to help our staff receive the safest, most appropriate care. With 265 employees, I know all of our staff. I'm not dealing in the hypothetical when they're ill or they have a family member who is sick. I truly care about them and want them to have access to the best-quality healthcare.

We've discussed our shared belief that safe, high-quality care is cost-effective. How do you attempt to measure this?

This is where the size of our organization becomes a disadvantage. We review our health-plan rate increases and compare them to the trend. We have a pretty clear idea of how and where we're spending our money. I have data on family and medical leave and disability claims, of course, but cannot access data concerning sick leave. We have good information on performance, but no way to tie it to health. And we know nothing about productivity. Building systems to collect all this information is prohibitively expensive for us.

Frankly, I don't need a bunch of data to compel people to do the right thing here. But, I still wish I had more information available to me.

I've heard you say on more than one occasion that employees will travel farther to go to a good restaurant than they will to a good chemotherapy center. How do you influence where employees seek healthcare?

No one wants to go to a provider with poor-quality outcomes. They wind up there because they don't know how to distinguish their choices, or they put too much trust in a particular doctor and follow his or her advice without thought. Right now, I'm looking < at > tackling this in stages: 1) educate people and nudge them to seek care < at > higher-quality hospitals, 2) offer an incentive to get employees to use higher-quality hospitals, and 3) eliminate the poor-quality hospitals from our network. The challenge for me is if each stage lasts one plan year, we could have employees receiving care < at hospitals with poor-quality ratings for two more years.

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How do you intend to address emotional health going forward, and will you consider tackling the overlap between mental health and medical, wellness and financial health?

Going forward, we are going to broadly focus on helping our staff build their resilience.

Drawing on work by [health-engagement expert] Alexandra Drane, we will organize our education and resources under the umbrellas of dealing with life obstacles, building buffers and minimizing magnifiers.

I'll share what we do and what we learn on my blog as we move forward.

Carol Harnett, an expert in the field of employee benefits, can be emailed via

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