By Melina Kambitsi, Vice President, Business Development and Member Services
Your company’s benefits related to employee health, disability and absenteeism can look like a patchwork quilt of relationships.
For example, your self-funded health benefit plan might have a third-party administrator (TPA); a provider network and a pharmacy benefit manager (PBM). You’re also likely to have a wellness program, an employee assistance program, workers’ compensation insurance and a disability program, plus several others.
So how do you know all these overlapping programs are working together for your best interest?
Hold a Health Care Vendor Summit
Your health care partners should talk to each other regularly and meet with you on a quarterly or semi-annual basis, depending on your needs and size. Holding a vendor summit is a great way to get that interaction started.
A half-day, face-to-face summit held early in your plan year will bring together all your vendors to identify services and set goals as part of an integrated approach to health, disability and absenteeism. The summit relies on a five-step process where you:
How to Prepare
- Set goals based on needs of employee population.
- Determine which vendors interact with these employees.
- Invite vendors to a summit to share information about their services.
- Set specific goals for each vendor for targeted health conditions.
- Define measures of success.
To prepare for the summit, analyze your benefit data to identify the top three to five conditions driving health care costs. This information will be invaluable in setting goals with vendors.
Next, create a shared vision to present to vendors. This vision typically has a dual focus of enhancing the employee experience while reducing waste and inefficiency.
It’s also important to set goals for your vendor summit. Your goals might include identifying a condition to focus on for the coming year and then determining how vendors can help improve outcomes for that condition.
Issue the Invitation
Create an invitation list that includes all the vendors who help you manage health-related services.
As part of the invitation, ask the vendor to do advance “homework” by identifying the top five conditions that impact your health benefit costs and employee productivity.
Ask vendors to explain what information led them to identify these five conditions and share their ideas for obtaining additional information or data. In addition, ask vendors to explain who gets vendor reports and how often those reports are available.
Target the Conditions
With this information in hand, the vendor summit group should be able to quickly reach a consensus on two or three conditions to target over the coming year.
Each condition should be defined by four stages; 1) employee is in a state of wellness; 2) employee has heightened risk of condition; 3) employee has the condition; and 4) employee has the condition with complications.
For each of the four stages, the summit will then aim to identify:
Make a Plan
- Which vendors offer what types of services and support?
- How does the vendor engage employees? How often?
- What could make the vendor more successful?
- How will the employer measure success?
The plan that emerges from the vendor summit should include:
- Key initiatives and goals to support targeted conditions
- Prioritization of initiatives by vendor, target audiences and due dates.
- Communication plan
- Follow-up plan
It’s important to learn how different vendors will coordinate services. Plan to work with each vendor to describe services, set targets and define measurements for your targeted conditions. Use scenarios to help you visualize how each vendor’s process works for a specific employee, such as the diabetic who is seeking help because she is having trouble with her vision.
Plan to regroup with vendors on a quarterly or semi-annual basis to evaluate progress and adjust the plan.
After participating in a vendor summit, your vendors are typically more likely to share vital information, align activities with the employer’s strategic goals, participate in an integrated health management approach and deliver measureable results.
That makes holding a vendor summit a worthwhile investment of your time and effort.