More insurance bang for their buck

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If insurance plans cost more, small businesses want more

Small businesses say they are being shortchanged by their health insurance companies.

A recent PricewaterhouseCoopers report shows businesses expect more from their insurance companies — They want more information, more technology and more health and wellness.

Premiums continue to rise — particularly in the small group market, and business owners are becoming savvier about the issues driving the cost of care. Those factors lead large- and small-business owners to demand more from insurance companies.

And the insurance companies are feeling the pressure.

“That market, small group, that’s the most volatile market out there,” said Kaiser-Permanente spokeswoman C.J. Moore. “They follow the costs. That’s the biggest factor. So they switch back and forth trying to find the cheapest plan, but they don’t always check out what that plan entails.”

Overall satisfaction eroded drastically this year, the report said. More than 59 percent of employers in both the large and small markets expressed dissatisfaction with their insurers. One-third rated reform as a top concern, and for large employers benefits are an important link to their workers.

“Small businesses were less satisfied with health insurers on a range of service issues,” said study author Michael Galper. “They simply want more out of the companies. They are not satisfied with what they are getting — and that goes beyond what’s being addressed by reform.”

As the costs go up, employers are looking for ways to save money — and they are looking at insurance companies to fill that gap.

“This is a historical problem,” said Tony Gagliardi, spokesman for the National Federation of Independent Businesses. “And as business owners learn more, they want more for their money. Some small businesses pay as much as 30 percent more for insurance than larger companies for the same exact coverage.”

In order to compete in that market, companies are looking to insurance companies for provider discounts and more technology.

“They see a lot of waste in the system,” Galper said. “They have to deal with that — and with getting better information about their employee population. They want insurers to use technology to lower costs.”

And they want ways to lower costs through health and wellness programs, something Kaiser Permanente is working on. The health insurer offers a free health coach to every Kaiser member.

“It’s just something special that we offer, because we realize that we have to give a little more for our members to stay with us,” Moore said. “And we offer electronic ways to reach and track health benefits and health statistics.”

Effective prevention and wellness is a shift more companies are demanding — and more insurance companies are following, Galper said.

But for Gagliardi’s members, cost is the driver.

He said small businesses would like to be able to band together to create a larger purchasing pool and get plans for the same amount as the larger, national companies.

“If we can spread the risk, increase our purchasing power, that would make a difference,” he said.

The survey showed that employers want better ways to engage employees and manage costs.

“Employers want more meaningful and higher quality data to help them control costs and keep their employees healthy,” Galper said. “Employers would like insurers to take an active role in waste reduction. They are looking for consistency and transparency.”

PWC has suggestion for insurance companies seeking to hold onto both large and small group markets.

“Employers want more than provider discounts,” Galper said. “Those are fine, but they are looking for something new. They want insurers to talk about waste in the system.”

Basically, companies are looking for a partner in their insurance company — a business relationship that will actually improve the health of their workers. Incentives and technology are only two ways to address that need, Galper said.

“Activities that require more effort, such as prevention screenings or chronic disease management, may need new methods, such as instant and constant feedback,” he said.

Gagliardi said employers are beginning to want more, simply because they know more about the health care delivery system. Many seek insurance companies that help collaborate and coordinate care.

“All this discussion has led to a vast amount of knowledge out there,” he said. “Business owners aren’t going to be passive. They know more about the costs, about costs shifts, about where the waste is. And they’re going to want answers.”