Containing Your Employee Healthcare Costs in Compliance with the Affordable Care Act

By Greg Van Ness, CEO


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Despite the broadening of coverage under the ACA for the uninsured in our communities and the positive movement toward greater accountability for patient outcomes from medical providers, the cost of medical insurance continues to rise for employers, employees, and their families at an unsustainable rate.   Medical inflation continues to significantly outpace GDP and wage growth, and the cost of providing medical benefits to employees is eroding employers’ ability to increase employees’ wages and add jobs that help grow the economy.


According to the recently released PricewaterhouseCoopers 2015 Healthcare Cost Increase study, because of those unsustainable increases in medical costs approximately 85% of employers are strongly considering implementing high-deductible plans in conjunction with passing more of the healthcare insurance premium costs to their employees, which will likely result in ongoing affordability problems for employees and their families who desire medical insurance.    Medical insurance premiums in the state exchanges are likely to rise at a similar pace, once the influx of the previously uninsured population now enrolled in the exchanges are accounted for in aggregate claims costs in those exchange risk pools.  Unless cost issues in the system are directly addressed in the near-term, medical insurance premium increases will likely continue to drain the economy of vitality and constrain economic growth.


For employers who seek more control and containment of medical cost inflation, controlling medical claims costs through worksite wellness programs is an avenue worth pursuing.  The keys to effective wellness programs are understanding what program components will engage employee participation in the program, and supporting those programs from the very top of the organization.  Wellness programs that include biometric screening can help identify major health risks that require immediate intervention in order to avoid critical illness.   Wellness programs may also offer incentives and program options that lead to healthier lifestyle choices in food and exercise, which lead to reduced medical claims costs and improvements in employee well-being, engagement, and productivity.


Tolman & Wiker Insurance Services provides a unique and very potent approach to Wellness and cost-containment for our clients as part of their Employee Benefit program design and implementation.  Our Wellness Practice has demonstrated significant return on investment with our clients, including reductions in medical claims and premium costs and measurable increases in employee engagement and productivity.    We look forward to working with you and your business, too!

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