How to help alleviate specialty Rx costs
Originally posted September 9, 2014 by Melissa A. Winn on https://ebn.benefitnews.com.
Half of large employers say the cost of specialty pharmacy drugs is their second or third highest cost-driver, behind high-cost claims and special conditions, according to a recent survey by the National Business Group on Health. Brian Marcotte, NBGH’s president, calls the concern “significant,” considering specialty pharmacy currently impacts only about 2% of the population, but advancements in the manufacturing of these expensive drugs threaten to greatly increase the number of employees using them.
As employers consider their 2015 health plan designs, they “are very focused on specialty pharmacy drugs and the potential impact they have” on the company’s bottom-line, says Marcotte. Benefit advisers can add value by offering solutions to reign in the costs of these drugs, including programs to limit the quantity of the drugs dispensed at any one given time, the use of prior authorization to confirm the necessity of the treatment, and even the use of a freestanding specialty pharmacy.
“Benefit advisers should make sure employers are utilizing all of the specialty clinical programs offered by the medical and pharmacy vendors for their benefits,” says Brenda Gagnon, a pharmacy benefit adviser and president and CEO of the health care consulting firm B.M Gagnon Associates.
This is especially true in light of the fact the utilization of the drugs is bound to increase. “Current estimates for specialty medications are that they will cost an employer 50% to 60% of their total health benefits by 2016,” says Gagnon.
That’s true not only because the high cost of developing and manufacturing the drugs is reflected in their high price tag, but also Gagnon says, because “drug manufacturers have put more effort into finding more than one drug therapy for the drug.”
For example, she notes, AbbVie’s Humira is used for rheumatoid arthritis, Crohn’s disease, colitis and psoriasis.
Research and development costs are “passed onto the employer when an employee is taking a specialty medication,” Gagnon adds, saying the cost of the drugs can be anywhere from $1,200 to $12,000 a month, depending on the disease.
Utilization controls
An employer client has no control over the high price tag on these drugs, says Michael Zucarelli, national pharmacy practice leader for the employee benefit and financial firm CBIZ.
Where benefit advisers can help employers tame their client’s drug spend, however, is through health plan options designed to manage these drugs’ utilization, he says.
First and foremost, plans should have some sort of appropriate use protocol or prior authorization. Such a procedure would ensure claims are reviewed to make sure the drugs are safe and effective for the employee, as well as safeguard the plan financially, suggests Zucarelli.
In addition, employers have an opportunity to manage drug use as the number of specialty drugs available to treat any one disease expands, creating competition within the drug classes.
Employers “can now become a little more creative in how they set up their plan. They may prefer one or a couple of treatments over another,” he says.
This can be designed as a formulary in which a less expensive drug option would be covered at 100% and the more expensive option would require the employee to pay 100% of the cost share, he says. Otherwise, it can be set up as a step-therapy program, in which the more expensive drug cannot even be used until the less expensive option has been tried and failed.
“We’re seeing plan sponsors look at that as an option and more are adopting it,” says Zucarelli, adding that he typically advises employers to institute a step-therapy program as soon as possible, while it affects only a small number of plan members.
Advisers can also work with employers on channel management, Zucarelli suggests, saying employers should have a consultant, pharmacy benefit manager, or medical plan carrier evaluate where the drug spend is to gain visibility and look at opportunities for site-of-care management.
“Maybe a patient is getting a particular specialty drug in a hospital infusion suite and that may not be the most convenient or cost-effective treatment,” he suggests.
Gagnon agrees employers can use a third-party consultant company like Artemtetrx, which uses data analytics to evaluate claims data and identify high drug spend and opportunities for cost management across clinical management, reimbursement management, site of care management and plan design.
When an employer client raises a question about a high-dollar claim, Zucarelli says the plan’s PBM or carrier could also be asked to do a case review and insure the patient is taking the high-cost drug for an appropriate use.
“Unfortunately, once an employee is on a certain drug, it’s hard to get them off of it or switch it,” he says, adding that that’s why he suggests employers get a lot of these tactics in place now, before the use of the drugs increases, which is inevitable.
“Getting these management techniques in place now is going to further minimize disruption,” he adds.
Are e-cigarettes friend or foe to employee wellness?
Originally posted September 8, 2014 by Nick Otto on https://ebn.benefitnews.com
As the gap widens on whether e-cigarettes are part of the solution or still part of the greater problem of employee smoking cessation, their popularity is still on the rise. Experts from the health management group HealthFitness have provided some additional tips for employers taking on the challenge of creating e-cigarette policies in the workplace.
The group advises workplace policies which classify e-cigarettes in the same regard as tobacco products. In doing so, it will minimize risks from known and unknown toxins as research continues on the long-term health impact of the devices.
“This recommendation is the highest standard of public safety,” Dennis Richling, HealthFitness’ chief medical and wellness officer, says in a recent blog post. In doing so, benefit managers’ policies will align with the current trends other employers are reportedly doing, he adds.
Currently, the Food and Drug Administration doesn’t regulate the use of e-cigarettes as smoking cessation devices. As such, the use of incentives to discourage the use of e-cigarettes has no clear right or wrong answer, “but is driven by what an employer believes best fits their situation.” Before making that decision, Richling says he recommends employers consider the following questions:
- Are you prepared to add complexity to your incentive programs?
- Does adding e-cigarettes matter?
- Do you use blood or saliva testing with your smoking cessation program?
As one example, HealthFitness notes there are several ongoing trials researching use of e-cigarettes as cessation devices. Adding their use as an incentive may “create an extra level of effort to manage what may be an appropriate use of e-cigarettes.”
Lastly, HealthFitness recommends using health assessments to educate employees on e-cigarettes. Because the likelihood that current users are either former tobacco users or current “dual users” of both e-cigarettes and regular tobacco progress, tracking e-cigarette data independently is still limited.
“However, the information needed to inform almost all e-cigarette users can be gained by assessing smoking status,” HealthFitness says. “And there is value in providing messaging to health assessment users who use tobacco products about the risks and the facts concerning e-cigarette use.”
5 tips to make retirement education meaningful
Originally posted on https://eba.benefitnews.com.
Through the use of education and communication, employers and benefit advisers can have a huge impact on their employees’ retirement readiness. Making that education meaningful, however, is key to employee engagement and understanding. Here are five tips from Grinkmeyer Leonard Financial and investment advisers with Commonwealth Financial Network on how to make retirement education meaningful.
1. Paint a picture of their "future self"
Employees who can envision their future selves are more likely to understand their financial needs during retirement. The advisers with Commonwealth Financial Network suggest one strategy for embracing your future self is to have employees envision not only their financial retirement goals, but also lifestyle retirement goals. By forcing today’s self to recognize how he or she will look in the future, employees are more likely to save for that future, they say.
2. Help them plan for an achievable number
For too long the financial services industry has focused on the daunting pot of money people should accumulate in order to retire, the advisers say, adding that breaking the number down to monthly saving increments is less scary and seems more achievable to employees.
3. Account for health care
A 2013 study conducted by Fidelity's Benefits Consulting Group estimated that out-of-pocket health care costs for a 65-year-old couple with no employer-provided retiree health care will be $220,000, assuming a life expectancy of 17 years for the man and 20 years for the woman. As part of a comprehensive financial education plan, the Commonwealth Financial Network advisers say it is imperative that medical and insurance costs be incorporated into the retirement planning discussion.
4. Start 'em young
The power of compounding interest is evident in retirement plan balances, the advisers say, adding that evidence has shown the benefits of starting to save at a young age. Interest adds up over time, so even starting to save at 30 instead of 40 can save exponentially more money.
5. Keep the message relatable
Paramount to the success of any education strategy is using simple terms and relatable examples to illustrate potentially complex issues, the advisers say. For example, telling a group of participants that inflation will erode the buying power of their dollar over the entirety of their retirement may be lost in translation, they say. But telling that same group of participants that the $5 sandwich they enjoy today will cost $22.93 in 30 years will likely keep their eyes from glazing over.
Better understanding of benefits helps both employee and employer
According to new research from Unum, a recent survey of more than 1,500 employees shows only half of U.S. employees would rate their employer as excellent or very good. Even less than that, the 47% who were offered benefits by their employer, rated the actual benefits as excellent or very good — some of the lowest ratings for benefits the Unum has seen in recent years.
The data points to a lack of employees getting information needed on the benefits being offered. Only 33% of those surveyed who were asked to review benefits in the prior year rated the benefits education they received as excellent or very good — a drop from 2012 and reversal of the upward trend since 2009.
“Offering employees effective benefits education can contribute to satisfaction with their employer,” says Bill Dalicandro, vice president of the consumer solutions group at Unum. “Even if employees don’t have a particularly good benefits package, those who say they received quality education about the benefits they are offered are far more likely to consider their employer a very good place to work.”
Employers can also get a win when providing educational guidance in choosing the right benefits. Correlation between employee satisfaction with their benefits continues to run parallel with overall employer satisfaction.
More than three-quarters of those employees who rate their benefits package as highly also rate their employer as an excellent or very good place to work. By contrast, only 17% of employees who consider their benefits package to be fair or poor rate their workplace as excellent or very good.
Additionally 79% of employees who reviewed benefits in the past year and rated their education as excellent or very good also rate their employer as excellent or very good — compared to 30% who said the education they received was fair or poor.
The survey also found:
- 40% of employees say they understand supplemental medical coverage somewhat or very well.
- 47% say they understand critical illness insurance somewhat or very well
- 48% whose employers offered long or short term disability insurance said no one explained disability insurance to them.
- 66% agree employers should do a better job educating employees about these important benefits.
“This research underscores the value of an effective benefits education plan, because when an employee understands their benefits, they tend to value them more and in turn may then value their employers more for providing access to them,” Dalicandro adds.
7 tips to prepare your workforce for flu season
Since seasonal flu activity can begin as early as October, the time to prepare is now. While the vaccine is one of the most efficient ways you can protect your employees, there are other actions you can take to brace your workplace for the upcoming flu season. Alan Kohll, founder and CEO of wellness vendor, TotalWellness, offers these tips:
1. Educate employees
Educate employees about flu symptoms and how the influenza virus is spread.
2. Step up hygiene
Step up your office’s hygiene practices. According to a 2012 study, the dirtiest places in the office include break room sink faucet handles, microwave door handles, keyboards and refrigerator door handles.
3. Review policies
Review your policies for PTO/sick leave and telecommuting.
4. Create a communications plan
Create a communications plan for flu season, from the signs and symptoms to flu shot myths, sick time policies, wellness reminders and flu shot clinic dates and times.
5. Develop a contingency plan
Have a contingency plan in place to help maintain normal business operations in the event that key employees are out sick or other disruptions occur.
6. Communicate health plan details
Ensure that employees are aware of health insurance plan details and that they know who to call with questions.
7. Host an on-site clinic
Host an on-site flu shot clinic or participate in a voucher program so that staff can easily get vaccinated at a local pharmacy.
IRS releases draft instructions for ACA reporting forms
Forms 1094-B and 1095-B are used by organizations that are not reporting to the IRS as large employers – insurers and sponsors of multiemployer plans, for example. Forms 1094-C and 1095-C, meanwhile, are used by organizations that are subject to the employer mandate.
“The instructions are voluminous and reflect the complexity behind the information, particularly that employers are going to have to provide,” says Amy Bergner, managing director, human resource solutions at PricewaterhouseCoopers in Washington, DC.
The IRS released the draft forms a few weeks ago but without draft instructions, “it was difficult to tell exactly what employers and insurers were going to have to do,” she notes. “Now we have these draft instructions that really walk through what’s behind all of the reporting.
Bergner says employers should review the draft instructions as soon as possible with all third-party providers who help them with tax reporting. “Even though these reports are not filed with the IRS or sent to employees until early in 2016, employers have to be capturing the information on a monthly basis starting in January 2015,” she says.
The purpose of the forms is three-fold:
1. When individuals file their individual tax returns, they’re going to have to report whether or not they have health insurance as required by the ACA’s individual mandate. The IRS can compare what the individual is reporting with what the employer is reporting.
2. The IRS can double check whether people who have received federal government subsidies to buy insurance on the exchanges were actually entitled to it. People who are offered employer-sponsored coverage are not entitled to the subsidy.
3. The IRS can enforce the employer mandate, which requires employers with 50 or more full-time employees to offer health insurance.
“The instructions include many of the complicated and detailed rules about the employer mandate, details usually reserved for regulations or other technical guidance,” says Bergner. “We expect that many employers and insurers will need assistance decoding the instructions and the underlying rules to be able to ultimately provide timely and accurate reports.”
Employers partner with academic institutions to create specialized programs
Originally posted August 27, 2014 by Nick Otto on https://ebn.benefitnews.com
It’s a new spin on an older system, as benefit managers are trying to evaluate the long-term benefits of helping to pay for their workers’ education — and more cost-effective and results-oriented methods of doing so. The big question: do these programs indeed serve to attract more candidates, and does the training necessarily produce workers who are better skilled and interested in staying with their current jobs?
In the past, tuition reimbursement programs were a more unstructured offering — occasionally the classes needed to be work-related in order to qualify for employer reimbursement, depending on an employer’s needs — resulting in a pleasant but not entirely critical employee benefit, with workers paid back for their studies as long as they maintained an acceptable
grade level.
Under a new model emerging at a variety of employers, direct partnerships with the online-specific satellites of accredited post-secondary institutions are helping to create more specialized and self-directed educational offerings, catered to the skill sets employers have found lacking in their workers. The participating college offers a discounted tuition rate and in exchange, the employer works to promote that particular program. Employees have less range of choice in educational offerings as a result, but may find the classes more individually suited to their needs and ultimately more important to their professional development.
“Corporate America is always trying to attract and retain the best talent, that’s certainly a very key HR strategy for most employers,” says Carol Sladek, partner and work-life consulting lead at Aon Hewitt. “So what we’re seeing is an increased interest on the part of employers to try to find the types of benefits and programs and policies that will help employees not only join their team, but stay on their teams and also help better employees along the way.”
Anthem Blue Cross and Blue Shield of New Hampshire partnered last year with College for America, a nonprofit college launched specifically for working adults and their employers, to create a competency-based program with no credit hours or courses. Students learn through projects targeted toward specific, employer-focused skills — communication, teamwork, ethics and others — resulting in either Associate- or Bachelor-level degrees. One of the biggest perks is the price tag: At $2,500 annually, the all-inclusive program is self-directed and online, providing an approach that allows students to progress through the program at their own pace.
Chris Dugan, director of public relations for Anthem’s New Hampshire operations, says it was one of the first companies to partner with the university last year, and since then, the insurer has had 56 employees participate in the program.
“Not only are employees going through this program stronger at their day job, but it could open up other opportunities in our company — so we promote this vigorously to our employees, and they seem to have strong interest [so far],” Dugan says. The convenience factor, plus Anthem’s arrangement to pay employees’ tuition, has also added to the new program’s success.
To date, College for America has enrolled nearly 1,000 students since its pilot launch in January 2013, adding more than 100 new students per month in recent months. Currently, it has about 60 employer partners — including corporate, government and nonprofit groups — offering the College for America program to their employees.
“We’re currently in program development discussions with several national employers and associations who see a specific labor market need where a competency-based, workforce-applicable degree would help with their talent development pipeline,” says Colin Van Ostern, a member of the college’s leadership team. “We’re seeing significant demand.”
Another example of corporate-academic partnerships can be seen with Starbucks, which recently created a program allowing any employee working 20 hours a week or more to be eligible for a full reimbursement if they enroll in Arizona State University’s online program as juniors or seniors. Freshmen and sophomores receive a partial scholarship and needs-based financial aid toward the foundational work of completing their degree.
According to data from EdAssist, an administrator of tuition assistance programs, spending on — and utilization of — tuition assistance varies by industry. Among health care companies in its database, for example, the average annual spending per employee on tuition assistance is $2,332, yet the industry boasts the highest utilization rate at 8%.
Anthem and Starbucks’ examples come in contrast to other employers’ internalized education programs — fast-food retailer McDonald’s and its well-known Hamburger University in Oak Brook, Ill., a corporate managerial training program that has offered skills-based training to thousands of company employees since being founded in 1961.
Whatever the venue, Karen Hutcheson a partner in the rewards and talent management practice at Mercer, says that employees are keen in keeping up with current skills.
“I’m finding employers also want to make sure their employees have those opportunities; it’s a win-win,” she says. “On the employer side, if you can educate your workforce in an affordable and manageable fashion, you can feed into stronger engagement.”
Higher education needs to be more nimble and responsive to student needs, she adds. And people in the workforce want strong skills, but the cost of traditional higher education is so high. “This is a nice way to marry the two together,” Hutcheson says.
Limiting options
On the flip side, overly focused programs do limit some employees’ options, and might lead to lower benefit participation.
“With the lack of choice, high potential employees may discount the value of obtaining a degree or graduate degree,” Hutcheson says. And although it’s still too early to tell, another potential downside would be the perceived value of an online degree versus the historical degree. “Not all Bachelors [degrees] are created the same,” she adds.
Bruce Elliott, manager of compensation and benefits at the Society for Human Resource Management, says the College for America model is part of a growing trend of employers working with community colleges, vocational schools and traditional universities to create structured programs.
Part of that growth, he says, seeks to offset a continued imbalance in the labor pool.
“During the height of the recession, there were employers desperate for skilled tradesmen and couldn’t find them to save their lives,” he says.
In the future, Elliott says he expects to see more corporate partnerships as a way of helping to drive down the cost of continuing education for employees — particularly in the Starbucks’ example.
“The reality is, these kids will be graduating with maybe $10,000 in debt,” compared to the much higher numbers in average student loan debt as the result of traditional, self-funded college programs. “You do the math.”
Aon Hewitt’s Sladek says that business costs and overall return on investment continue to be the biggest questions facing benefit managers as they consider the wider range of educational options.
“A lot of employers are sitting back waiting to see what will happen,” she says. “The Starbucks thing was really interesting and there was a lot of interest. I think a lot of other employers are standing on the edge watching.”
Hutcheson calls it a “wave of the future.”
“What we’re seeing in the workforce are people being more focused on building and maintaining skills,” she says. “We see employers wanting to see their employees be more prepared and in charge.”
Reducing benefit costs while still valuing employees
Originally posted August 26, 2014 by Steve Grossi on https://ebn.benefitnews.com.
As part of valuing our employees, benefits are viewed as a direct extension of pay and considered to be a vital part of an employee’s total compensation package. Benefits represent a sizeable investment for BOK Financial as well as for each employee. It’s our corporate culture to place a great deal of attention on benefits, and helping employees understand all of the value of their benefits package is a key focus for our HR team.
People who work for us are independent thinkers. It’s important to make our own decisions, and that’s especially true when it comes to health benefits. This is the reason our company is committed to a program that offers employees the flexibility to choose their coverage in most major benefit areas. Each employee can put together a personal package to suit their needs, and I believe that this flexibility shows the company’s commitment to each and every member of our staff as well as their families.
But this level of commitment to our employees – although vital – is expensive. After payroll, benefits costs were our No. 1 company expense, and as a result we found ourselves coming to terms with the impending Cadillac Tax, a penalty against companies over a particular threshold in terms of premiums resulting from the Affordable Care Act.
We added a consumer-directed health plan to our benefits offering, along with a health savings account, hoping to bring overall benefits costs down and reduce our exposure to the Cadillac Tax. Our belief was that the CDHP would suit the needs of many employees, and premiums would be lower for both the company and the employee. But explaining the benefit of a CDHP to employees is challenging – people are confused by the options, and most simply choose to do nothing and remain in their current plan. Others assume that the most expensive plan is the best, and default to that choice.
After one year with the CDHP, adoption was well short of our company goal, at only 5%. We went looking for help, and ended up with a solution from Tango, a company that helps organizations save money by optimizing health benefits, while keeping employees happy.
The first step was to educate our employees, and Tango explained the differences between each plan in simple, relevant terms. A plan optimizer tool allowed employees to walk through a series of questions and decide which plan was the best based on their individual needs. Since the tool is online, employees can log in from home and walk through the steps with their spouse, and discuss their options. Our CEO and his wife went online at home to use the plan optimizer, and they ended up choosing the CDHP. In all, over a thousand of our employees logged on to the online tool, with most spending at least 20 minutes reviewing and comparing their options.
For even more employee awareness, Tango put a communication plan in place that included email-based updates and information. Weekly and monthly communications continue to go out to the employees explaining how to open and use their HSA, and other helpful tips on topics like reimbursements and tax filing. The emails were very specific and targeted, so employees were more likely to open and read them. Tango also provided videos and webinars specifically created for our employees with a direct comparison between the CDHP and the traditional PPO plan – helping to demystify the choice between the plans. Normally this kind of information would come from the HR team, but Tango’s level of service meant that our HR team could focus on other critical employee needs.
Reviewing our results at the end of the first enrollment period with Tango, we saw adoption of the CDHP and HSA go from 5% of the employee base up to 30%. Our employees were pleased with the plan changes and with the amount of information they were getting about the growth of their HSAs. And it was a huge win for the company: BOK Financial saved over $880,000 in premiums and avoided an additional $190,000 in taxes.
BOK Financial continues to work with Tango to boost further adoption of the CDHP, and to retain existing plan members and ensure that employees are getting the maximum benefit out of their HSAs. As a chief human resource officer, the ability to increase adoption of the CDHP while maintaining our relationships with employees was very important to me. I’m thrilled that we’re able to retain our commitment to value our employees, even as we make changes that benefit the company’s bottom line.
Avoiding PPACA excise tax a priority
Originally posted August 20, 2014 by Dan Cook on www.benefitspro.com.
Despite foreseeing record-breaking employee health care costs in the near term, major employers will continue to offer coverage to full and part-time workers. However, coverage for spouses and dependents could be targeted for cutbacks.
That’s the latest from a Towers Watson survey that found employers generally anticipate a 5.2 percent increase next year in health plan costs, which would put coverage cost per employee at an all-time high, Towers Watson said.
However, many employers are planning to make design changes to their plans. Should they occur, employers then project a 4 percent plan increase.
“Despite this cost trend, most (83 percent) employers consider health benefits an important element of their employee value proposition, and plan to continue subsidizing and managing them for both full-time and part-time active employees,” Towers Watson said. Virtually all of these large employers surveyed said they will continue to offer health benefits to employees, with few indicating they were ready to move coverage to a private exchange.
The results were gleaned from the company’s 2014 Health Care Changes Ahead Survey.
Large employers were asked about their health care-related cost concerns for the future. A major one is the excise tax that goes into effect in 2018 as part of the full rollout of the Patient Protection and Affordable Care Act.
“Nearly three-quarters (73 percent) of employers said they are somewhat or very concerned they will trigger the tax based on their current plans and cost trajectory,” Towers Watson said. “More than four in 10 (43 percent) said avoiding the tax is the top priority for their health care strategies in 2015. As a result of the excise tax and other provisions of the health care reform law, CEOs and CFOs are more actively engaged in strategy discussions.”
The objective is not to eliminate or even substantially reduce employee coverage, Towers Watson said, but to continue to manage costs as finely as possible without gutting coverage.
“The emphasis is on achieving or maintaining a high-performance health plan,” said Randall Abbott, senior consultant at Towers Watson. “And CFOs are now focused on a new gold standard: managing health cost increases to the Consumer Price Index. This requires acute attention to improving program performance."
Other key findings from the study:
- 81 percent of employers plan moderate to significant changes to their health care plans over the next three years, up from 72 percent a year ago;
- 48 percent are considering tying incentives to reaching a specified health outcome such as biometric targets, compared with just 10 percent that intend to adopt it in 2015;
- 37 percent are considering offering plans with a higher level of benefit based on the use of high-performance or narrow networks of medical providers, compared with just 7 percent in 2015;
- 34 percent are considering telemedicine, compared with 15 percent in 2015, as employers encourage employees to use such telemedicine strategies as virtual physician office visits to improve access and efficiency of care delivery;
- 33 percent are considering significantly reducing company subsidies for spouses and dependents (10 percent have already implemented such reductions, and 9 percent intend to do so in 2015);
- 26 percent said they are considering spouse exclusions or surcharges if coverage is available elsewhere (30 percent have that tactic in place now, and another 7 percent expect to add it in 2015);
- 30 percent of employers considering caps on health care coverage subsidies for active employees, using defined contribution approaches (13 percent have them in place today and another 3 percent planning them for 2015).
Employers continue to study private exchanges, although 77 percent “are not at all confident public exchanges will provide a viable alternative for their active full-time employees in 2015 or 2016.”
Still, 24 percent said private exchanges could provide a viable alternative for their active full-time employees in 2016. They are looking at three key factors to emerge that would push them in that direction:
- Evidence they can deliver greater value than their current self-managed model (64 percent);
- Adoption of private exchanges by other large companies in their industry (34 percent);
- An inability to stay below the excise tax ceiling as 2018 approaches (26 percent).
“The most effective employers are continually evaluating new strategies for improving health plan performance,” Abbott said. “Examples include a steady migration to account-based health plans, action-based incentives, adoption of value-based payment methods with health plan partners and plan designs that drive efficiencies. Other options are technology-based solutions such as telemedicine, fitness devices or trackers, and social media to encourage employees to take a more active role in both their personal health status and how they use health care goods and services.”