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Survey: Employee wellness programs biggest driver toward reducing cost of health care

BY Michael Johnsen

MENLO PARK, Calif. — Employee wellness programs have become a popular strategy for employers trying to control costs, according to the Kaiser Family Foundation/Health Research and Educational Trust 2013 Employer Health Benefits Survey released Tuesday. In 2013, 35% of employers reported they have a very effective strategy for controlling costs, a larger share than says the same about any other strategy, including disease management (22%), consumer-driven health plans (20%) or higher cost sharing (17%). 

Nearly all large employers (at least 200 workers) offer at least one wellness program, which can take many forms and target a wide range of conditions. More than a third (36%) of large employers who offer wellness programs offer some kind of financial incentive for workers to participate, such as lower premiums or a lower deductible, receiving a larger contribution to a tax-preferred savings account, or gift cards, cash or other direct financial incentives.

Among large firms offering health benefits, more than half (55%) offer some kind of biometric screenings to measure workers’ health risks. Of these, 11% reward or penalize workers financially based on whether they achieve specific biometric outcomes. Under the Patient Protection and Affordable Care Act, employers will have broader use of financial incentives to encourage workers to improve their health status and outcomes.

“This will be an important issue to watch next year, as employers will have more flexibility and could ask workers to pay more because of their lifestyles and health conditions,” stated Kaiser VP Gary Claxton, the study’s lead investigator and director of the Foundation’s Health Care Marketplace Project.

For the first time, the survey also asked large employers about their interest in private health insurance exchanges, a relatively new concept that pulls together a wide range of insurance plans which participating employers can offer to their workers to choose from. Though relatively few chose this option in 2013, 29% of those with at least 5,000 workers say they are considering offering benefits through a private exchange in the future. These large firms employ almost 40% of all covered workers, so their interest could portend a significant shift in the way many people get their health insurance in the future.

While employers continue to seek ways to reduce healthcare costs, the rise in healthcare premiums has actually been moderating this year before some of the final parts of the ACA go into effect. 

Annual premiums for employer-sponsored family health coverage reached $16,351 this year, up 4% from last year, with workers on average paying $4,565 toward the cost of their coverage, according to the survey. During the same period, workers’ wages and general inflation were up 1.8% and 1.1% respectively.

This year’s rise in premiums remains moderate by historical standards. Since 2003, premiums have increased 80%, nearly three times as fast as wages (31%) and inflation (27%). The slow growth in premiums means that fewer employer plans are likely to be subject to the ACA’s high-cost plan tax that takes effect in 2018. The Congressional Budget Office recently reduced its estimate of the number of plans that would trigger the tax, and a continued low growth rate could further reduce the impact of this provision.

“We are in a prolonged period of moderation in premiums, which should create some breathing room for the private sector to try to reduce costs without cutting back benefits for workers,” stated Drew Altman, Kaiser president and CEO.

The survey found that firms with many lower-wage workers (at least 35% earning $23,000 or less annually) require workers to pay $1,363 more on average toward family premiums than workers at firms with fewer lower-wage workers ($5,818 vs. $4,455 annually). The lower-wage firms on average offered less costly coverage too, creating a large disparity in the share of the premium that their workers pay (39% vs. 29%).

This year, 78% of all covered workers faced a general annual deductible, up from 72% in 2012. Workers typically must pay this deductible before most services are covered by their health plan. The average deductible this year for worker-only coverage was $1,135, similar to the $1,097 average deductible in 2012.

The survey also found that large deductibles of at least $1,000 or more are common in employer-sponsored plans, especially among workers of smaller firms. This year, 38% of all covered workers faced such a deductible. At small firms, 58% of covered workers now face deductibles of at least $1,000, including nearly a third (31%) who face deductibles of at least $2,000, up from 12% in 2008.

The 15th annual Kaiser/HRET survey is a joint project of the Kaiser Family Foundation and the Health Research & Educational Trust. The survey was conducted between January and May of 2013 and included 2,948 randomly selected, non-federal public and private firms with three or more employees (2,067 of which responded to the full survey and 881 of which responded to a single question about offering coverage). 


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Diplomat ranks third among private healthcare companies in Inc. 5000 list

BY Alaric DeArment

FLINT, Mich. — Diplomat Specialty Pharmacy has made Inc. magazine’s list of the top 5,000 fastest-growing private companies in the United States for the fifth consecutive year, ranking third in the healthcare field, the company said Wednesday.

"Recognition on the Inc. 5000 list continues to be an important metric in gauging our overall growth," Diplomat CEO Phil Hagerman said. "What is especially meaningful to the Diplomat team is we continue to grow the business and forge relationships with new healthcare industry partners while achieving sustained customer and physician satisfaction rates above 98%."

The company created 500 jobs in the Flint, Mich., area between 2009 and 2012 and was cited by Inc. in December 2012 as one of the country’s top 100 job creators.

"Diplomat remains on track to add a total of 1,000 new jobs between 2010 and 2015," Hagerman said. "We’ll need that increased capacity as projected specialty pharmacy purchases are projected to be 50% of the total drug spend by 2018."

Hagerman cited the company’s attention to patient care and adherence.

"The key to optimal patient compliance and adherence lies with patient education and training, packaging that keeps drugs safe and secure, yet is easy for patients to open, side-effect management kits, nurse adherence calls for clinical support and guidance and adaptive technology, whether that be through smartphones, prescription bottles with glow caps or packing with alarms and reminders," Hagerman said. "Diplomat is a leader in these areas, and we will continue to focus efforts on new approaches to compliance and adherence through our high-tech, high-touch patient strategy."


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Entera Health launches EnteraGam

BY Alaric DeArment

CARY, N.C. — Entera Health has launched a new prescription medical food product for patients with intestinal disorders, the company said.

The drug maker announced the availability of EnteraGam (serum-derived bovine immunoglobulin protein isolate, SBI) for patients with chronic loose or frequent stools due to irritable bowel syndrome or HIV. The drug is meant to treat patients who have limited or impaired ability to ingest, digest, absorb or metabolize ordinary foodstuffs or certain nutrients.

The company is offering a savings program allowing insured patients to pay as little as $25 for their prescriptions. The program will be available in more than 40,000 pharmacies, the company said.

 

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