When an employee of Hill Country Memorial Hospital developed chronic kidney disease, the not-for-profit hospital in Fredericksburg, Texas faced a whopping bill. Not only was an employee facing a lifetime of dialysis treatments three times a week, missed work hours and increased medical care, the 80-bed hospital had maxed out its $1 million premium for its employee health plan.
“It cost us quite a bit,” recalls Becky Laughlin, the current benefits manager, who was the benefits coordinator at Hill Country Memorial Hospital when the incident occurred.
After the episode, the HR and benefits team looked for a solution. They found one in data management provider Advanced Plan for Health, which oversees its employee medical care expenses generated by its third-party employee benefit administrator Web TPA. Using its Poindexter program, APH oversees the hospital’s employee medical expenses, looks for patterns of cost overruns, pharmaceutical pricing and possible drug seeking behavior, overuse of emergency room and urgent care facilities. It generates reports that are sent to employers on a weekly, monthly or quarterly basis.
Chronic kidney disease is a health crisis that affects employer and employees—and it continues to increase. So, what can employers do to help their employees stay healthy and control their costs?
By Barbara Rutkowski
Published December 08 2017, 12:10pm EST