November 1, 2011

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Allison Johnson

November 1, 2011

SMITH: In the business community, our chief priority is economic development. And next is education. What business leaders are starting to understand is that Medicaid is the biggest threat to education. When Medicaid costs balloon, if that is the case, it’s got to come from somewhere. And the pattern across the nation is it comes from higher education, which then you’ve got the irony of higher education needing more dollars to train physicians.

It’s just a bad cycle to get caught in. So our business leaders are saying that we have to solve this if we want to make a difference in education and remain economically competitive with K-12 and higher education.

MCOMBER: Hopefully we did learn lessons in the ‘90s that will help us this time around. And the intent, I think, is not quite managed care. The intent is to say, “You guys are responsible for outcomes. Help us plan on where we need to go with this, what kind of services we need to give, what kind of care.”

But there’s one other piece that we didn’t have before that hopefully we take advantage of this time, and that is data. The data was never shared with the physicians for them to know how much prescriptions or tests or anything else costs. Now we are getting that data.

We’ve trained citizens for the last 30 years that you can have the best healthcare in the world and someone else is going to pay 90 percent of it. How do we begin to discuss personal responsibility and allocating resources the most effective way?

CAMPBELL: I believe Humana has started a policy where they will not hire employees that smoke. They gave their people plenty of notice that, “As of this date, we have a smoke-free environment.” We haven’t seen anyone do it yet on regulating by BMI or weight. But we are getting to the idea of an employer saying, “Health is important to us. We’re a health-conscious organization, and we want to have employees that recognize that,” and they put that as part of their employment in the workforce.

ADAMS: Generally, healthcare workers are the highest utilizers of healthcare. So as an employer, we’re dealing with the same challenges that every large employer is dealing with, and that is utilization of healthcare services.

We’re trying a few unique things. We offer incentives to employees if they’ll participate in wellness screenings and health exams. Employees can receive a $500 contribution into their flexible healthcare spending account, which is pretax dollars, to use for other out-of-pocket healthcare expenses. This year, we’re adding another component. Employees who choose not to go through the health screening and through the wellness review will only be offered our highest-deductible basic healthcare plan option, which is kind of ironic because we may now actually be incentivizing more underinsured.

HURST: One thing that representatives could help us with is legislation, whether it’s federal or state, that allows us to offer wellness programs to our employer groups that we consult with. We can offer a premium deferential if employees enter into a wellness program, but that can’t be tied to specific behavior changes.

So you cannot go to an employer group and say, “Here is a differential in your premium, and if you lose those 25 pounds, great, you get to keep that.” You can send people to be a part of the wellness program, but you can’t really tie it to any specific behavior. That’s something that becomes controversial in many ways, because if that legislation was passed and you’re interviewing someone for a job—who do you hire?

SPENCER: I’m employed by a small employer that was recently purchased by a large employer; so I’ve come from a company that has none of those educational or wellness programs to a large employer that has all of that. So my concern is how do we get that to the smaller employers? The largest bulk of business is small-employer business.

MCOMBER: The education piece is something that we really need to focus on. On the controlled substance issue, for example, where we have a big problem in Utah with abuse and misuse of controlled substances, since we have increased the campaign to the public, we’ve seen that they are becoming more aware, that the numbers are going down. So we need to increase public awareness of things that will help them be more responsible for their own health and that will help them make better choices.

SANPEI: I’m optimistic about the future. The challenges are big, but in Utah we do have a lot of things going for us. We do have a healthier population. We’re starting from a better position than most of the rest of the country. We have a growing community, we’ve got collaborative provider community, we’ve got engaged business leaders.

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