Listen to the Lub-Dub- A campaign for healthier hearts

27^th September 2009 is World Heart Day. Over 17.2 million people die each year from cardiovascular diseases, making these the leading cause of death worldwide. Yet 80% of premature deaths from heart disease and stroke could be avoided by controlling the main risk factors: tobacco, unhealthy diet and physical inactivity.

Almost half of those who die from chronic diseases are in their productive years. The economic consequences - driven by productivity reduction and increase in costs caused by these diseases among workforces - are dramatic. Countries such as Brazil, China, Russia and India currently lose more than 20 million productive life-years annually to chronic disease, and that number is expected to grow 65% by 2030. The losses in productivity associated with those diseases like disability, unplanned absences and increased accidents are as much as 400% more than the cost of treatment. The WHO estimates that between 2005-2015 income loss (in international dollars) could rise to as much as $237 billion in India.

Yet it is mostly large corporations in developed countries that offer workplace health programmes. There is an urgent need to extend these benefits to all employees, in all industries and sectors in our country .

PeopleHealth, in line with its mission of educating and motivating people in to a culture of health is working towards mitigating the risk factors associated with workplace sickness through a series of communication and awareness campaigns.

We invite you to be a part of this continuous awareness programs and encourage your employees choose healthier lifestyle options.

What should you do to promote Healthier Hearts in the work place ?

· Display the Poster on Heart care

o You could also include your organisation’s logo and print as many of them to display it in your office surroundings

· Circulate the “Listen to the Lub-Dub”- A e-guide to a healthier heart to all your team members (e-mail benefits@peoplehealth.in for a free copy)

· Call peoplehealth on +91-80-653 00 999 if you need further support to promote the activity

Let’s all do our little bit in promoting worksite wellness which could lead to the prosperity of self, organization, society and the nation!

Go Healthy Now!

Getting the Maximum of healthcare benefits How do we avoid increase in insurance premiums?

 

My previous blog tried to expose the aspects of Health Insurance and Healthcare in the Indian context. The following blog tries to address matters on preventing the huge increase in health insurance premiums which is every organization's concern area during annual insurance renewals.

Haven't we all heard the old adage "Prevention is better than cure"? It can't be truer in the case of Health Management Initiatives at organizational levels. There are new benefit systems that is being designed that include flexible, hybrid designs that take a holistic view of employee health.

When we are all healthy and keep fit, the chances of falling sick and using the insurance benefits come down leading to lower claims. This in turn will help all of us in controlling the increase in insurance costs.

A step in this direction is a 'World of Wellness' initiative of PeopleHealth. Programs under this will be customized and implemented based on the diverse needs of employees. The main objective is reduce health risks of employees and thereby bring down the claim on lifestyle diseases.

Walking uphill together

PeopleHealth today is working towards incorporating Healthy lifestyle and wellness programs into benefit structures of organizations. However the stakeholders- Organizations, Insurance Providers and wellness Custodians will have to jointly assume greater responsibility for the success of such initiatives.

What should the organization do?

• Educate the employees of the organization in using the health insurance appropriately
  
  • Knowledge of insurance benefits is very important. Always do a thorough study before using the insurance benefits.
    
  • If its an emergency seek the support of your TPA in utilizing the benefits
    
  • If it's a non-emergency
    
    • Check if your requirement is a common procedure(E.g.: Maternity ,Bye Pass surgery, Cataract, Knee replacement etc)
      
      • If it is a common procedure enquire if the rates quoted is the same across similar facilities
        
      • Also check if the hospital has differential rates for insured and the non-insured.
        
    • If the rates for the non-insured is lower, you might opt to use that facility and claim your insurance later from your TPA
      

 

Excerpts from a PWC study

Eighty percent of companies surveyed said employers could help reduce costs by providing employees with more information about healthcare prices and quality. Most employers were confident of their employees' ability to make good decisions if given accurate and easily accessible information. Close to seven out of 10 employers believed that if they provided better information to evaluate drugs, doctors and hospitals, their employees would have lower healthcare costs and higher quality care. However, only 38% of employers indicated that they provide "a great deal" of information, updated regularly, to their employees for this purpose, while 42% said they provide a "moderate" amount.

When survey respondents were asked which actions, if taken, would reduce their company's healthcare costs, most agreed that the following three actions would do so:

1. • Make employees pay a higher percentage of healthcare costs
   
2. • Give employees more information about healthcare prices and quality
   
3. • Provide financial incentives for employees participating in healthy lifestyle programs
   

 

What will PeopleHealth do?

• Strategies: We will set a course that aligns health care strategies with people and business strategies. We will open up channels for collaboration that can increase information sharing and the development of new solutions.
  
• Flexibility: We will design benefit plans and programs and develop targeted programs that address the specific needs of the team members to most effectively improve the health as well as increase the opportunity for cost savings.
  
• Think prevention: We will develop a cost-sharing mechanism that promotes access to preventive services and take steps to integrate preventive services and insurance management.
  
• Revisit wellness: New initiatives to encourage healthy lifestyles and wellness will be considered as part of the benefit plan design to reduce healthcare expenditures
  

  These programs may need to include incentives for participation, in order to encourage employees to lead healthier lifestyles. This initiative provides an opportunity for innovation to collaborate with employees to design new wellness and prevention programs, fostering employee involvement in their own health.
  

• Value transparency: We can source and develop information on the costs of common procedures and the appropriate way of utilising it.
  
• Provide education: PeopleHealth will develop and deliver training and education to enable employees to be better consumers–to fully understand the benefits and understand the real cost of healthcare and its effect on their personal budget and the organization's bottom line.
  

  Deploy an education process that is continuous and engages employees in an interesting and convenient manner. In order to maintain a successful program, employees need to be reminded frequently what programs are available, how they can participate, and the rewards available for that participation. Executing these changes will require changes across the spectrum requiring leadership and changing roles and activities of each of the stakeholders
  

In Conclusion, there are many opportunities for us to take proactive steps in managing healthcare costs and enhancing the quality of the benefits that are available. We will take a more holistic look at the problem. The change to proactive healthcare is neither simple nor quick, but if executed well, may drive long-term benefits to all of us alike.

Reference:

1. Healthcast 2020:Creating a sustainable future-A study by PRICEWATERHOUSECOOPERS
   
2. www.irdaindia.org
   
3. www.ibef.org
   
4. PricewaterhouseCoopers' Health Research Institute
   
5. First Consulting Group
   
6. McKinsey studies on Healthcare
   

Health Care and Health Insurance -Indian Perspective

The Indian healthcare system is well defined on paper and was effectively implemented in the early years of independence. However over the last few decades the system of healthcare delivery has changed a lot with the advent of liberalization. We have well known public healthcare providers co-existing with private service providers. The Public health systems in most states barring Kerala and West Bengal have not progressed with the times and today cater predominantly to lower economic strata of the society. The Middle class has started relying on private nursing homes and hospitals owing to better hygiene and availability of better healthcare professionals. India spends about 6.5 to 7% of GDP on Health care (official estimates hover around 6%) out of which 1.3% is in the Govt. sector (this accounts for 22% of overall spending) and 4.7% in private sector (78% of overall spending).

Though healthcare costs in India is one of the lowest in the world, it is increasing at a fast pace .If proper measures are not taken by all of us jointly, it could reach price levels of the western nations making life difficult.

What is Health Insurance?

Insurance is defined as the equitable transfer of the risk of a loss, from one entity to another, in exchange for a premium. The insurance rate is a factor used to determine the amount, called the premium, to be charged for a certain amount of insurance coverage.

Cost of Insurance

Like mentioned earlier, the cost of health coverage has been going up and it is inevitable to maintain premiums at same levels. The reasons for this can be classified into two:

Macro Economic Trends: These are factors relating to the country as a whole. The factors include interest rates, law of supply and demand with respect to professionals, facilities, overall health status of the population and many more. This trend develops over a period in time if we do not take sufficient measures in our individual and group capacity.

Group insurance behavior: For most of us health insurance is provided/facilitated by the organizations that we work in. The organization helps in securing the best possible rates for insurance cover for all its employees and pays a combined premium for this. However at the end of the year when the policy is reviewed, if it is found that the insurance company has paid out more amount than it collected as premium towards financing the healthcare needs of the organization’s employees, they increase their premiums in the subsequent years to make up for their loss. This is called as claim loading and can vary between 40% to 400%.

We all can join hands together and ensure that we act responsibly when it comes to utilization of benefits. This will lead to containment of claims and if done continuously can lower the insurance premiums over a period of time