The arena of healthcare technology is currently seeing array of development, not only within the technical side of things, but also on the legislative front. This article reflects on the administrative side of healthcare, incorporating the employees and support staff working at different levels across different institutions. The healthcare law recently announced by the Centers for Medicare and Medicaid Services (CMS) has come at an opportune time when the American business and industry, including the healthcare industry is toying with the idea of using preventive care management for improving overall employee productivity.

The Impact

With the final draft of the law in place, employers and consumer groups would be able to make informed decisions about the care they need. Employers would find it easy as they would not have to compromise on their goals while offering customized long term care to their employees. The new law permits coverage to different groups of employees at different levels such as a no-cost option of offering a voluntary program where full premium is paid by employees; a base coverage that is paid by the employers with an option given to employees for buying a higher benefit by paying extra; and offer of an employer-paid coverage to reward valued employees to encourage employee retention and protect employees’ productivity. Employees working in small size companies can choose an insurance scheme under Medicare as many or these companies are not in a position to offer health plans for retirees due to financial constraints. Further, long term care insurance fetches tax benefits to both the employer and the employee.

Preventive Care and Productivity

Studies show that in 2010 the number of employees covered under various schemes offered by their employers stood at 68 percent compared to just over 64 per cent in 2007. Self-insured Plans – where large employers pay cost of healthcare claims of the employees – and Managed Care Plans like Health Maintenance Organization (HMO), Point of Service Plans (POS), or Preferred Provider Organization (PPO) etc, have contributed to this significant growth. Also there are consumer-driven health plans (latest alternative to managed care plans) where members are permitted to use a health care account to pay for medical services they use like HSA or HRA, while high deductible health plans cover major health issues.

Big companies today offer on-site medical clinics with a view to raise the level of preventive care of their employees. It is advantageous to the employers because their employees need not take time off their schedules to see the doctor and they get preventive care near the workplace. Employers are increasingly using workplace clinics to help employees manage chronic as well as acute conditions the latter is exposed to. These preventive care service clinics help the employees to avoid major medical costs. Also there are few organizations where primary care is coordinated by specialists, hospitals and other providers. Partnership Health Care (PHC) is another form of preventive care management. At the Toms River Regional School in New Jersey, its employees and family members usually approach the PHC for treatment and the system has turned out to be successful.

Although critics of President Obama have dubbed employer based plans as “cost shifting plans rather than a cost cutting exercise.” This is particularly due to raising the eligibility age for Medicare. More and more employers are expected to turn innovative in the field of preventive care management to boost employee productivity in the future.