Explanation of Benefits

Keeping Your Employees Safe

An abundance of resources enables companies to steer patients to the safest hospitals and doctors.

Keeping Your Employees Safe

Unless they’re engaged in an illegal activity, most employers don’t knowingly send their workers into dangerous situations. We’re not talking about angry clients here but rather physical environments that put workers’ health and safety at risk. On a strictly fiscal level, it’s not a good use of time and money if there’s a chance they may not come back for a while, in the same shape or not at all.

But employers do it every day when workers need to go to the hospital or doctor and they don’t steer their valued employees to the safest health care providers possible.

There’s been an explosion in the number of publicly available resources that report on the quality and safety of services provided by hospitals and doctors. Smart employers should be using those resources to select—directly or through their health insurance carrier—where their employees receive care. You want them back, you want them back quickly and you want them back in one piece.


How dangerous is it?
Let me scare you with some facts:

The U.S. Department of Health and Human Services says there were nearly 4 million “hospital-acquired conditions” (HACs) in 2013 (1.usa.gov/1xL0fzz). HACs are bad things that happen to patients when they’re in the hospital that the government thinks could be avoided. Among them are adverse drug events, falls, blood clots and various types of infections. HACs happened to people in 2013 at a rate of 121 per 1,000 patient discharges.

The Centers for Disease Control and Prevention, meanwhile, tracks “health care-associated infections,” or HAIs. The CDC says more than 700,000 hospitalized patients, or one in 25, get an HAI each year during their stay in the hospital (1.usa.gov/12tBlt3).

It’s not much safer at the doctor’s office. The CDC estimates that 453,000 people were infected in 2011 with deadly bacteria called Clostridium difficile, or C. difficile, one of the six HAIs tracked by the agency. Of those, 293,000 got C. difficile from a health care setting, including 81,300 from a community health care setting such as a physician’s office or clinic (bit.ly/1AhLnGN).

To prevent employees from becoming a stat in the next HHS or CDC report, employers should be accessing and using a number of new resources that offer hospital- and physician-specific patient safety performance records. Among them:

The federal government’s Hospital Compare website, where users can type in the name of a specific hospital and pull up data on such safety measures as rates for 30-day re-admission, complication and mortality (1.usa.gov/1cqANBQ).

The government has a similar website for physicians called Physician Compare, but the performance measures for now are limited to how well they treat diabetes and heart disease (1.usa.gov/1ExALd8). Still, it’s worth a check if you have employees with either condition or just want to check the medical credentials of physicians in your provider network.

The Leapfrog Group, a not-for-profit that represents employer health care interests, offers hospital-specific safety scores based on the more than 2,500 hospitals that participate in its annual hospital safety survey (bit.ly/1gB8rJE). The Leapfrog Group also has what it calls its hidden surcharge calculator, which allows companies to figure out how much more they’ll pay in hospital charges if they use a hospital with a poor safety score (bit.ly/1G0UW4S).

Minnesota employers in particular are fortunate to have access to the Adverse Health Events in Minnesota report published each year by the Minnesota Department of Health. The state requires hospitals and ambulatory surgery centers to report any of 29 patient safety violations, including wrong-site surgery and wrong-patient surgery. Some 300 of those happened over a one-year period that ended Oct. 6, 2014, according to the latest report released in February (bit.ly/1ARXSfI). The report tells you who did what to whom an average of six times per week.

Similar publicly available patient safety resources are coming online all the time, and there’s no excuse for employers not to know where they’re sending their employees for care. At the very least, employers should make these resources readily available to workers. Better yet, they should only do business with the safest hospitals and doctors by contracting with them directly or through their insurance carrier.

Short take

As an employer, you know what you think of your health benefits plan, why you give your workers the options you do and how you decide to split the cost between you and your employees. But what do your employees think about what you’re doing? If you’re afraid to ask but want to know, read a new report from the Employee Benefit Research Institute (bit.ly/1Bm6Y6g). The report is based on a representative sample of 1,517 workers who have employer-sponsored health coverage. It turns out that they’re pretty happy with what you’re doing. Some 69 percent of the workers said they were satisfied with their health plan. In fact, 85 percent said they were confident that their employer chose the best plan available for workers. What will keep them satisfied and make them even happier? Choice and cost. Some 97 percent said having a choice of plans is important to them, and 77 percent said they’re interested in having even more choices. And it’s likely that they would choose cheaper plans. Some 82 percent said the amount of premiums, deductibles and copayments were major considerations in choosing a health benefits plan.


I don’t mind being wrong, but I really love being right. In November, I wrote about medication therapy management (MTM) and why employers should offer it as a covered health benefit (bit.ly/1FzgvpB). MTM helps people follow their prescription drug regimens, through various tactics ranging from consultations with pharmacists to mobile technologies that monitor medication use. By taking meds properly, people avoid unnecessary, preventable and expensive trips to the doctor or hospital. Employers whose workers take meds properly avoid higher health care costs and insurance premiums that accompany unnecessary, preventable and expensive trips to the doctor or hospital. Smart employers should make MTM available to their workers. Spend a little more up front, save a lot more on the back end. How much more? Try $8.6 million for every 100,000 workers, or $86 per employee annually if everyone took their pills. That’s according to a report from Healthentic, a Seattle-based employee health analytics firm. The company looked at a sample of 100,000 people in its database of 38.7 million covered lives and found that 24,595, or nearly 25 percent, had diabetes, high blood pressure or high cholesterol. Of those, 12,456, or 51 percent, were nonadherent, meaning they didn’t take their meds properly or at all. That resulted in 521 avoidable hospitalizations at a total cost of $8.6 million (bit.ly/182Jsix). It’s time to take your medicine.

David Burda (twitter.com/@davidrburda, dburda@msp-c.com) is editorial director, health care strategies, for MSP-C, where he serves as the chief health care content strategist and health care subject matter expert.


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