By: David Ostrowsky

Earlier this month, the self-insurance industry’s most prominent thought-leaders, innovative service providers, and esteemed subject matter experts convened at the 2023 Self-Insurance Institute of America (SIIA) National Conference at the JW Marriott Phoenix Desert Ridge Resort & Spa. The SIIA National Conference, which this year covered such pressing topics as artificial intelligence, surprise billing, emerging trends impacting the employer stop-loss market, and recent legislative and regulatory updates, is widely considered to be the self-insurance industry’s annual marquee event, bringing together hundreds of industry professionals including TPAs, vendors (there were over 950 booths representing industry vendors stationed in the exhibitor hall), brokers, captive managers, stop-loss carriers, and solution providers. Naturally, The Phia Group was well represented with a six-person contingent consisting of Adam Russo, Garrick Hunt, Tim Callender, Jason Davis, Jen McCormick, and Brady Bizarro present.

In addition to meeting with clients to strategize about how to improve our partnerships going into 2024, Phia had two representatives – CEO Adam V. Russo, Esq. and Brady Bizarro, Esq., Senior Director of Legal Compliance & Regulatory Affairs – deliver one of the conference’s final presentations (“Empowering Plan Participants to Leverage Cost Containment Strategies”). The premise of Russo and Bizarro’s presentation was fairly straightforward: The recent trends in healthcare are cause for concern. Consider that with premiums for family health plans having increased by 54 percent in recent years, employee contributions have shot up 71 percent. Sadly, the increase in wage growth (26 percent) has not been commensurate with such drastic spikes. Put another way, tens of millions of industrious Americans, already grappling with inflation and a declining stock market, have been deprived of what they deserve – access to affordable, first-rate healthcare. Although there is no single panacea to this systemic problem bedeviling the American workforce, employers, as Russo and Bizarro reasoned, can take steps to empower their employees toward becoming engaged and knowledgeable consumers of healthcare.

Russo and Bizarro’s presentation had a particularly acute focus on espousing the merits of employee workshops and incentive programs to accomplish this goal. Regardless of the industry, it is often challenging to make a given employee population care about their healthcare spending. For many, simply being aware of paycheck deductions and out-of-pocket costs is sufficient. But what if employees learn how to access data that indicates whether they’re seeing the most capable providers? What if employees learn that a given facility they are considering for surgery is three times more expensive than an alternative one, which would translate to higher healthcare premiums? What makes these presentations even more compelling is when management, in conjunction with their respective HR department, can provide proper contextual background and empirical information – that is easily accessible in an online repository -- to elucidate the message. Rather than speaking in broad terms, offering specific examples of cost containment measures germane to the company’s make-up, health plan, and geographic location(s) can further pique participants’ interests.

Ultimately, though, for some employees, educational workshops still are not enough. They need personalized monetary incentives to be more engaged. Hence, the incentive programs that Attorneys Russo and Bizarro discussed in their presentation. In short, this is where employers may need to get creative. While there are more traditional methods for offering participants financial rewards (i.e., initiating a claim audit review program, encouraging preemptive consultation regarding medical procedures and specialty drugs), plans can customize incentive programs geared toward their employee population’s needs. For example, The Phia Group has long championed a program whereby employees (or their spouses) expecting babies will receive a $300 monthly stipend for diapers and wipes for 12 months if they choose to deliver at a facility identified as high quality, low-cost. In fact, in 2016 the Boston Globe ran a story on employee benefit programs (“Employers reward workers who shop around for health care”) that highlighted this unique program. This is just one example of how selecting the best provider at the best price can be a win-win for the company (as in potentially saving tens of thousands of dollars) and employee.

As seasoned experts in the healthcare cost containment industry, Attorneys Russo and Bizarro, on behalf of The Phia Group, were honored to deliver such a well-received presentation at SIIA’s biggest annual convention and look forward to enlightening the audience at next year’s conference.