Partners In Care’s Key Questions to Ask Yourself if You are Wondering Whether Your Health Benefits are Optimized:

• Do you have a strong handle on what the cost drivers are for your population?  If so, what are they?
• Do you know how many Diabetics are in your population?  Do you know what percentage are compliant with clinical guidelines?  What steps are being taken for each non-compliant patient?  Have you been approached to assist in boosting compliance rates?
• Do you know how many Asthmatics are in your population?  Do you know what percentage are compliant with clinical guidelines?  What steps are being taken for each non-compliant patient?  Have you been approached to assist in boosting compliance rates?
• Do you know the status of Preventive Diagnostic testing for Cancer for your population?  What is the compliance for Pap Smear, Mammography, and Endoscopy?
• Do you know what’s going on with Hypertension?
• What is the tobacco use rate in the population?  Is it trending down?  What steps are being taken to move it down?
• What are the BMI and LDL levels for your employees, do you know what percentage are in compliance with testing, with actual levels?
• What is the workplace position on supporting physical activity?
• Is there a Corporate Medical Director on staff or on tap? 
• Is there a Corporately Sponsored Primary Care Service onsite?
• Is there any integration between Workers Comp and Medical Benefits?
• Do you sponsor an annual Health Risk Assessment for each of your employees?  What are the results?  Any key issues?

• Do you currently finance any of the following programs via your health benefits:
  1. Disease Management
  2. Case Management
  3. Care Management
  4. Healthcare Advocacy
  5. End of Life Programs and Medical Ethicists
• If the answer to any of the preceding questions is yes, do you know whether they are effectively integrating with the practicing physicians in the region?  If not, do you know the key barriers?
• Do you sponsor an annual Enrollee Satisfaction survey (ie. CAHPS)? What are the results?  Any key issues?
• Do you sponsor an annual process of Employee Focus Groups?  What are the results?  Any key issues?
• Do you know what percentage of the Premium is paid for by Employees? The Company?
• Do you know what the healthcare cost sharing Percentages are between Employees, The Company, and Coordination of Benefits?
• Are Plan Designs optimized for management of chronic conditions?
• Do you know what percentage of Employer Paid Health Plan Costs are avoidable due to improved Patient Compliance?
• What are the key metrics you use monthly to monitor the success of your health benefits? Quarterly? Semi Annually? Annually?