UBP blog


Do you know what the five costliest health conditions are?

As an employer, when asked what the five costliest health conditions are what do you think would top your list, cancer and heart disease, correct? It depends on what factors you look at to determine cost.

The Journal of Occupational and Environmental Medicine (JOEM) recently published a study revealing that employers who focus solely on employees’ direct medical and pharmacy costs in creating cost-containment strategies are missing a major component of the picture. These findings were based on data from over 51,000 employees and 1.13 million medical and pharmacy claims.

Where employers could be missing the point:

Employers who just consider direct medical costs are missing out on “presenteeism” costs. These costs are incurred when workers have health conditions that aren’t severe enough to keep them home. They come into work, cannot perform their jobs at full tilt and cause a drain on company productivity. 

In fact, for every dollar spent on employees’ direct medical and pharmacy costs, employers can expect roughly $2.30 in productivity related costs.

The  JOEM study found that when considering direct medical and drug costs alone, the top 5 conditions driving health care costs up are:

  • Cancer (other than skin cancer)
  • Back/neck pain
  • Coronary heart disease
  • Chronic pain
  • High cholesterol

This means that those of you who guessed cancer and heart disease got numbers 1 and 3 on this list.

But, when they factor health-related productivity costs, the top 5 conditions driving health care costs are:

  • Depression
  • Obesity
  • Arthritis
  • Back/neck pain
  • Anxiety

In light of these findings, what’s one major step employers can take to improve productivity and bottom-line results?

When developing your overall employee health strategies and disease management programs, make certain to first recognize and prioritize these conditions. That way you can create targeted solutions that address them head on and save health care dollars in the long run.

These solutions are just a small component of Benefit Plan Optimization (BPO™). So many employers out there are paying too much for their benefits and getting far too little in return. They’re definitely not getting the most out of their benefits and our 13 point diagnostic test could be just what the doctor ordered.

Call us now at 617-859-1777 to schedule yours or visit our website www.universalbenefitplans.com and fill out one of our contact forms letting us know your biggest benefits problem. We’ll certainly get in touch with you ASAP to discuss possible solutions.



Had it up to here with double-digit rate increases? Partial self-funding could be your solution.

On July 1, 2009, a new plan design—the partially self-funded plan—became available in Massachusetts. This plan design saves small and mid-size firms anywhere from 5-50% in group healthcare costs and alleviates a couple of the biggest pains associated with traditional fully-funded health insurance.

Pain #1: Small employers with 50 employees or less have been getting double-digit rate increases because they are in the same claims pool.

Solution: Get out of the pool and into your own.

Partial self-funding lets groups get out of the claims pool with everyone else and into their own pools. Also, with the new partially self-funded plans, employers have access to employee health data to help them best assume financial risk for funding health benefits.

Pain #2: Fully-funded health plans look like “all-you-can eat healthcare buffets”. You pay one price and it’s all the healthcare you can use. This isn’t the most cost-effective way to design a health benefit plan.

Solution: Design your own plan that’s not “all-you-can eat healthcare”. Instead, your plan will be “all that you need healthcare.”

With partial self-funding, employers have access to employee claims data every month as well as employee health data. This is what helps them to custom design an “all that you need” plan.

Two carriers in Massachusetts have begun to sell partially self-funded plans as of 7/1/09 and all of these plans meet the state’s minimum credible coverage (MCC) requirements.

We’d love the opportunity to discuss these plans with your company and see what we can save you, so give us a call at 617-859-1777 so we can get a conversation started.

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