Benefits Buzz

Calorie Counter Apps -- Making Thanksgiving Way Better (or Way Worse?)

Thanksgiving may be one of our favorite holidays, but it sure does nothing to help anyone trying to lose weight or stay on a diet. This year, your iPhone or Blackberry may be to the rescue (or, just may be the bearer of bad news). Lots of calorie-counter apps can help you (and your employees) keep on track with eating right.

Just in time for Thanksgiving, MobileHealthNews.com has a run-down of the top apps. Here's what they say:

In the coming years these calorie tracking applications will become far more user friendly by being coupled with wireless peel-and-stick sensors that automatically count a person’s calorie intake. Companies like Philometron are working on those sensors right now — until then we have to manually enter or look up our food’s calories, which makes tracking a chore.

A chore, yes, but way easier than any online method or paper and pen. Some of these apps were designed for managing diabetes or keeping up with a specific diet plan--all good stuff.

These are just a few of the countless mobile apps putting health and fitness info in your employees' hands. This is going to be a fun, fun space to watch as more and more wellness companies and health plans get in the game of mobile apps, making tracking health and wellness easier and more fun.

As for me, I think I'll start using these apps after Thanksgiving. 

Editor's Note - Jennifer Benz is founder and chief strategist at Benz Communications, a boutique consulting firm that focuses on employee benefits communication. You can reach her at jen@benzcommunications.com or via Twitter @jenbenz.

How to Annoy Your Benefits Administrator: Ask for a Mobile Enrollment App Now...

... and maybe, just maybe, you'll get it by next year.

It is almost open enrollment and, by default, about that time to be testing your online enrollment system. Chances are you've gotten in there and realized that, much to our dismay, most online enrollment sites are just not as intuitive or user-friendly as the Amazon/Facebook/Google online world we've become accustomed to.

There is such a disconnect between the mostly clunky HR systems online world (enrollment websites, HRIS systems, etc.) and the rest of the online world of super-personalized consumer, social media and gaming websites. Do employees tolerate this because they have to? Yes. Is it preventing them from being engaged in their benefits and enrollment decision-making? For sure. 

It is long past due for most HR platforms to have a major face-lift. For years and years, many enrollment sites haven't even met basic usability standards. Now, social media, personalization and gaming (just to mention a few factors) have totally changed the game when it comes to the online experience, setting the bar even higher. Four out of five adults are using social media sites and mobile phone usage of the web is skyrocketing.

In the benefits world, we tend to think that if an employee isn't sitting in front of a desk at work all day that they don't have access to the internet. Not so, especially when you factor in mobile devices. In fact, mobile may prove to be a much more effective way to reach the "un-wired" workforce than websites ever could be. And, there is so much exciting work going on with mobile apps for health care. From monitoring diabetes to managing HIV/AIDS to fitness. Not to mention all the other amazing things you can do with an iPhone or Blackberry and a data plan. This is going to be the new standard and what your employees expect--seamless, ridiculously simple, fun, engaging and integrated both online and through mobile devices.

So, while you're in there testing your enrollment platform and making sure all your price tags are accurate, go ahead and tell your benefits administrator that it is time for a major upgrade to the user experience. Ask them for a mobile enrollment app too. Let their jaw drop before you add on "next year." And, then, keep asking until you get it! 

By the way, do you have an online enrollment site that actually IS as intuitive as Amazon or Google? If so, please send it our way (pretty please!) and we'll show it off here! 

Editor's Note - Jennifer Benz is founder and chief strategist at Benz Communications, a boutique consulting firm that focuses on employee benefits communication. You can reach her at jen@benzcommunications.com or via Twitter @jenbenz.

Flu Prevention--Mostly Common Sense, but Do Your Benefits Policies Support It?

The Chicago Tribune's cover of the Sunday business section has a story, like dozens we're seeing now, about Firms bracing for a rash of flu absences. While I hope the H1N1 flu season doesn't prove to be much worse than a typical flu season, most companies (and certainly the major media) are already assuming the worse.

What struck me from this Tribune article was the prevention advice: 

Tips for H1N1 flu prevention and treatment

-- Cover your nose and mouth with a tissue when you cough or sneeze.

-- Wash your hands often with soap and water, or use alcohol-based sanitizers, especially after you cough or sneeze.

-- Avoid touching your eyes, nose or mouth to limit the spread of germs.

-- Avoid close contact with sick people.

-- If sick, stay home for seven days after your symptoms begin or until you have been symptom-free for 24 hours, whichever is longer.

-- Follow public health advice regarding school closings, avoiding crowds and other social-distancing measures.

-- Get both the seasonal and H1N1 flu vaccinations, when available. This is especially important for pregnant women, caregivers to infants and health care personnel.

-- If you contract swine flu, talk to your doctor about antiviral medications Tamiflu and Relenza, which can lessen the duration and severity of the illness.

-- For more information visit flu.gov.

Source: Centers for Disease Control and Prevention

Pretty much all common sense, right? The first 5 tips especially are behaviors that make sense ALL the time--not just when there's a pandemic. But, no matter how much the CDC says it, and no matter how much we all know it makes sense, how many people actually stay home when they are sick? (Let alone for seven days!?!!?)

This isn't all about company policy (it is also a lot about individual choices) but, there are a ton of benefit programs and policy factors at play here--time off programs, sick leave, coverage for preventive care, short-term disability policies, family leave, access to child care, the list goes on and on. A company can't be successful with the message "please stay home when you're sick" if they don't have the policies, business process and culture that allow for that.

While many companies have moved from separate sick, holiday and vacation banks to one single "Paid time off" for flexibility, those policies may unintentionally encourage people to work when they are sick. Would you rather come into the office with the sniffles or take a day off of your upcoming vacation to Maui?

What if furloughs have drained people's vacation and PTO banks this year? How will you encourage workers to stay home when they're sick if they are going to have to take a pay cut to do it? Do your policies support parents who may need to stay home with sick kids?

And, what about hourly and low-wage workers? How do you encourage them to take time off if being sick for a week may mean not being able to make rent that month?

Think about the business culture too. Do the work requirements of a specific line of business set the expectation that no one can ever miss a day? How many knowledge workers still come into the office when they're sick even though they have laptops and cell phones, because they don't have a good relationship with their manager? How many managers don't really understand the time off and benefit policies in the first place?

Lots of questions and no easy answers. And, much at stake as we know the cost of lost productivity and absenteeism. As you plan for the flu season, look deeper--beyond common sense communication and business planning--are your benefits programs, policies and business culture truly supporting the health of your workforce this flu season? Or, are they discrediting your message and encouraging exactly the opposite behaviors you need?

Editor's Note - Jennifer Benz is founder and chief strategist at Benz Communications, a boutique consulting firm that focuses on employee benefits communication. You can reach her at jen@benzcommunications.com or via Twitter @jenbenz. 

Open Enrollment IS Different This Year...

Open enrollment is just around the corner and many of you are already feeling like this year is going to be different. And, it will be. There’s a lot going on--the economy, the national debate on health care, the increased influence of social media. And, all of this is changing the way employees think about their benefits--and should be changing the way you think about enrollment.

Three big factors are shifting the employee mindset faster than you can say "default elections" and you need to know how to react:

1. Employees care about their benefits more than ever before. Survey after survey shows how much employees value their benefits–-both health care and financial. With salaries frozen, or decreasing, and the value of health care benefits always on the rise, benefits make up a larger part of total compensation than in years past--and, as a result, a larger part of your employment brand and value proposition.

2. At the same time, benefits are on the national stage--and you’re going to get more hard-to-answer questions. Health care reform has put health care benefits front-and-center in the national news. CEOs are getting in the debate. Employees and families will want to know how legislation may change their benefits and their health care.  As such, this is a prime opportunity for you to demonstrate and reinforce the value of your benefits offerings. 


3. And, if that wasn't enough, social media is changing (edit: has already completely changed) expectations for how, when, and why employees receive information. In an age of iPhones, Facebook, Twitter, and real-time access to any piece of information, the traditional methods of communicating benefits information are just not good enough. Employees want easier access to information and they want it to be easy to take action on the information they receive.  


So, great, but what do you do with that information? It is almost September, so a little late to overhaul your technology systems or completely change your communication strategy. But, there are simple ways you can improve your enrollment communication this year:

Connect benefits to the business. If you’ve never educated your employees about your benefits philosophy and how it is connected to your business, now is the perfect opportunity. Arm managers with information about total compensation and use them to help tell the whole story. Simple talking points or checklists will allow them to push your benefits message further.

Keep it simple. Employees' top concerns during enrollment always are: What's new? What will it cost me? This is no different than in years past, and you can spell out these answers (and why) in simple, easy-to-understand terms along with simple step-by-step instructions on how to enroll. If you haven’t already done so, create a one-page enrollment “Tip Sheet” that lists what’s changing in as simple a format as possible (perhaps just a list), gives brief enrollment instructions, and tells employees and families where to go for all the details. 

Focus on employee’s personal needs.  Resist the temptation to include figures about your total benefits spend or tell employees how many billion dollars per year bad health care decisions are costing the U.S. They are hearing this enough in the news and are already zoned out before you finish saying "billion." Your employees need to know how it impacts them, their lives and their families. If you talk about your overall health care costs, break it down into what the company spends per employee. When you talk about changes that could decrease costs, tell your employees what that will mean to their pocketbook. 

Promote missed or under-utilized benefits. Put together a list of the 5 to 10 benefit plans employees aren't using enough--health savings account, fitness benefits, voluntary insurance, hidden features of the EAP, preventive care benefits, commuter benefits, etc.--as a one-page tip sheet. Title it “The Top 10 Employee Benefits You’re Missing” or “10 Ways You’re Not Getting The Most From Your Benefit Plans."  Ask employees for their ideas. 

Start using social media. Now that 80 percent of Americans are using social media, do you think you can start integrating it into your benefits communication? It doesn't have to be intimidating. Start a benefits blog to focus on reminders and tips, and give employees a way to join the conversation. Use Twitter to post frequent updates and provide low-cost customer service. Social media is a perfect--and cost-effective--way to get employees engaged and to be responsive to their needs this year. This is especially important if enrollment meetings have been cut.

Editor's Note - Jennifer Benz is founder and chief strategist at Benz Communications, a boutique consulting firm that focuses on employee benefits communication. You can reach her at jen@benzcommunications.com or via Twitter @jenbenz. 

Pfizer Program Helps Unemployed Maintain Access to Rx

There's no shortage of discussion about the risk of rising health care costs and tightening budgets discouraging people from taking important prescription drugs. It is a problem for both those with insurance (but high copays for brand name drugs) and those without insurance who can't fork out the cash for pricey prescriptions every month. And, it is a short-term personal budget fix that has awful long-term health implications (which, of course, means long-term health expenses too -- for the individual, their employer, really all of us).

So, this Pfizer program caught my eye. MAINTAIN is a program that lets unemployed individuals (and their families) who are in financial need and lack prescription coverage continue to get their Pfizer medicines free-of-charge for up to one year (or until they become insured, whichever comes first).

This is right from the official Pfizer info: 

Through MAINTAIN, more than 70 Pfizer medicines are offered that treat a range of chronic health conditions. It is easy to learn if you may be eligible, by visiting www.PfizerHelpfulAnswers.com or calling 866-706-2400. The program is user-friendly, with a one-page application that Pfizer will typically process within two to three weeks. The program is expected to accept applications through December 31, 2009.

There are four eligibility requirements for MAINTAIN:

• Applicants must be able to demonstrate loss of employment since January 1, 2009;
• Lack prescription coverage;
• Attest to financial need; and,
• Be on their Pfizer medicine for at least three months prior to unemployment and enrolling in the program.

Uninsured patients who need a Pfizer medicine but who do not qualify for MAINTAIN may qualify for Pfizer’s other Patient Assistance Programs.

No matter what you think of big pharma, you can't complain about this program. And, what I like even more is this nifty little tool on their website to help you find Assistance Programs that are right for you (available in Spanish too). Medical plans can be super confusing, and prescription drug programs are notorious for being anything but user friendly (my favorite being the all-too-common labels "preferred" and "non-preferred" for brand name drugs--usually the "non-preferred" is the higher copay, meaning "not preferred by your PBM--we don't really care about your perspective.")  So, it is really nice to see the extra step taken to make these programs accessible, not just out there for the good-guy status.

Also, I'm often asked what employers can do to "soften the blow" of layoffs. There's not really any way to make getting laid off seem like good news, but employers can provide departing employees with helpful resources like this program and other assistance programs. That's a simple step that shows real concern for your workforce--even after they leave. 

Editor's Note - Jennifer Benz is founder and chief strategist at Benz Communications, a boutique consulting firm that focuses on employee benefits communication.

Discounted Health Care for Buying Local Veggies? Is this Heaven?

I live in the mecca of local and organic produce. There are so many farmer's markets to choose from on a given week that you could eat like royalty nearly year-round and hardly step foot in a grocery store. The daddy of them all, the Ferry Plaza Farmers Market, and my favorite low-key version, The Alemany Market, are bustling year round and have arguably some of the best coffee, specialty food, gourmet treats and, of course, produce in the country. (Not that I'm biased or anything.) 

But, one of my favorite treats of the summer is my Community Supported Agriculture (CSA) veggie box. Once a week I pick up a box of the tastiest just-picked fruits and veggies. I read the info sheet on all the obscure or not-so-obscure items inside and plot out what to cook, freeze or eat on the spot (the strawberries don't always make it all the way home). I'll be the first to admit I'm a bit of a geek about this but it is so much fun--kind of like Christmas morning once a week (plus supporting the community and all that good stuff too). Unless you threw in a chef to cook the veggies for me, I would never have thought a CSA could get better. Until now.

In Madison, people are getting rebates on their health care for joining a CSA! The Madison Area Community Supported Agriculture Coalition (that is a mouthful!) has a program called Eat Healthy Rebate where their CSA members get rebates on their health plans--up to $200 bucks! This info from the Minneapolis Star Tribune:

CSAs are particularly popular around Madison, Wis. There, Physicians Plus Insurance Corp. in 2005 began offering $200 premium rebates to member families who joined CSAs. The program appears to have been the first of its kind in the country. In 2006, the first full year of the program, 972 members got the CSA rebate; heading into this season, 1,460 will qualify, said Physicians Plus marketing manager Scott Shoemaker.

If people are motivated to eat "healthier foods, exercise and practice preventive health measures, they're going to be healthier in the long run and need less health management down the road," Shoemaker said. "They'll go in to the doctor less. And costs will go down."

This is pure brilliance in my opinion. Why not pair eating healthy with lowering your health care costs -- and supporting the local community all at the same time?

This could be a great fit for employer wellness incentives too. Employees are often offered reimbursements for gym memberships that go unused--maybe for some employees those incentive dollars could be better spent on healthy eating? 

Are there other examples of pairing local agriculture with health incentives? Please leave examples--or your ideas!--in the comments below. 

Do It Pro Bono: Getting the Most Benefit From Time Off to Volunteer

Volunteering is definitely hot right now. President Obama has made it part of his national agenda and laid-off workers are flooding nonprofits with applications to volunteer. Many many companies have time off to volunteer as part of their benefits program and vocal companies like Salesforce.com tout their volunteering + donations so much that they even teach other organizations how to follow their model.

But, what's really exciting (and, just in time for National Volunteer Week), is the growing appreciation that giving employees time off to volunteer is not only good for the community, but good for your employees--and good for business.

Talent Management's April cover story Volunteerism’s Impact on Talent Management says it all:

"Organizations should encourage, value and support extracurricular volunteer efforts, not just because it is the right thing to do but because these volunteer activities will increase employee engagement, underscore the employer brand, support recruitment and retention initiatives, and develop valuable workplace skills that ultimately will help the employer succeed."

Now, that sounds like a business case any CFO can appreciate.

Limeade, a wellness company, is taking that one step further and linking volunteer efforts to productivity in their health risk assessment. Instead of just asking employees for their BMIs and cholesterol levels, Limeade asks the employee what he or she wants to achieve--from health to social to career goals--and lets the employee pick up to three. "Giving back" is one of these. Others are things like "get more sleep" and "have more energy."

Henry Albrecht, the CEO of Limeade, says that Giving Back option is there because it is linked to higher productivity. "Giving Back is a goal on the Limeade assessment because altruism predicts better business and personal performance. Including factors like these allows Limeade to predict more than 10 times the variability in productivity than just looking at health factors alone. It's about being a high-performance company--not just flagging health risks and 'singling out the costly.' Our own rigorous statistical analysis shows that 'Concern for Others' predicts both productivity and well-being (both of which are connected to other positive business outcomes like profits and customer satisfaction)." 

So, volunteering can increase engagement, develop talent, improve recruiting efforts and even bump up profits and customer satisfaction. Wow. But, how do you get the most bang for your volunteering buck? Two ways:

--Promote your volunteering benefits. (And, promote your donation and gift-matching programs, too--they're all benefits!) This seems like a no-brainer, but plenty of companies give their employees 2 or 3 days a year off to volunteer and then forget to remind their employees to take the time off. Or, worse, their demanding work environment doesn't allow for it. Promote this benefit--and encourage managers to do the same. (If your company doesn't have this benefit, now is a great time to add it!)

--Encourage pro bono work as the most valuable way to volunteer and link those volunteer opportunities to learning and development. Pro bono projects use employees' professional skills. I would never discourage volunteer work like cleaning up parks or building homes for Habitat for Humanity, but pro bono work has so much more potential to engage and develop employees--and pro bono work also delivers the most value to the nonprofit sector, which is desperately in need of the skills your employees have. Most people find donating their unique skills more rewarding than "stuffing envelopes" and other fewer-skills-required jobs. And, pro bono projects and pro bono consulting can often be integrated into employees' day-to-day work rather than having to take everyone off-site for a day or two for a concentrated volunteer project. Need some inspiration? Check out how Umpqua Bank quantifies the impact of all of their associates volunteering (they have nearly 70% participation!).

Not linking time off to volunteer to learning and development is a huge missed opportunity. From the 2008 Deloitte Volunteer IMPACT Survey, a nationwide survey for Fortune 500 HR pros: "Fully 91 percent of respondents agree that skills-based volunteering (which involves the contribution of business knowledge and experience to help nonprofits increase their capacity) would add value to training and development programs, particularly as it relates to fostering business and leadership skills.  However, only 16 percent make it a regular practice to intentionally offer these opportunities for employee development, suggesting a missed opportunity to boost learning in a way that offers substantial benefits."

More on that from the Talent Management article: As Peter F. Drucker wrote in the article "Managing Knowledge Means Managing Oneself," "The real development I've seen of people in organizations, especially in big ones, comes from their being volunteers in a nonprofit organization. I hope we will soon begin to talk about the nonprofit organization as the great social opportunity for business. It is the opportunity for business to develop managers far more effectively than any company or university can. It is one of the unique benefits that the social sector can offer."

Did you hear that? Pro bono work provides opportunities to develop managers far more effectively than any company or university can! (And, hey, it is way cheaper than an MBA.)

Pro bono work also has the ability to elevate everyday professionals to hero status, especially when you're helping organizations that are solving some of society's most challenging problems. That is the theme of a new childrens' book Mommy and Daddy Do It Pro Bono. Written by Aaron Hurst, the founder of The Taproot Foundation, an organization that engages professionals in pro bono work across the country, and his wife, Kara Hurst, a global corporate social responsibility leader, the book shows what typical professionals look like through the eyes of children--and how significant pro bono work can be. It is a fun look at the impact of volunteer work not just on the organizations and individuals involved, but as a way to be a role model in every profession.

It is also the first children's book to feature an HR Manager--perhaps the best roll model in a company for the value of pro bono work (especially since nonprofits need HR help now more than ever). And, it is on sale, just in time for National Volunteer Week, and just in time for you to add a promo about your volunteer time off program to your next benefits update.

Author's note - A big thank you to Liz Guthridge, Charlotte Graeber and Chip Abernathy who provided me with some of the examples above via Twitter.

Editor's Note - Jennifer Benz is founder and chief strategist at Benz Communications, a boutique consulting firm that focuses on employee benefits communication. She admits to not being even slightly impartial on the topic of pro bono work, having been involved with the Taproot Foundation since 2002.

Is Twitter a Viable Tool for Employee Benefits Communication?

Twitter is everywhere. The micro-blogging platform, that asks you “What are you doing?” and only gives you 140 characters to respond, gets more press lately than celebrity mishaps. It is growing crazy fast, CNN loves to integrate it into the newscast and it gives even the biggest celebrities a chance to seem like real people.

Often dismissed as “fluff” in the social media landscape, Twitter is actually an invaluable tool for business, letting you quickly interact with a huge group of industry thought leaders, grab news headlines and even see what your competitors are talking about. The uses of Twitter have surprised even the founders themselves. It took me a little while to really buy in to the power of Twitter, but now I’m officially hooked.

But, can this platform be effective for employee benefits communication? Can it handle the complex needs of communicating to employees and their families about health care, 401(k)s, stock options, wellness programs, EAPs and all the other crazy and complex programs that are out there? 

I asked that on Twitter, and here are just a few of the replies:

So, it is a resounding YES. And, I agree completely. Here's why.

Four Reasons Why Twitter Works for Benefits Communication

Short and sweet. Twitter forces you to keep things to 140 characters, or about 20 words. That means you have to get to the point fast and entice your audience to link for more information. This is precisely the way effective communication should be structured, especially in our media-saturated world. And, this works really well for benefits information, where each individual needs to quickly find the information that is relevant for them and go. Too often, benefits communication is delivered in a one-size-fits-all package that has so much technical information and detail that the actual message is lost completely. There is a place for that (in your Summary Plan Description, for example) but the majority of benefits communication should be about engaging employees and families so they take action and make good decisions. Twitters’ quick to-the-point format would be great for delivering those action items in clear and simple terms.

On the Internet, for everyone to see. There’s nothing private about Twitter, as some have learned the hard way, but that is a good thing for your benefits communication. You want to get information into the hands of your employees (and new hires!) and their spouses and families as easily as possible. Unnecessary passwords are just an opportunity for your audience to get distracted by YouTube or Facebook and never return to your site or the important task they meant to do. There are Twitter-esque tools for the enterprise, like Yammer, that can live behind a firewall, but sequestering your benefits info behind all that security keeps it out of the hands of the spouses and families who are driving the largest portion of your costs. Not convinced? Here’s a full article on this topic alone.

Interactive. The @ feature on Twitter makes it easy to send a quick question or direct a reply at an individual. This makes the platform incredibly interactive—and efficient. The vast majority of benefits questions that are handled either by self-service websites and costly call centers are simple, simple, simple. “What’s the phone number for our health plan?” “Where do I submit claims for the FSA?” “What’s the deadline for the stock plan enrollment?” “Can I get reimbursed for salsa dance lessons as part of our fitness incentive?” All of these are simple less-than-10-word answers that could be handled by a benefits team member or a call center rep with minimal effort. I’d love to see a company roll out Twitter help as an adjunct to their call center. (Yes, obviously, there must be some common sense training that goes along with this but call center reps and benefits pros who are sophisticated enough to handle HIPAA regulations and FMLA rules are also smart enough to know when to say “we can’t answer that in a public forum—call us at this number.”)

Twitter can come to you. I know someone is thinking “but our employees aren’t on Twitter yet, why would we use that?” and that is a valid point. You have to go where your employees and families already are. And, you can do that with Twitter. All of the applications and widgets and add-ons that make putting a Twitter feed into another website easy are part of the reason the platform has grown so quickly. So, yes, you have to go where your people already are—is that your Intranet, your benefits website, Facebook, LinkedIn? Or, is it their mobile phones? Twitter can work anywhere and I think the mobile applications are going to become even more interesting and useful.

BUT, (there has to be a “but” right?), I do have a few cautions before you drop all your current communication channels and hire someone to man Twitter 24/7.

Some Cautions

If you use Twitter for benefits communication, it MUST be part of an integrated campaign. Twitter is just one tool and you have to give employees and families comprehensive resources and frequent updates in other media, of course. The ideal communication strategy is going to have a mix of online, print, interactive and hopefully face-to-face communication. And, just like any website, you can’t have an “If we build it, they will come” mindset—you have to consistently remind employees about the resources out there and why they should bother taking a look. (And, no, I don’t think good old-fashioned print communication mailed to homes is going away anytime soon—especially among companies who do not have completely wired workforces.)

Jargon alert. Benefits has enough jargon and silly acronyms already without throwing a new language of “Twitter” and “Tweeting” in the mix. If you use Twitter for your benefits communication, you must be very cautious not to further confuse employees or forget to define acronyms. It is no fun to spell out "high deductible health plan" when you’ve only got 140 characters to work within, but chances are pretty good your employees are not going to know HDHP, at least not the first time around. 

Understand the time commitment. An investment in any social media takes time and you need to accurately understand the commitment required, which could be significant. If you have someone on your benefits team monitoring Twitter and answering questions in real time, it might make sense to say “We respond between 10am and 2pm PT Monday-Friday. We’ll get back to you as soon as we can” so that you set appropriate expectations with employees—and so that individual can actually get some work done outside of those hours. 

I'm convinced Twitter holds tremendous promise to help engage employees and their families and get them taking action with their benefits. What do you think? Please comment below or let me know on Twitter.

Editor's Note - Jennifer Benz is founder and chief strategist at Benz Communications, a boutique consulting firm that focuses on employee benefits communication. She helps companies, large and small, connect with their people so that those people (and their families!) understand all the confusing, but oh-so-important, benefits programs that are out there. She's located in San Francisco.

Crossing the Border: How Far Will You Go with Medical Tourism?

There are not many word combinations more awkward than "medical tourism." But, that's not preventing a whole industry from springing up around the more-and-more common notion that you just might jet off to Bangkok or Buenos Aires for your next knee replacement, face lift or even heart surgery--along with a cozy recovery pool-side and a few days at the spa, of course.

There's lots of talk about medical tourism making a major breakthrough in '09. The stars are aligning not just because the economy is demanding cost-cutting measures that may have seemed extreme before, but because the globalization of health care is making huge strides in terms of quality and accessibility. Over 50 countries are trying to attract patients from the US with JCI-accredited facilities and US-trained doctors and some with outcomes data that would make some of our best hospitals blush. The result: 1.5 million Americans traveled outside the country for health care in 2008, saving 50-80% on the cost of services here. McKinsey expects the number of "medical tourists" to increase 20% annually.

Once just for uninsured or under-insured, medical tourism is now being targeted for the group health insurance market. The reasons for this are pretty obvious--employers represent a huge potential market. And, why market individual-by-individual when one contract can get you thousands of potential patients at once? Several major insurance carriers are writing this into their plans and large employers should not be surprised to see this in renewals this year.

Whether you think this trend is delightful or disturbing, watching this pan out in the group market will be fascinating. We struggle to get employees and their families to do simple things like go to the doctor once a year, get the necessary cancer screenings and actually take their prescription drugs as directed. Even though we have spent years attempting to make employees great "consumers" of health care, most people are overwhelmed and feel unequipped to make important health care decisions--especially when a disease or accident strikes.

How will they react to the option of going to Costa Rica instead of the local hospital for that hip replacement? How will they be able to evaluate the risk and reward? Sure, the employer may save tens of thousands of dollars and be able to pass that along to the employee in terms of a waived deductible (with a family trip to boot!), but how do you help that individual get comfortable with the process? And, how do you serve this up as a real option when there's such big money at stake? (And, those questions just touch the surface of the compliance/liability issues.)

While these are messy messy questions, in the best scenario, medical tourism could actually help push the envelope on consumerism in health care. Clearly, all those millions of people traveling abroad for surgery are already savvy consumers--price shopping, comparing their options, picking facilities and tallying up the costs of the medical procedures and the whole trip (one would argue, you're always a better consumer when it is your own money you're spending, as is the case with uninsured individuals). Subjecting US hospitals to a transparent and open comparison with their foreign counterparts on outcomes data could shed a whole new light on the quality of care we receive here. A surge in Americans traveling outside the US for cutting-edge procedures that the FDA is slow to approve may help adoption of new technology, like stem cell treatments. Getting away from the notion that the best care is always in your backyard may help employees be more receptive to turning to data (not word of mouth) when they pick their next doctor.

But, I'm afraid that is an overly optimistic view. At least in the short term, the option to go abroad is going to add to the overall confusion about how, where and when to get the best care. (This may be less so for companies who have a global workforce already or whose employees travel abroad regularly for work and for fun. But, imagine explaining to an employee who has never left the country that you'd like them to consider going to Bangkok for their next major surgery!) But, with a thoughtful approach, the employers and insurers and facilitators forging through this new frontier may come out winners--if they can keep their costs down while keeping employees happy (and healthy!). Couldn't hurt if they throw in a few more days at the spa, too.

Thanks to Robert Repke at Global Medical Conexions for lots of background material. His presentation in San Francisco sparked this post.

Editor's Note - Jennifer Benz is founder and chief strategist at Benz Communications, a boutique consulting firm that focuses on employee benefits communication. She helps companies large and small connect with their people so that those people (and their families!) understand all the confusing but oh-so-important benefits programs that are out there. She's located in San Francisco, but her team and clients are all over the place.