After months of crunching numbers, your company concludes the only way to control its rising health care costs is to replace its current plan with a high-deductible, consumer-driven health plan. You assume employees are going to hate it, and you're already envisioning the nasty calls you're going to get from irate workers who see an increase in their out-of-pocket expenses. So should you even bother asking employees what they think, since the plan design's already a done deal?
Yes, says Denise Donnelly, a partner with Mercer. She conducts employee focus groups on behalf of her employer-clients and believes focus groups always reveal helpful information. "It's not that you're going to employees and asking them to design the plan for you," she says. "You're soliciting feedback in order to better answer questions, address roadblocks to change and make sure you're minimizing anxiety as much as possible."
There's a tendency for employers to believe they already know what employees think. But Donnelly says she learns something new every time she conducts a focus group. "It's really surprising and illuminating how sophisticated employees are when it comes to health care, and it's always surprising," she says. "You just always see another point of view that didn't occur to you."
Another concern employers have about focus groups is that they might hear an unreasonable wish list on which they're unable to act. "There's fear about managing expectations, and that they'll set up some false expectations," says Ruth Hunt of Buck Consultants. "Of course, the antidote to that is being very careful and deliberate about the way you construct the process."
So, whether you're trying to assess employees' readiness for change, implementing a bold new benefits strategy or simply tweaking an existing program, here are some tips from the pros on how to conduct a successful focus group.
1. Start small. Good focus groups are generally small, says Donnelly. "You don't want to go over 15 or 20 people because then it becomes too difficult to have a real conversation."
2. Select participants carefully. Consider the groups of employees you're trying to reach based on demographics, business unit, geographic location, ethnicity or employee level.
For example, if you're trying to enhance the success of your wellness program and you've noticed that employees younger than 35 rarely complete the health risk assessment, you may want to delve into that and figure out why. In that case, you'd want your focus group to be comprised mainly of those employees.
"Maybe you need to skew your selection process to get to the bottom of why those subgroups are outliers and what do you need to do about it," says Hunt.
3. Compose the focus group carefully. You never want to put managers with subordinates, for example, because "you never want that employee looking at their supervisor and thinking, 'I can't say what I really think because my supervisor's here in the room,'" says Hunt.
Or, if you're discussing financial topics, you might not want higher-paid and lower-paid employees in the same room "because some of the issues are going to be different about their ability to contribute to a health savings account or a 401(k), for instance," she continues. "Being sensitive to that is helpful because you're trying to get candor in the responses.
4. Promise confidentiality. "It's very important in focus groups to set them up with that promise of confidentiality, anonymity and assurance there will not be retribution for giving honest feedback," says Hunt. This can usually be accomplished by having a third-party facilitator conduct the focus group.
"Lots of times employers want to participate in the focus groups, all for good reasons - they want to hear firsthand what employees have to say - but sometimes employees are reluctant to be completely candid if there's someone from the company in the room," says Donnelly.
5. Set the ground rules. Be very clear with participants about the objectives of the focus group. That means letting people know upfront what is and isn't possible as a result of the focus group.
If the plan design's already set, and you're conducting the focus group to fine-tune the communications strategy and to learn how to best communicate the change, and you want people's input on the best way to do that, tell them you're not there to talk about plan design.
"Being upfront with people right at the beginning helps set the right tone," says Donnelly.
6. Choose a skillful facilitator. It's easy for a highly opinionated employee to take over a focus group and have his/her views be construed as the opinion of the majority. So ensure your facilitator is able to confirm interpretations.
For example, a facilitator might say: "You say you didn't open your HSA because it was just too complex - you didn't understand the process. Can I see a show of hands if that was the reason why you didn't officially open your HSA? Was the process too complex or were there other reasons?"
"Very often, you'll find other people's reasons were different," notes Hunt. "That way you can make sure you're not misreading the opinion of the group and how widely held an opinion might be."
7. Use mini-surveys. Sometimes people will sit in a focus group and nod their heads even when they're hearing something that isn't really their own opinion, says Hunt.
To avoid this 'group-think' taking over, Hunt will sometimes give participants, as they enter the room, a short, one-page mini-survey to find out what they think before they can be influenced by the opinions of their peers in the group.
8. Follow up. Thank people for their time and for giving you their honest feedback. Clarify what's going to happen next and, whatever you do, follow through, says Hunt.
"Because otherwise they'll be cynical, and you won't have their trust the next time you go out and tap them for their input," she cautions.
In the case of negative feedback, it's important to deal with it constructively after the focus group, says Hunt.
"Acknowledge, for example, that you know there's continued frustration with the rapid rise in health care costs, but here's what we can do together to try and address that," she says. "Turn those energies toward constructive alternatives."
9. Let employees throughout the rest of the organization know you held a focus group.
"One of my favorite lines is 'here's what we heard' and then summarize it, even if it's just a few bullet points," says Hunt. "And then say, 'Here's what we're going to do about it,' so they can see something constructive. It shows you cared enough to ask and cared enough to do something about it."
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