Why switching to an HDHP requires new communications strategy
When Carolinas HealthCare System moved from a traditional preferred provider or copay arrangement to a self-insured high-deductible health plan plus an HSA, they needed a brand new communications program to educate employees about the changes.
Advertising firm LaineGabriel and communications strategy company Dancor Solutions were tasked with helping them get the message out in an engaging way to 35,000 full- and part-time employees working in more than 900 care locations in North and South Carolina.
“Over a three-year period, CHCS created some new plans and let our folks opt-in voluntarily to get their feet wet and give us a sense how these programs worked for employees and for the company,” says Scott Laws, assistant vice president of human resources, total rewards, for CHCS. “Then we slowly transitioned fully into a consumer-driven health plan.”
All CHCS employees, including part-timers who work at least 24 hours a week, are eligible to participate in the new plan. Single employees pay premiums that start at $9.52 per pay period for each of 26 pay periods, while family coverage begins at a cost of $156.38 every two weeks.
The centerpiece of the revised program is a health savings account. Currently, the company contributes just more than $2,000 per year for single employees and about $3,400 for family participation. The company payments to the HSA were designed to cover a significant part of the deductibles of $1,850 for individual workers and $3,700 for families.
There are also numerous incentives for employees and their families to make additional tax-deductible HSA contributions that accumulate tax-free and can be withdrawn without any tax consequences.
“The challenge HR faced is how to find a way to distill complex benefits information to the point where 80% to 90% of the employee population could understand it without much help,” says LaineGabriel’s principal and chief creative officer James Gabriel Brown.
“Before, our communications plan was a typical total rewards model using different consultants and vendors, and traditional health care communications language,” says Lucy Dean, assistant vice president of human resources, communications, for CHCS. “With the introduction of a consumer-directed plan, our teammates are spending their own money, so we needed to help them change their behavior so they could become comfortable with that approach over time.”
Laws and Dean had an initial meeting with Dancor early on in the plan redesign cycle. “They helped us get out our healthcare consulting-language mindset and told us we have to keep it simple,” Dean says. She explains that Dancor also recommended straightforward messages because they would be shared directly with physicians, leaders and staff without cascading from one layer of the company to the next.
“An old-school benefits communications campaign consisted of memos, postings and email updates that ended up being lost in the sea of other communications employees receive,” Brown says. “A more contemporary approach is something more akin to an advertising campaign that addresses what’s in it for individual employees to enroll.”
LaineGabriel worked with CHCS on the digital component of the communications rollout. “They told us, forget the three-minute video. You need 30-second or 45-second or one-minute snippets that help educate employees and inspire them to want to learn more,” Dean says.
Six videos were created prior to open enrollment that focused on storytelling. They include a launch video highlighting upcoming changes, an introduction to open enrollment starring the chief human resources officer, and the story of one nurse who married and had children, so additional benefits like an accident policy now meant more to him. Another notable episode features another Carolinas employee talking about how she saves and spends “her money” in the company HSA. Finally, there is advice from a physician about disease prevention, and a pharmacist discussing the importance of preventive medications.
Another significant difference in the new communications approach is the channels used to disseminate information.
“People are looking at this information with family members more at home than at work, so we could no longer offer it only through our Intranet gateway. It had to be Internet-based,” Dean continues. “To supplement the campaign, we also did live roadshow meetings to groups of different sizes, and we incorporated presentations about the new consumer-directed plan into all of our [wellness] events,” Laws adds.
A key aspect of the new communications campaign is that Carolinas HealthCare System chief human resources officer Debra Plousha Moore committed to sending out a weekly email entitled “Did you know?” that contains a nugget of information about the organization’s health or retirement benefits.
“This has been going on for almost 18 months now, and it’s attractive to employees from millennials to baby boomers,” Dean explains. “She hears all the time from teammates how much they appreciate it and receives suggestions for future topics.”
“After more than a year into this, we are also getting much more insightful questions from employees about not only how the HSA works but more sophisticated investment issues,” Laws says.
While the new communications campaign was more expensive in the first year than in the past, Dean says, “Whenever you are rewriting the book, it’s going to cost more, but we have been able to reuse the same materials in subsequent years.”
Both Dean and Laws believe the return on the investment in a new, more up-to-date communications plan has been significant. “Our participation in the health plan went from 83% up to 88% — about 1,000 new participants — which doesn’t sound like a lot, but when you think about the radical nature of what we did, it’s pretty exciting,” Law says. “We are particularly encouraged that participation by lower-paid teammates earning less than $30,000 per year grew 11%.”
In addition, Dean says, “When we launched the plan, we had 85% of eligible employees participating and contributing to the HSA, but the number has actually grown to 90%. That’s a fantastic statistic because a consumer-directed plan does not work effectively without an HSA.”
Their key takeaways from this experience for other employers wrestling with the communications challenges arising out of the transition to a consumer-directed plan is there is no longer any finite communications period for benefits. “Benefits communications have to be simple and straightforward in plain language all year long,” Laws concludes.