What Should City Leaders Do About Healthcare?

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This is the second piece in a three-part series about pensions and healthcare. Each piece will include insights gained at different state municipal league meetings across the country. Find the first installment here.

The National League of Cities (NLC) was recently back on the road — this time to discuss healthcare. Williamsburg, Virginia, home to the College of William & Mary, welcomed us with open arms for the annual conference of the Virginia Municipal League.

I went into the conference expecting to hear trepidation over healthcare reform at the federal level. But what I heard instead was hope and promise from city officials who were excited to raise questions and implement policies that would make their cities healthier, irrespective of what’s happening in Washington.

To start, get to know your citizens, recommends Paul Campbell, Director of State & Local Solutions at UnitedHealthcare — and that means getting to know their health status. For example, did you know that nearly 25 percent of the more than 29 million adults who have diabetes in the U.S. don’t know it, according to the Centers for Disease Control and Prevention? Did you also know that a staggering 90 percent of the more than 86 million adults who have prediabetes in the U.S. don’t know it?

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That means many individuals don’t even know they have a problem, let alone what they could be doing about it. And diabetes is just one example. The point is, city leaders need to position themselves to be informed and active decision makers, and the way to do so is by getting their hands on the right data.

So, where do they start? UnitedHealthcare recommends asking your benefits staff the following 10 questions, which were developed during the Governing Summit on Cost of Government in January 2013:

  1. Who makes up your population?
  2. What medical conditions/diseases do they have?
  3. Which of these diseases have the biggest impact on your costs?
  4. What is the financial impact of your high-risk population?
  5. Are high-performing providers being utilized more often?
  6. What programs, tools and resources are in place to support your members?
  7. When was the last time your plan design was reviewed?
  8. What are your goals for health and benefits over the next three to five years?
  9. How far are you willing or able to move along the health care continuum?
  10. How are you measuring success?

Undoubtedly, all of these questions converge to the ultimate question: Is my population healthy? As we all know, some people are healthier than others. And some are more motivated than others to get healthy or remain healthy.

One state that has implemented a wellness program to help motivate its employees to maintain a healthy lifestyle is Indiana. By partnering with Go365, a personalized wellness and rewards program, the state has encouraged thousands of employees to get to stepping, with the magic number being 10,000 steps per day as recommended by the Centers for Disease Control and Prevention.

Source: Eighth Annual Employer-Sponsored Health and Wellbeing Survey, Fidelity and NBGH 2017

Of course, employers not only want their employees to be healthy and productive citizens, but they also want to manage healthcare costs.

As shown in the figure, nearly 85 percent of employers cited this as one of their top three objectives. And approximately 55 percent of employers plan to expand investments in their wellbeing programs in the near term, suggesting that many employers are being proactive in ensuring a healthier workforce and a more viable future.

So, ask your benefits staff these 10 questions. If they have great answers, you probably have a great strategy. If they don’t, there is an opportunity to save money and improve the health of your employees.

About the author:

Anita Yadavalli is program director for city fiscal policy in NLC’s Center for City Solutions.

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