Lebanon
D-H offers its employees three different health care plans, and the coverage with the lowest deductible is $1,400 for an individual and $2,800 for a family. While D-H said insurance premiums haven’t increased since 2012, the requirement that employees pay mainly out of their own pockets until they meet the deductible has deterred some of them from getting necessary care and meant that some of them ended up in emergency rooms or inpatient beds, Dartmouth-Hitchcock CEO Joanne Conroy said last week.
“High-deductible health plans actually do not make people healthy,” Conroy told a group gathered at Colby-Sawyer College in New London last week for a talk on the future of health care.
Conroy said she was concerned that workers making less than $50,000 at D-H — which has some 10,000 employees — are opting to skip medications or preventive doctor visits they need to stay healthy because of the deductibles.
Health savings accounts, or HSAs, allow people with high-deductible health insurance plans to set aside money on a pre-tax basis to pay for qualified medical expenses such as deductibles and co-payments. The threshold to be considered a high-deductible plan is $1,350 for individuals, $2,700 for a family.
For 2019, D-H will increase its individual HSA contribution from $300 to $1,200 for those making less than $50,000 a year and from $300 to $600 for those earning between $50,000 and $150,000, D-H spokesman Rick Adams said in an email.
As a result, 74 percent of all D-H employees will see an increase in D-H’s contribution to HSAs, he said.
Adams declined to provide information on how many employees fit into each income bracket.
“As you know, we regard information on individual compensation and benefits as confidential, except as required by law, as in our annual IRS Form 990 filing,” he said in response to the request.
In helping its lower-paid employees in this way, D-H aims to reduce out-of-pocket costs for those employees and ensure that they get the care they need, Conroy said.
The change, which goes into effect next year, also is aimed at retaining and recruiting employees in a tight labor market, Conroy said.
“I feel like I’m back in the 1950s when employers were trying to attract really highly qualified employees to their organizations and they did it with health insurance,” she said. “You know we’re back there again because we’re almost a zero-unemployment state.”
The unemployment rate in New Hampshire was 2.7 percent in September, according to the latest numbers from the New Hampshire Employment Security Economic and Labor Market Information Bureau.
When D-H administrators shared news of the HSA payments with housekeeping staff, some cried tears of joy, Conroy said CFO Dan Jantzen told her.
“All money is green,” Conroy said. “It can be their compensation. It can be their benefits. But it’s all the same.”
Conroy indicated that the organization may do more to address the problem of high-deductible health plans in the future.
She said that employers across the country are facing a similar challenge, and she pointed to the joint effort by Berkshire Hathaway, Amazon and JPMorgan Chase to develop an independent health care company as a sign that “something’s wrong with the way we’re delivering care.”
In addition to this benefit change, Conroy in her New London speech also outlined plans to implement new practices and technology. For example, as part of the effort to reduce costs, Conroy said D-H has introduced “prehab,” which helps patients develop the strength they will need to recover from a joint replacement surgery ahead of time.
As a result, in recent years time in the hospital following a joint replacement has been reduced from a few days to an outpatient procedure, she said.
D-H’s telehealth program, known as Connected Care, which uses video technology to offer the expertise of specialists in a variety of areas to hospitals throughout northern New England, helps community hospital providers care for patients closer to home and avoids transfers to higher levels of care, she said.
Beyond that, Conroy said she expects that New Hampshire soon will be able to make virtual visits directly to patients in their homes.
“A lot of the services we give are not hands-on,” she said.
Speaking with patients through a video call can be an efficient way for patients to get answers to their questions without a trip to see their provider in person, she said.
At the same time, Conroy also said there may be some circumstances when it makes more sense for providers to care for patients at home through home visits.
For example, patients who are sick enough to be in a hospital but live in the senior living facilities near Alice Peck Day Memorial Hospital in Lebanon and near Mt. Ascutney Hospital and Health Center in Windsor may be able to receive care from their providers in their own homes, she said.
“More to come on this,” she said.
Nora Doyle-Burr can be reached at ndoyleburr@vnews.com or 603-727-3213.
