Keep health costs down & employees happy: Designing millennial benefits framework — Marilyn Crawford, HAWA

00:04 Milton: Great. Thank you so much everyone for joining us for another edition of Telehealth Failures & Secrets to Success. And this week we have a personal treat for you, Marilyn. And she’s just a phenomenally successful entrepreneur, business executive. A lot of her friends call her the Rachael Ray of healthcare. And I guess… And I think all of you have never seen her bio, I think she’s gonna share some really, really interesting insight, to not just really about health but really just the bigger picture in there. So I’ve been personally looking forward to her presentation for a while. I guess, Marilyn, before we start in there, maybe you could just share a bit about yourself. How did you get into the healthcare industry? Just everything about maybe paint a more well rounded dimension of who you are.

01:01 Marilyn: That would be great. Thank you so much for that introduction, Milton. Happy to be here on the webinar today. I started my journey in healthcare over 30 years ago in hospitals and health systems. Also worked in some physician practice. Looking at all sides of the healthcare continuum brought me down the road of community health, as well as public health programming. I then entered the world, the exciting and dynamic world, of corporate health and wellness, and spent quite a bit of time there before proceeding onto the insurance side of things. So I’ve really been fortunate to really have those opportunities because it gives me an advanced look at all sides of the continuum. And I believe that that’s gonna come into play today as I talk to you all about keeping healthcare costs down and employees happy. And how we might design millennial benefits in this very fast changing workforce.

01:58 Milton: Super. How about Marilyn, how about you before that, where did you grow up? What did you…

[laughter]

02:06 Marilyn: Oh my goodness. I actually grew up in an area called the Quad Cities. So it bordered Illinois and Iowa. Very much a farm community. And shortly after… Right before I got married, moved up into the Chicagoland area.

02:28 Milton: Okay. Super. I guess what we’ll do is maybe, Marilyn, if you could just share with us a couple of slides just sharing some of your thoughts on this. Then after that we’ll just open up to the audience. We’ll just have a conversation.

02:43 Marilyn: That sounds great. Thank you, Milton. So, we’re getting ready. The millennials are the fastest growing employee population now. And they act and think a little bit different than previous generations. One of the first things that myself, as well as the millennials, do when they sit down at a dining establishment is they check for the WiFi password. They also are up to speed on the latest and greatest of absolutely everything, especially when it comes to diet and exercise. As the second illustration for a little comic relief says, “I’ll have a skinny, gluten free, egg white only, fat free cheese omelette please.” So we know we’ve entered something new and different.

03:30 Marilyn: But to understand benefits, my belief is we have to understand cost. And so, do you know the annual treatment cost per age group here? I must say that I’d like to share that with you. It really spans from about $1,800 all the way to $5,500 depending upon that age grouping. So what’s the problem that we see? The problem is we have to understand that, as we look at a three-generation overview, you’ll notice on the bottom line, our millennials are the lowest health care cost. So it just begs us to wanna know more about this fast-growing millennial population. While the Gen-Xers are still in the picture, big and bold, they’ve got that mid-range cost. But very important to note, that baby boomer now is about 13% of the average workforce. And they’re the ones that are still going to the PCP, the primary care, 80% of the time.

04:29 Marilyn: So what’s the difference? The shift is towards retail clinics and telehealth, as we are seeing our millennial population race to retail clinics as well as use telehealth. It’s interesting to note this fact that I put in red. The Gen-Xers, one in three don’t go to the doctor out of fear of something, finding out that something’s wrong with them. Isn’t that an interesting perspective as you prepare for your benefits in 2018? And 93% of the millennials aren’t scheduling those preventative physician visits. So they don’t have that baseline data that they really could use, or do they?

05:08 Marilyn: Now let’s take a close up look at the retail clinics. Why are they going to the retail clinics? They’re going there for so many different things. And the important thing to note is not only the millennials are going there, but Generation X, baby boomers, and the matures are also going there. And for a variety of reasons. We think of retail clinics for things like flu shots or flu-like symptoms, or things like that. But they’re also accessing them for things like puncture wounds, rashes, getting a blood pressure check, looking at lab services, things like that. So everywhere for the millennials, from 38% to 64% of those surveys are using those clinics. So we wanna make sure we look at that in our benefit strategy.

05:53 Marilyn: Now a close up on telehealth. There was over 70% using telehealth and all of you on the webinar today, I would guess, or most are very familiar with episodic care. It’s been widely discussed that it’s a general healthcare where you can see a doctor over secure video or over the phone, you’re able to look at general health conditions like colds and flu, eye infections, ear infections, 24/7. And it’s built into most, if not all, of our healthcare plans and strategy. What you may not be really familiar with is the up and coming other use cases that are emerging now like wellness management, [06:38] ____ care, telepsych, even things like telestroke, telespeech, ER diversions, second opinion, teledental, can you believe that? I can because I’ve been having the honor of really visiting with a lot of different organizations that are pioneering in telehealth over the last few years and it’s an exciting time to really create efficiencies and decrease costs overall. But it’s even more important to know because we’ve got this great big huge group of millennials entering and emerging in that workforce in full force numbers. A matter of fact, if you can look from my chart here, today it’s about 40%, a little over 40%. And then in two short years, we’re gonna be at 50% and then 12 years, 75% of that workforce.

07:32 Marilyn: Is that an aha moment for you? I know it was for me when I found out about it and it really encouraged me to do this great research on understanding the millennials. To build benefits towards the millennial fastest growing population, we need to understand that this group grew up with technology. They’re very advanced and it’s exciting to see their minds work. They want to be very progressive digitally, it’s just a must. It’s a key. That focus on efficiency and affordability is very important because the do get a little bit restless if things are done in a more old fashioned way. They also will be the first to check numbers, transparency figures, find the cheapest treatment plan, as well as appeal something that doesn’t seem quite right to them. Interesting enough though, I don’t know if you’ve heard this, but we call them the “drive-thru generation” because that’s how they want their healthcare delivered. Not that they’re gonna get it at a McDonald’s or a different chain like that, however they want it quick and they want it efficient and they want it affordable. They don’t see a doctor all that often, it’s actually less than once a year and they do prefer seeing them virtually; all really important things to know, if you look at those stats that I just showed you, as far as that staggering number of 75% in a few short years.

09:00 Marilyn: So, what else is important that I want you to understand about millennials? Did you know millennials want more coaching and feedback? Gosh, not every generation was really eager to hear feedback. A matter of fact, some of our generations were really not eager at all to hear our feedback, but this generation is living a little bit stressed out, little bit sleep deprived, and it could be because of some of the technology that they have in their hands these days. But they also are taking some chances with some of the gaps in care and the education that they lack, but they do love to do as much research as possible all over the internet. So, we wanna make sure our sources are the right sources. They do rely on their social life with social media and they’ll use that to research healthcare. They feel the same about exercise and fitness as we felt in past generations about the ability for an antibiotic to cure an infection. It’s that close to heart to them. And the focus is more on that day to day usage of health and wellness and lifestyle choices leading to a long-term payoff for them.

10:15 Marilyn: I love the millennial population. They have the highest education of past generations, so they’ve got endless amounts of ideas to use in our organizations. It also is a very diverse minority, diverse generation. So, we’re seeing all sorts of new opportunities as we look at the millennial generation, but how can we take all this great information and put it into our conversations about how we can create new benefit strategies and a new healthcare system. And what’s the big problem? I’ve identified, Milton, the biggest problem is that our current healthcare system was built for that estimated 13% of the workforce. It’s the highest cost, but also the lowest percent now of the workforce. So, I’m encouraging everyone to look at a new healthcare system and benefit strategy that’s more focused towards that fastest growing employee population, while still meeting the needs, the important and very valuable needs of our aging workforce. Very important that we change our focus as well as reverse our status quo.

11:32 Marilyn: Now, this time of year and throughout our lives, we’ve probably seen a few Charlie Brown cartoons, and in this particular one, Lucy says, “The doctor is out.” So, what does that mean to us? The doctor is out? Wait a second. All the generations past wanted to see the doctor in person. Now, we’ve got that focus, that high focus on digital efficiencies and affordability so that when we look at our plans, when we look at our incentive strategies, when we look at our co-paid and our deductibles, focusing all of that towards this new generation of millennials that’s coming up, our digital efficiencies and affordability is gonna be very important.

12:15 Marilyn: And Milton, alternative care models is the way to go ’cause only a few percent are using traditional models. Very important that we look at different types of incentives towards those alternative care models. Now when we look at technology, latest and greatest is at the top of the list, so do an audit on all your providers and all your benefit providers. Look at all the different platforms and say, “Is this too much? Is this a little bit old and ageing? Do I even wanna use it?” And if the answer is no, it might be time to look at some new opportunities, some new partners. But it’s a great time to do that reversing of the status quo. So often we hear from many of those that I speak with on a day to day basis, “Well, I just wanna do the same thing ’cause it’s kinda easier, I hate to say that, but it is just a little bit easier.” We’ve all said that for a little bit too long. So I encourage everybody to take a fresh look, and now I’m actually seeing that happen. And it’s very exciting to see people get engaged in that conversation again as far as these best in class benefits.

13:27 Marilyn: Now, if the benefits have adopted connected care, that’s gonna meet the needs of the millennials quite well, because they’re all about connected care devices and wearables. So they’ll think you’re speaking their language and they’ll be so excited that you’re also immersed in that as well. But I do encourage you to go beyond episodic care this year. Look at Telehealth Services in 2018 that include everything from episodic to telewellness to chronic, ideally in a interconnected approach. Knowledge is power. I’ve got a quick focus on employers and then a quick focus on our physician population that are on the webinar today. But employers, it has to be easy, if you’ve got to go to too many different log ins and too many benefit providers, the millennials are gonna shut the door and find something that works for them. They also will delay and avoid, and this is really important. Delaying and avoiding treatment is something that they would do to avoid that cost, however they’re not understanding that that may have an even larger significant impact and a larger cost because they did delay or avoid.

14:41 Marilyn: Now, they are very, very good at self treating at home, and getting advice from many different trusted sources including physicians and including other health care advocates, nurses, other people that they respect and a lot of information online. Doctor Google we call it. Millennials cite affordability as number one in picking their healthcare plans. So look at your plans that you’ve got going for this year, and your plans for the future. Is that gonna meet… Which one is the millennials gonna pick, and is that gonna work very well for them. Millennials struggle with decisions too. I’ve stated it here and it’s one of things that there’s so much information out there now. So all that information coming at you on a day to day basis, kind of brings a paralysis of analysis. So, if we limit the choices, if we take down the number of benefit providers and we consolidate them into an easy to use system, app or platform, that’s gonna get widely used. If there’s too much, we might not pick anything.

15:50 Marilyn: Now from the physicians, ’cause I know we have a lot of physicians. All is exciting and new because we’ve got faster payment options, we can get paid faster. We just have to make sure that we’re doing that electronically in our practices. These millennials, they love conversation, they want to have conversation with their physician, that’s what the surveys are saying. But they also wanna commune electronically versus face to face, so that virtual practice is gonna be very important. And kind of creating that retail clinic feel in your practice, I think is a really good opportunity for you to re-look at practice management.

16:29 Marilyn: Engaging that patient with a patient engagement EHR platform is gonna be necessary, they wanna talk to you through that platform. And using mobile devices to engage those patients. I think when we look at things from a physician’s side, it’s very interesting because they wanna be part of the solution, they wanna be part of the conversation, as we advise and support them. And they wanna be ahead of us, they wanna be in the front of the line with their own health support and knowledge. So I ask you all and I ask you Milton, are you ready for the fastest growing population in our work…