BOCA RATON, FLA. -- When it comes to explaining changes in health benefits, "It's not what you say, it's what they hear," observed Frank Luntz, one of America's top pollsters, during his keynote address at the 23rd Annual Benefits Forum & Expo here on Sept. 26, 2010.
Polling data points out ways to engage employees effectively to take a larger role in reducing health care costs, said Luntz, lead consultant for The Word Doctors LLC, a communications consultancy. As he emphasized the importance of choosing effective words that resonate with the workforce, Luntz cited a wide range of polls he's conducted revealing the hurdles employers face in earning employee support for less wasteful, more cost-conscious health care decision-making.
To begin with, employers need to understand how their employees are likely to view the world, Luntz said. "Fear of the future is real," he noted, and fearful Americans are more apt to distrust their leaders—and their employers. However, 51 percent of Americans he polled identified "ethical business practices" as the factor that would make them most likely to trust their employer.
When asked about their personal priorities, Americans responded, in order of importance, having:
• More money (top item for men).
• More time (top item for women).
• More choices.
• Fewer hassles.
To the extent that it's feasible, awareness of these priorities should be highlighted in messages to employees about their health care benefits and how they are changing.
While Luntz believes that employees must bear more of the cost of health care, including higher deductibles, in order to curtail overutilization, he doesn't like the term "consumer-driven"; instead, he prefers "employee-driven." "Consumer" denotes a purely dollar and sense relationship," he said, whereas "employee-driven" emphasizes the relationship with the employer.
Luntz noted research showing that an employer's statement that "we have made a positive change in our benefits" is viewed as a negative outcome by 51 percent of Fortune 500 employees. "Americans want stability and predictability—not surprises," Luntz said. This means that employers should demonstrate how a change will bring fewer hassles and less bureaucracy.
The statement "we have made a positive change
in our benefits" was seen as a negative outcome
by 51 percent of employees.
Whereas employees don't look kindly on "cost shifting," they favor having more personal control over their health care decisions, free from the dictates of insurance bureaucrats—and that can be a selling point for consumer/employee-driven changes.
"Demonstrate how shifting decision-making to employees can increase predictability and simplicity, and reduce red tape," Luntz advised.
Also keep in mind that the complaints employees most commonly cite with their current health plan include:
• Monthly premium costs.
• High cost of co-pays.
• Confusion over the plan.
While no one really wants to pay a higher deductible, consumer/employee-driven plans are simpler to understand and carry the clear benefit of lower premiums compared to traditional health plans, and these are facts that can and should be emphasized.
"Use numbers to demonstrate the value of what you're offering, otherwise these are just assertions," Luntz said. Moreover, unsustainable health care spending means higher premiums and a less secure outlook for the business. "Explain 'why,' 'therefore,' and 'so that,' " Luntz said. "Demonstrate why it matters to employees."
What Employees Want
What do employees most want from their health care coverage? Luntz cited polls showing the top factors to be:
• Their company's commitment to provide health care.
• To be viewed as human beings, not numbers.
• To trust that the treatment they need will be available when they need it, without delay (as in prior authorization).
• Protection for the "sacred" doctor-patient relationship.
• Less waste, fraud and abuse that triggers higher costs.
"Employees want 'my access to my doctor and my hospital, and my ability to afford it,' " Luntz said.
But more than anything else, "employees want to feel they have control," he added, which relates back to trust (that health care coverage will be there), stability and predictability (no insurance company is going to deny them necessary treatment).
In terms of effective messaging, Luntz recommended simplicity, brevity, credibility and consistency. "Employees don't want to read long texts, and won't," he said. So focus on visuals.
"When you include a graphic on the page, employees are 60 percent more likely to read that page," he said. Pictures of employees receiving services from a doctor or other health care practitioner, such as examining an X-ray with them, are particularly effective.
But that doesn't mean "dumbing down" the message in a patronizing way, Luntz said. It means clear and simple communication.
A recent poll showed that 51 percent of employees prefer to receive health care information through e-mail or online, and 26 percent prefer receiving an easy-to-read handout or booklet. "Five years ago, receiving the booklet was the No. 1 response," Luntz said.
Whether print or online, one of the best formats for communication is Q&A style, he recommended. "Ask the questions that employees are most likely to ask, the way they are likely to ask them."
And keep the message positive. "Enjoy a balanced diet" is far more effective than "eat in moderation."
"Language matters," Luntz summed up.
Stephen Miller is an online editor/manager for SHRM.
Consumer-Driven Health: Communicating CDH Plan Designs, SHRM Online Benefits Discipline, March 2006
SHRM Online Benefits Discipline
SHRM Online Health Care Reform web page