How the JHMB Makes Decision About Your Benefits
For the last 10 years, the Joint Health Management Board (JHMB) has been working hard to build and maintain a cost-effective healthcare program for the District’s employees, retirees, and their families. This hasn’t been an easy task given the numerous changes to the US healthcare market during this same period.
The dramatic annual increases in healthcare premiums, expenses, and the structural changes to the marketplace, have all presented the JHMB with an on-going, fundamental conundrum – how to provide its members with the most cost-effective, high-quality, and sustainable plan. As we look to the future, sustainability is proving to be the most important objective to meet.
Part 1 – Using Data to Drive Decision Making
You can rest assured that data is at the heart of every decision the JHMB makes. Each month the group reviews its “Dashboard” – a key packet of data points provided by the group’s Data Integrator that details revenue, expenses, and participation rates, among other things. This monthly review helps the JHMB identify trends and key gaps to make strategic adjustments to the plan. In addition, the team receives monthly reports from the Benefits Administrator, legal team, and other professional staff that shed light on areas that affect the quality and sustainability of the plan.
Most recently, the plan discovered that the price of a prescription drug covered by the plan increased exponentially in a matter of weeks. As a result, the JHMB partnered with its prescription benefits manager (PBM) to identify an alternative drug (generic) that would provide affected members with a suitable alternative at a much more reasonable price.
In addition, the JHMB has also launched a drug formulary in 2016 to slow the rise in prescription drug costs. Staying abreast of changing marketing forces (such as dramatic increases in specialty drug costs) and implementing structural changes to the plan design based on data, helps the JHMB ensure that the cost-effective, quality healthcare its members have today will be sustainable well into the future.
Part 2 – Wellness Education & Trends
In recent years, the JHMB has increased its focus on wellness education through its WellPATH Employee Wellness Program. Each year this program helps over 1,000 members receive flu shots, stay fit through Group Fitness classes, receive wellness education through monthly webinars, seasonal challenges, and annual wellness screenings. While the JHMB does its part to ensure the plan is sustainable, you can do your part by leveraging these on-going, preventive health activities to stay healthy and/or identifying health issues before they become more serious. Many of these programs are offered at significantly reduced rates and some (like the webinars and annual screenings) even reward you for participation.
Check out more about the WellPATH Program, including the Employee and Family Wellness Expo held at Hoover High School on March 19, 2016 at www.JHMBHealthConnect.com/wellpath.
More to Come
This is series of articles the JHMB will release in the coming weeks to provide you with more details about how it makes decisions on your behalf. If you have questions or ideas to share, please feel free to contact the JHMB. We welcome your feedback!