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How a Home Health Transformed Employee Benefits with ICHRA

Written by Susanne | Jul 30, 2024 8:04:58 PM

Gallagher Home Health Services, a company navigating the complexities of the healthcare industry, faced significant challenges in providing cost-effective and flexible health benefits for its diverse workforce.

Struggling with rising insurance costs and the limitations of traditional group health plans, Gallagher Home Health Services sought a solution that could offer better choices and affordability for their employees.

 

Company Overview

Gallagher Home Health Services is headquartered in Pittsburgh, Pennsylvania and operates with two satellite offices. The company primarily focuses on providing home healthcare services, with 75% of its workforce comprising remote field staff, including therapists and nurses, who deliver care directly to patients at their homes or healthcare facilities. The remaining workforce comprises semi-remote office staff, with around 25 employees consistently working there.

 

Gallagher Home Health Services’ Struggle with Rising Costs and Recruitment

Gallagher Home Health Services faced several significant challenges, primarily driven by the impacts of COVID-19 and shifts within the healthcare industry. The pandemic brought widespread employment issues, with many healthcare workers seeking non-direct patient care roles. This led to a tightened labor market and increased difficulty in recruiting and retaining staff. This trend hit Gallagher Home Health Services hard, as they rely heavily on field staff like therapists and nurses who provide care directly to patients.

Additionally, the evolving landscape of healthcare reimbursement, particularly changes in Medicare and insurance revenue streams, further complicated Gallagher's operational environment. These financial pressures were compounded by the rising costs of group health insurance, which saw double-digit renewal rate increases year after year. Highmark and UPMC, the primary insurers in their area, were proposing renewal rate hikes of 10-20%, making it increasingly difficult to maintain affordable and satisfactory health coverage for their employees.

The combination of a competitive job market, high insurance costs, and the need to offer appealing benefits to attract and retain talent created a perfect storm of challenges for Gallagher Home Health Services. To overcome these obstacles, they needed a solution that could provide financial stability, flexibility, and competitiveness in their employee benefits.

 

 

Inefficiencies and Limitations of Traditional Health Insurance

Before partnering with Take Command, Gallagher Home Health Services relied on traditional group health insurance plans offered by major local providers, Highmark and UPMC. These plans, while comprehensive, became increasingly untenable due to skyrocketing renewal rates. Each year, Gallagher faced double-digit percentage increases in premiums—starting at 10-15%, then 15-20%, and eventually surpassing 20%. Despite having relatively few claims, the company was still hit with substantial premium hikes, exacerbating its financial strain.

The group health insurance model presented additional challenges in meeting the diverse needs of Gallagher’s workforce. Finding a one-size-fits-all solution was nearly impossible with employees ranging from single individuals to families of various sizes. Health-conscious employees sought basic coverage, while others required comprehensive plans with extensive benefits. This lack of flexibility often resulted in dissatisfaction among employees, who felt the offered plans did not adequately match their health needs and financial situations.

The high costs associated with these plans impacted Gallagher's ability to attract new talent. Potential job applicants would often reject offers due to the prohibitive cost of the available health insurance options. Even when Gallagher matched or exceeded salary offers from competitors, the expensive and inflexible insurance plans deterred prospective employees. The local competition between Highmark and UPMC further aggravated the situation, making it difficult for Gallagher to stand out in the job market.

Faced with these persistent challenges, Gallagher Home Health Services realized the need for a more adaptable and cost-effective approach to employee health benefits. This realization set the stage for exploring innovative solutions like the Individual Coverage Health Reimbursement Arrangement (ICHRA) to better serve its workforce and stabilize its financial outlook.

Discovering a New Path: Exploring ICHRA

Gallagher Home Health Services' journey towards finding a more sustainable health benefits solution began with their broker, Doug Moore. John Larson, who had a background in benefits consulting, was already familiar with various healthcare funding models. Having worked with Union Trust Funds in Pittsburgh, New Jersey, and West Virginia, John had experienced the intricacies of self-funded health plans and the volatile stop-loss market, particularly during the 2008 financial crisis.

Doug introduced John and the Gallagher team to Individual Coverage Health Reimbursement Arrangements (ICHRA) from Take Command. The ICHRA model was appealing because it offered flexibility and cost control, addressing the specific needs of Gallagher’s diverse workforce. Unlike traditional group health insurance plans, ICHRA allowed employees to choose from various individual health plans tailored to their unique health needs and financial situations.

The introduction to Take Command’s ICHRA came at a crucial time. Gallagher was caught between the rising costs of traditional health insurance and the need to offer competitive benefits to attract and retain employees. The traditional models were no longer viable, as they provided little flexibility and imposed substantial financial burdens due to their one-size-fits-all approach.

Intrigued by the potential of ICHRA, John and his team began exploring this new option. The connection to Take Command was solidified through a doctor's group that Doug had previously worked with, who had successfully implemented ICHRA. This real-world example of ICHRA’s effectiveness provided Gallagher's confidence to consider it seriously.

Doug's recommendation and the peer group's successful implementation underscored ICHRA as a viable solution. The flexibility to choose from various plans and control costs without the unpredictability of traditional insurance renewals presented a compelling case for Gallagher Home Health Services. This marked the beginning of their transition to a more adaptable and financially sustainable health benefits model.

 

Navigating the Decision-Making Process: Choosing ICHRA

The decision-making process at Gallagher Home Health Services for transitioning to the ICHRA model was both thorough and collaborative. The primary decision-makers included Ben, the President and CFO, and the HR team, with John playing a crucial role due to his extensive experience in benefits consulting.

Faced with the escalating costs and inflexibility of their current health insurance plans, Gallagher Home Health Services was determined to find a better solution. Their trusted broker, Doug Moore, provided comprehensive information about the ICHRA model. He highlighted its potential to offer employees cost control, flexibility, and various plan options. This detailed information helped Gallagher see ICHRA as a feasible alternative to traditional group health insurance.

The decision-making process involved several key steps:

  1. Information Gathering and Analysis: Gallagher Home Health Services conducted an impact analysis with the help of Take Command. This analysis provided insights into how ICHRA would affect their financials, employee satisfaction, and overall benefits strategy.
  2. Collaborative Discussions: Ben and the HR team held multiple discussions to weigh the pros and cons of the ICHRA model. They considered cost savings, employee preferences, and improved recruitment and retention potential.
  3. Broker Support: Doug Moore was pivotal in offering expertise and answering questions about the ICHRA model. His guidance helped demystify the complexities of ICHRA and provided a clear path forward.
  4. Due Diligence: Gallagher conducted due diligence by comparing ICHRA with other potential solutions. They evaluated the risks and benefits, considering the diverse needs of their workforce and the financial implications for the company.

During this period, Gallagher Home Health Services managed various other operational demands, including recruiting, hiring, and employee relations. Despite these pressures, the team remained focused on finding a sustainable benefits solution aligned with their strategic goals.

Ultimately, the collaborative decision-making process, supported by detailed analysis and expert guidance, led Gallagher Home Health Services to adopt the ICHRA model. This decision promised a more flexible, cost-effective approach to employee health benefits tailored to meet the unique needs of the workforce and the company's financial goals.

Seamless Implementation and Remarkable Results

Implementing the ICHRA model with Take Command’s assistance was pivotal for Gallagher Home Health Services, bringing about significant positive changes in its benefits strategy. The transition process, while initially complex, was made smoother with the dedicated support from Take Command and their broker, Doug Moore.

Implementation Process:

  1. Initial Setup and Communication: Take Command worked closely with Gallagher to set up the ICHRA model. They provided detailed guidance on structuring the health reimbursement arrangements to align with the company’s budget and employee needs. Clear communication was maintained throughout the process to ensure all stakeholders understood the new system and its benefits.
  2. Employee Education and Enrollment: Educating the employees was a critical step. Take Command conducted informative sessions to help employees understand the ICHRA model, how to choose the right individual health plans and the benefits of having personalized health coverage options. This education phase ensured that employees were well-informed and confident in healthcare decisions.
  3. Technical Support and Platform Utilization: Take Command’s tech-forward platform played a crucial role in simplifying the administration of the ICHRA. The user-friendly interface allowed the HR team and employees to manage their health benefits efficiently. Gallagher Home Health Services leveraged this platform to streamline the benefits administration process, reducing the administrative burden on their internal team.

Transformative Results and Lasting Impact

The shift to the ICHRA model yielded impressive results for Gallagher Home Health Services, addressing its key challenges and improving overall employee satisfaction.

  1. Cost Savings: One of the most notable outcomes was the significant reduction in healthcare costs. By transitioning to the ICHRA model, Gallagher was able to control their health benefits budget more effectively, avoiding the unpredictable and steep renewal rate increases associated with traditional group plans. This cost control enabled them to allocate resources more strategically across the organization.
  2. Improved Recruitment and Retention: The flexibility and choice provided by the ICHRA model positively impacted recruitment and retention. Prospective employees were attracted to the personalized health benefits, which offered various plans tailored to individual needs and financial situations. Existing employees appreciated the ability to choose plans that best suited their families, leading to increased job satisfaction and loyalty.
  3. Employee Satisfaction: The feedback from employees was overwhelmingly positive. The ability to select from multiple health plans and carriers meant that employees could find coverage that matched their specific health needs and preferences. This personalized approach enhanced their satisfaction and contributed to a stronger sense of well-being and support from their employer.
  4. Fairness and Equity: The ICHRA model introduced a fairer contribution system. Unlike the previous one-size-fits-all approach, the new model ensured that contributions were aligned with individual circumstances, such as family size and health requirements. This equitable distribution of benefits helped foster a more inclusive and supportive workplace culture.

Key Benefits of Take Command’s ICHRA

Gallagher Home Health Services' adoption of Take Command’s Individual Coverage Health Reimbursement Arrangement (ICHRA) brought several key benefits, transforming its approach to employee health benefits and addressing its most pressing challenges.

Flexibility in Plan Choices and Cost Control

One of the primary advantages of the ICHRA model is its flexibility. Unlike traditional group health plans, ICHRA allows employees to select from various health insurance plans that best fit their needs. This flexibility meant that Gallagher’s employees could choose plans with the required coverage, whether they were single individuals or families with varying health needs. This personalized approach ensured that employees were no longer stuck with a one-size-fits-all plan that didn’t cater to their circumstances.

For Gallagher Home Health Services, this flexibility translated into significant cost control. By setting a fixed budget for health reimbursements, Gallagher could more effectively predict and manage their healthcare expenses. This control helped them avoid the unpredictability of steep renewal rate hikes, ensuring financial stability and better resource allocation.

Enhanced Recruitment and Retention

The ability to offer personalized and affordable health benefits substantially impacted Gallagher’s recruitment and retention efforts. Before implementing ICHRA, Gallagher struggled to compete with other employers due to their group health plans' high costs and limited options. Potential employees often reject job offers because of the prohibitive cost of health insurance.

With ICHRA, Gallagher could offer a competitive edge in the job market. Prospective employees were attracted to the company’s flexible benefits, which allowed them to choose their preferred insurance plans and carriers. This option significantly improved Gallagher’s ability to attract top talent in the competitive healthcare industry.

For existing employees, the personalized benefits enhanced job satisfaction and loyalty. Knowing that they could select plans that suited their individual and family needs made employees feel valued and supported, leading to increased retention rates.

Fair Contribution System

The ICHRA model introduced a fair and equitable contribution system for Gallagher Home Health Services’ workforce. Under the previous group health plan, all employees paid the same amount regardless of their specific needs or family size. This system was particularly challenging for families with more dependents, who felt the contributions were disproportionate.

With ICHRA, contributions are aligned with individual circumstances, ensuring that employees pay their fair share based on their chosen plans and family configurations. This equitable distribution of costs fostered a sense of fairness and inclusivity within the organization, enhancing overall employee morale.

Access to a Wide Range of Plans

The ICHRA model opened access to various health plans and carriers. Employees could choose from multiple networks, including HMO and PPO options, ensuring they found coverage matching their health needs and financial preferences. In areas like Allegheny County, employees had access to over 70 plans, providing ample choices and competitive pricing.

This extensive selection meant that employees no longer had to compromise on their health coverage. Whether they needed comprehensive plans with extensive benefits or basic coverage with lower premiums, they could find suitable options within the ICHRA framework.

Support from Take Command

Throughout the transition and ongoing management of the ICHRA model, Gallagher Home Health Services benefited from Take Command's dedicated support. Their tech-forward platform streamlined the administration process, reducing the time and effort required to manage health benefits. Regular interactions with their client success manager ensured that issues or questions were promptly addressed, making the process seamless and efficient.

Take Command’s expertise and customer-centric approach gave Gallagher the confidence and resources to successfully implement and sustain the ICHRA model, ultimately leading to a more robust and effective health benefits strategy for their organization.

Reflections and Key Insights from Gallagher Home Health Services' Journey

Reflecting on its journey with Take Command’s ICHRA, Gallagher Home Health Services has garnered several valuable insights and lessons that have significantly shaped its benefits strategy and overall approach to employee care.

Reflections from John and the Gallagher Team

John and the Gallagher Home Health Services team have consistently expressed satisfaction with the ICHRA model transition. One of the most notable aspects of this transition was the comprehensive support provided by Take Command. From the initial setup to ongoing management, Take Command’s team, particularly their client success manager, Caroline, ensured a smooth and efficient implementation process. Regular weekly check-ins helped address emerging issues and provided a platform for continuous improvement.

Key Benefits Realized

The flexibility and cost control offered by the ICHRA model have proven to be game-changers for Gallagher. Employees now have the autonomy to select plans that best meet their individual and family needs, resulting in higher satisfaction and engagement. The financial predictability of setting a fixed budget for health reimbursements has allowed Gallagher to manage their expenses more effectively, avoiding the unpredictable hikes associated with traditional group plans.

Advice for Other Home Health Agencies

For other home health agencies considering a switch to the ICHRA model, John offers some key advice:

  1. Thorough Research and Due Diligence: Understand the specific needs of your workforce and evaluate how the ICHRA model can address those needs. Conduct a detailed impact analysis to assess potential benefits and challenges.
  2. Employee Education: Ensure your employees are well informed about the new benefits model. Provide them with the necessary resources and support to make informed decisions about their health coverage.
  3. Leverage Expert Support: Partner with a reliable and experienced HRA administrator like Take Command. Their expertise and customer-centric approach can significantly ease the transition process and ensure long-term success.

 

Final Thoughts and Next Steps

Gallagher Home Health Services' transition to Take Command’s ICHRA model has been a transformative journey, bringing about substantial improvements in cost control, employee satisfaction, and overall benefits strategy.

As Gallagher Home Health Services continues to grow and adapt in the dynamic healthcare landscape, its experience with ICHRA provides a valuable blueprint for other organizations seeking to enhance their benefits offerings. If you want to transform your healthcare benefits and achieve similar success, explore ICHRA or contact Take Command for a personalized consultation.

Ready to take the next step in optimizing your health benefits? Learn how Take Command’s ICHRA can give your organization the flexibility, cost control, and employee satisfaction you need to thrive.