INCREASING EMPLOYEE deductibles, copays and premium contributions are obvious, though objectionable, solutions to the problem employers face with mounting health care costs. Alternatively, some companies have become creative in their attempts to reduce these costs — or at least attempt to slow their growth.
A recent article in The Wall street Journal described some of the extremes to which companies will go to deal with the rising cost of health care beyond passing along the cost to workers. Among the novel approaches cited was a company that is tackling the high expense of medications by giving incentives to its workers to travel to Mexico to get their prescriptions filled at lower prices.
Employees choosing this option also receive $500 to keep for themselves each time they go to fill a three-month prescription. The article goes on to describe that the only way one company could find to reach a low-cost provider of some drugs was to “put (employees) on a plane and send them to Tijuana.” Despite the cost of travel and cash payments, the firm reportedly saved around 40 to 60 percent compared with getting medications in the United States.
But there is a better way to reduce health care expenses, and it is readily available to employers, large and small: Provide a working environment that nourishes employees, psychologically by training managers and supervisors in a better way to intrinsically motivate their subordinates. Many studies have sourced the causes behind trips to the doctor to be stress-related. And a major cause of many psychosomatic illnesses is the anxiety attributed to dealing with one’s boss.
This solution has the potential to decrease claims activity — not by inhibiting (due to increased copays and deductibles) sick employees from getting the medical care they need — but by getting at the root cause.
A leading theory of motivation is Self-determination Theory, developed by my colleagues and co-authors Ed Deci and Rich Ryan. They have inspired and conducted research throughout the world. Among the findings: When certain psychological needs are satisfied, leading to the experience of intrinsic or self-motivation, employees perform their work more effectively and with less anxiety.
I was the lead author of one such study, involving more than 500 workers. Participants were asked — by way of responses to a series of items, which they completed anonymously — how their needs for autonomy, competence and relatedness were being met at work. The questionnaire had statements to which they responded on a scale from 1 (not being satisfied) to 7 (being satisfied very well). In this study, the satisfaction of these needs correlated positively with, among other things, a measure of health.
For example, one item assessing how the need for autonomy, or having some voice, was being met, had employees respond to the statement “I feel I can make a lot of inputs in deciding how my job gets done.” A second need is for competence — to be able to grow and accomplish things at one’s job. A sample question is: “I have been able to learn interesting new skills on my job.” The third category of need is that for relatedness or connectedness, that is, experiencing mutual reliance and respect. An example in this area is: “I get along with people at work.”
Managers can do many things to improve worker satisfaction in these areas in a positive way. That those in supervisory roles have an effect on their workers’ motivation is evident throughout the workforce. For example, the excessive use of control through the proverbial “carrots and sticks” method has been largely criticized for adding to workers’ anxiety, and thereby increasing errors. By contrast, providing encouragement and a sense of real team has brought out the very best in athletes as well as production line workers and office employees.
Granted, it is not as simple as it might sound in this short treatment of the topic, but it is eminently possible, if the corporate will is there. There is the potential for creating an enduring healthy culture.
An old adage is “What gets measured gets done.” Improving the work environment can not only reduce claims experience but can lead to greater efficiency and create a more enjoyable and healthy place to come to work each day.