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Evidence-Based Benefit Design: Toward a Sustainable Health Care Future for Employers

Bunn, William B. III MD, JD, MPH; Stave, Gregg M. MD, JD, MPH; Allen, Harris PhD; Naim, Ahmad B. MD

Journal of Occupational & Environmental Medicine: October 2010 - Volume 52 - Issue 10 - pp 951-955
doi: 10.1097/JOM.0b013e3181f72acb
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Health care costs for employers are rising much faster than inflation. The common approach to health benefit design of increasing cost sharing has failed to contain costs. Some employers, however, have been successful at mitigating the cost trend or actually reducing health care costs. These employers have in common a dedication to data analysis, a search for cost drivers, and a willingness to adjust their approach to health benefit design to address these cost drivers. This approach has much in common with the movement in clinical practice toward evidence-based medicine. We propose that employers adopt a similar approach toward health benefits termed evidence-based benefit design, which is based on a health and productivity framework focused on direct and indirect costs. Evidence-based benefit design incorporates the relevant literature and employer-specific data that are integrated and regularly analyzed.

From the Health, Safety, Security and Productivity (Dr Bunn), Navistar, Inc, Warrenville, Ill; Northwestern University School of Medicine (Dr Bunn), Chicago, Ill; Division of Community and Family Medicine (Dr Stave), Duke University Medical Center, Durham, NC; Harris Allen Group, LLC (Dr Allen), Brookline, Mass; Health Economics and Outcomes Research (Dr Naim), Centocor Ortho Biotech Services, LLC, Horsham, Pa.

Address correspondence to: Ahmad B. Naim, MD, Health Economics and Outcomes Research, Centocor Ortho Biotech Services, LLC, 800 Ridgeview Drive, Horsham, PA 19044; E-mail: anaim@its.jnj.com.

©2010The American College of Occupational and Environmental Medicine