Understanding the “Black Box” of Employer Decisions about Health Insurance Benefits: The Case of Depression Products
Abstract
:1. Introduction
2. Results and Discussion
2.1. Sample
Size | |
% small (100 to 500 employees) | 35.2 |
% medium (501 to 2,500 employees) | 33.0 |
% large (2,501 plus employees) | 31.8 |
Type | |
% for-profit | 54.2 |
% not-for-profit | 26.3 |
% public sector | 19.5 |
Company age (SD) | 73.6 (47.5) |
Health plan carriers (SD) | 1.9 (2.1) |
Insurance Risk | |
% fully insured | 24.3 |
% self-insured | 51.0 |
% mixture of fully and self-insured | 24.7 |
2.2. Arguments Made in Support of and Against Depression Product Purchase
“What kinds of arguments were made in support of purchasing a depression product?” | Percentage of EB Employer Responses by Theme (n = 38) | Percentage of UC Employer Responses by Theme (n = 43) |
---|---|---|
Greater productivity** | 47.4% | 25.6% |
Want to provide for employee’s needs | 29.0% | 20.9% |
Consider depression to be valuable and a needed product | 26.3% | 16.3% |
Healthy workforce | 21.1% | 20.9% |
Company costs/return on investment (ROI)* | 18.4% | 4.7% |
Concerns about health care costs | 15.8% | 27.9% |
Having a depression product helps meet employer’s goals | 7.9% | 11.6% |
A product is already available | 5.3% | 4.7% |
No arguments made in support | 5.3% | 11.6% |
Co-morbid physical and mental health issues | 0% | 4.7% |
“What kinds of arguments were made against purchasing a depression product?” | Percentage of EB Employer Responses by Theme (n = 38) | Percentage of UC Employer Responses by Theme (n = 43) |
---|---|---|
No arguments made | 47.4% | 30.2% |
Cost or benefit to employer | 31.6% | 46.5% |
Confidentiality concerns | 18.4% | 11.6% |
Value is not certain | 15.8% | 7.0% |
It is (or should be) covered by health insurance | 7.9% | 7.0% |
Not needed or used by employees | 7.9% | 20.9% |
Government mandate | 0% | 4.7% |
Too stigmatized an issue for employer to offer for employees | 0% | 4.7% |
Not employer’s business | 0% | 2.3% |
Less valuable than other health conditions | 0% | 2.3% |
Not sure how to publicize | 0% | 2.3% |
2.3. Triggers to Depression Product Purchase
“Your organization has not purchased a depression product. Imagine that two years from now, your organization decided to purchase a depression product. Can you describe the changes that must have occurred for your employer to make that decision?” | Percentage of EB Employer Responses by Theme (n = 122) | Percentage of UC Employer Responses by Theme (n = 124) |
---|---|---|
Visible (public) depression episode or otherwise demonstrated need | 25.4% | 20.2% |
Data showing lost productivity or poor performance | 21.3% | 17.7% |
Increased health care costs | 17.2% | 14.5% |
Change in/support from management | 10.7% | 13.7% |
Economy/company finances have to change | 11.5% | 5.7% |
Demonstrated return on investment (ROI) or cost-benefit analysis | 8.2% | 5.7% |
None, does not apply or no response | 7.4% | 5.7% |
Better products made available | 6.6% | 2.4% |
Need additional information, understanding or training | 5.7% | 4.8% |
Products should be part of health package | 4.9% | 7.3% |
Company has or is taking steps to implement program | 3.3% | 4.8% |
No need for product/need would have to be demonstrated | 3.3% | 6.5% |
Not sure | 2.5% | 2.4% |
Requests from employees | 1.6% | 2.4% |
Change in provider network | 1.6% | 0% |
Confidentiality | 1.6% | 0% |
Want to offer support to employees | 1.6% | 0% |
Other more urgent health issues must be resolved first | 0.8% | 0.8% |
Government mandate | 0.8% | 1.6% |
Better relationship with HMO/providers | 0.8% | 0% |
A depression product should be simple to use | 0.8% | 0% |
Do not want to appear to encourage treatment for depression | 0% | 0.8% |
2.4. Influence of Return on Investment in Benefit Decision-Making
“Some health benefits/initiatives have a positive return on investment to the organization, while others do not. During the past 12 months, to what degree did return on investment influence your decision-making about additional health benefits/initiatives?” | Percentage of EB Employer Responses by Theme (n = 127) | Percentage of UC Employer Responses by Theme (n = 130) |
---|---|---|
Large influence/this is an important issue | 44.1% | 45.4% |
None/did not answer | 21.3% | 14.6% |
Some influence | 19.7% | 17.7% |
Not sure | 11.0% | 16.9% |
Hard to calculate, but trying to determine | 6.3% | 6.2% |
Does not apply | 3.9% | 6.9% |
Hard to calculate and not trying to determine | 3.9% | 2.3% |
Have other priorities now | 2.4% | 3.9% |
2.5. Discussion
3. Experimental Section
4. Conclusions
Acknowledgments
References and Notes
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© 2013 by the authors; licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution license (http://creativecommons.org/licenses/by/3.0/).
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Rost, K.; Papadopoulos, A.; Wang, S.; Marshall, D. Understanding the “Black Box” of Employer Decisions about Health Insurance Benefits: The Case of Depression Products. Risks 2013, 1, 34-42. https://doi.org/10.3390/risks1010034
Rost K, Papadopoulos A, Wang S, Marshall D. Understanding the “Black Box” of Employer Decisions about Health Insurance Benefits: The Case of Depression Products. Risks. 2013; 1(1):34-42. https://doi.org/10.3390/risks1010034
Chicago/Turabian StyleRost, Kathryn, Airia Papadopoulos, Su Wang, and Donna Marshall. 2013. "Understanding the “Black Box” of Employer Decisions about Health Insurance Benefits: The Case of Depression Products" Risks 1, no. 1: 34-42. https://doi.org/10.3390/risks1010034