How to manage healthcare costs

Employers can help manage health insurance costs by supporting employees to live a healthy life.

The recent National Health Service (NHS) turmoil and serious lapses in quality of care have prompted a call by a number of employers to address these deficiencies and the potential impact on their workforces.

But how should employers do this? Should they revisit strategic risks? Should they add private medical insurance (PMI) to their remuneration package ? Or should they go further and organise their own on-site health practice? And can they afford to do so?

A primary consideration for employers should be the extent to which employees appear to be less willing to take responsibility for their own health. They are more likely to turn to their doctor to alleviate anxiety about health as well as for minor ailments. Worse still, they overload accident and emergency departments with trivia, putting at risk those who need emergency help.

Poor lifestyle choices give the UK the second highest level of obesity in the world, with its consequences of diabetes, stroke, heart disease and cancer, and our propensity for binge drinking is driving up liver damage.

More frail elderly

But there are unavoidable healthcare issues, too. With people living longer, there is an increasing number of frail elderly, and among these about 750,000 have dementia.

Relatives, friends and professionals caring for these frail groups are under increasing stress. Six million people are involved informally in this care: one of the stress factors leading one in three to need support for mental, rather than physical, health at some time in their life.

To focus on supporting healthier lifestyles and improving wellbeing, employers could organise cost-neutral events, such as occasional lunchtime seminars exploring the impact on health of lifestyle choice.

Alongside these classes, employers could offer subsidised gym membership or stress reducing activities such as relaxation classes or massage sessions. These will translate into improved productivity and staff engagement. Other support might include classes in how to cope with relatives with dementia. This leads to a whole new depth of emotional intelligence, which can translate directly into better relationships in the working environment, including more effective handling of difficult decisions.

Respite care

Insurance packages that provide respite care for frail elderly relatives are another cost effective way to support a workforce. Employers could even consider subsidising care packages for frail elderly by working with local care providers. This would boost an employer’s competitiveness and reduce absenteeism.

Employers should try to avoid being swayed by an insurance package that looks attractive, but offers little more than is available from the NHS. Instead, they should strengthen their existing benefits package to tackle poor health. In particular, employers should ensure their insurance plan covers mental health, but keep premiums down by providing excellent support for stress reduction and healthy living. Employers should also work with public health teams to help smokers to quit, and to support healthier eating for those at risk from obesity.

Offering annual health checks linked to health advice can also reduce absence and improve productivity. A good insurer may offer a mobile wellness and screening facility: it is in everyone’s interest to catch any serious problems early.


  • Sub-standard National Health Service (NHS) care is prompting employers to review their employee healthcare provisions.
  • Employers can help control costs by encouraging staff to take responsibility for their own health.
  • Employers should avoid offering workplace treatment or services already provided by the NHS.

Sign up to our newsletters

Receive news and guidance on a range of HR issues direct to your inbox

This field is for validation purposes and should be left unchanged.


David Welbourn is deputy director at the Centre for Health Enterprise, Cass Business School