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The importance of managing employee health and productivity in an organizational view, which addresses the most expensive drivers in the health care costs with prevention, education and employee responsibility as key areas is discussed.

The methods for employees to implement an integrated health risk management (IHRM) program to significantly lower health care costs to a degree unattainable through traditional cost control strategies, while raising the workers' productivity and well being at the same time.

Cost control is the usual motivation for companies to assess their health care plans. However, the relationship between cost-efficient health care and other organizational features demands an integrated assessment approach, which can be facilitated by computer technology. The integrated assessment approach using computer technology helps to account for the effect of cost-efficient health care plans on other parameters such as employee health and productivity.

Pitney Bowes Inc. developed a comprehensive cost information method in 1994 to select the most cost-efficient health care provider for its employees. After one year, company-wide health care services were below $75 million, which is less than the $81 million projected for 1994 and is also below the actual 1993 health care costs of $77 million. Within the company's operations base in Connecticut, health care costs dropped by 9.3% despite the addition of 2,000 employees and 3,500 dependents, while the state's average health care costs rose by 10% over 1993.

Market share, provider contracting agreements and utilization management methods are some of the factors that cause dramatic variations in the economic efficiency of health maintenance organizations (HMOs). Employers who plan to implement HMO strategies should conduct at least quantitative assessments to ensure that they will not incur unnecessary costs. A combination of quantitative and qualitative assessments of HMOs is presented as a best practice strategy for evaluating HMOs.

The results-based approach to managing health care plans has become even more necessary for corporate health care managers because of new business demands. The factors that have contributed to a more demanding health care environment include rising health care costs, the defeat of federal health care reform in Congress, consolidation in the healthcare industry and increased capability for information processing. Several components of a results-based approach to healthcare plan management are discussed.

Nearly 20% of adults in the US suffer from depression at some point, and depression has a major effect on job productivity and health care costs. Ways in which employers can handle depression in the workforce are examined.