Open enrollment is upon us and for the majority of employers, that means offering employees a high deductible health plan. It is also the time of year when benefits professionals are most likely to remind employees to shop around when using their health care and invite them to engage with a price transparency tool. And yet if you focus solely on these strategies, you may be missing a monumental opportunity to curb your health care spending while also improving your employees’ health.

The bulk of employer health care spending on an annual basis is driven by the care provided to a handful of very high cost employees, like the employee with multiple chronic conditions or the employee with recurrent cancer. A new report out from the American Health Policy Institute and Leavitt Partners documents that among 26 large employers, 1.2 percent of employees are high cost claimants who comprise 31 percent of total health care spending. High deductible health plans do nothing to contain costs for these employees who quickly meet their deductible. Benefits professionals need a multi-pronged strategy to improve care and contain costs for this special population.

Many employers have already deployed one common strategy designed especially for employees with multiple chronic conditions: wellness. But the jury is still out on the ROI of engaging the sick to exercise and eat better. To understand how we can save dollars while improving care, we need to take a closer look at the five critical points in an employee’s health care journey where costs can jump suddenly and dramatically. Then we can better understand the strategies and tools benefits professionals have at their disposal to intervene during these critical moments.