Employers are focusing efforts on how healthcare is delivered and paid for according to the Large Employers’ 2018 Health Care Strategy and Plan Design Survey released by the National Business Group on Health on August 8. The 22nd Annual Best Practices in Health Care Employer Survey by Willis Towers Watson released a week earlier had similar findings. That survey reported that employers will focus on cost management strategies that slow the rising cost of healthcare and improving member health.
The Business Group on Health survey projects that total healthcare costs this year will be $13,482 per employee, and will rise to $14,156 in 2018. Employers will cover nearly 70% of those costs, while employees will pay for about 30%, or about $4,400.
Employer Cost Management and Health Improvement Strategies
Both surveys outline the strategies that employers plan to implement:
- 96% of the employers surveyed will encourage the use of telehealth services in states where the practice is permitted.
- 56% will make behavioral telehealth services available to their members.
- Accountable Care Organizations (ACOs)
- 21% will promote ACOs. Employers think ACOs are better able to address healthcare quality than the current system does.
- Health Centers
- 54% will offer onsite or near site health centers.
- Employers believe health centers decrease absenteeism and improve presenteeism.
- Centers of Excellence (COEs)
- 88% expect to use COEs for certain procedures such as transplants or orthopedic surgery.
- 48% of the COEs will included bundled or other alternative payment arrangements.
- Value-based Benefit Design (VBID)
- Nearly 40% have adopted some element of VBID involving reduced cost sharing or premiums when employees manage chronic conditions or get higher quality or more efficient care.
- High Performance Networks
- 15% have already implemented high performance networks.
- 36% are planning or considering to use them by 2019.
- Specialty Pharmacy Controls
- 44% will put site of care management practices into play to control escalating specialty pharmacy costs.
- 70% will deploy more aggressive utilization management programs.
- Consumer Directed Health Plan (CDHP)
- 90% will offer at least one CDHP.
- Nearly 40% will offer only a CDHP.
- 80% of those offering a CDHP couple a high deductible health plan with a health savings account.
- 28% of those offering a CDHP couple a high deductible health plan with a health reimbursement arrangement.
- Mobile Apps
- 19% of employers currently cover the use of mobile apps for condition management or health risk reduction.
- 28% plan or are considering to cover mobile aps by 2019.
Expand the Use of Analytics
Julie Stone, a national health care practice leader at Willis Towers Watson, said that employers plan to expand their use of analytics over the next 3 years. While she didn’t go into further detail, I have some tips for employers to consider to get the most insight from their data.
Many employers offer more than one health plan, have multiple locations across the country, and offer carve out programs, like pharmacy benefits, to control costs. These variances create numerous silos of data, making it nearly impossible to get to get a true look at how your programs are performing.
To be successful and get the most comprehensive view, you must integrate the data across all programs—medical, Rx, vision, dental, biometrics/wellness, workers’ compensation, absence, disability, and others. Integration will give you never before seen insight, such as:
- Program correlations; for example, how switching to a high deductible health plan impacts utilization and other program enrollment and costs, specifically workers’ compensation and disability
- Your total pharmacy costs by looking at both your pharmacy data and pharmacy charges paid under your medical benefit
- If diabetic patients are getting recommended testing, e.g., A1c and foot exams
- If members with heart disease are taking their medications as directed
- If members are filling opioid prescriptions under both the pharmacy and workers’ compensation programs
- What wage replacement and lost productivity are costing your company.
Leverage Historical Data
When you use a third party vendor to integrate your data, make sure the vendor will accept your historical data. Analyzing at least 3 years of historical data will establish a solid baseline so you have something to measure your changes against.
Access to Your Data for Analysis
Most vendors provide static reports, which aren’t much more comprehensive than the reports you’re getting now. You and your benefit advisor need better access to your data to perform a deep dive into the issues impacting your programs. You can quickly get answers to your questions and put the knowledge to work to make more strategic decisions and implement targeted interventions.
You and your executives will establish key performance indicators to track the metrics that matter to you. You should find a vendor that offers customizable reporting, not a standard set of dashboards and reports that don’t measure the benefit program metrics you care about.
Having insight into your benefits and human capital program performance will help you design programs that fit your population and address the real cost drivers you’re facing.