October 26, 2018

In the Quest for Better Healthcare, Employers Are Turning Activist. Do They Have the Right Approach?

By Peggy Fischer

To Deliver Better Healthcare, Employers Need to Unlock the Power of their Strategies

It's not just Amazon, JPMorgan and Berkshire Hathaway. Facing unsustainable 5-6% healthcare cost trend and poor employee experiences, the vast majority (81%) of large employers are no longer content with a “wait and see” approach to their employee healthcare strategies, according to the National Business Group on Health 2019 Large Employers Healthcare Strategy and Plan Design survey. In fact, in the quest for better healthcare, nearly 50% are turning activist - embracing a wide range of innovative strategies designed to bend the healthcare cost curve and win the hearts of employees and their family members, the survey shows.

Why Now?

Not only have traditional employee benefits strategies failed to deliver the results employers seek, but new external factors are only making matters worse, in their view. For instance, only 12% of employers believe provider consolidation will reduce healthcare costs, while 30% believe costs will increase as a result. The same goes for the consumer healthcare experience: only 18% of employers think it's getting better as providers consolidate, while more than 40% see the consumer experience staying the same or getting worse. Similarly, more than half of large employers are skeptical that PBM and health plan integration will result in lower costs, and more than 90% are looking for a new solution for the rising cost of prescription drugs.

Employers Turn to Value-Based Care

Taking charge, self-insured employers say they are adopting value-based care and other strategies designed to control costs and improve the quality and experience of healthcare. According to the NBGH survey, employers are turning to:

  • Accountable Care Organizations - Thirty-five percent of employers say they are turning to providers that are banding together to assume responsibility for the quality, outcomes and cost of care for a defined population.
  • Centers of Excellence - Nearly 90% of employers are using COEs to deliver high-quality care for specific conditions and procedures, including bariatric surgery, knee replacement surgery, fertility treatments and cancer.
  • Behavioral Health - In the effort to get employees the help they need, especially as the opioid crisis deepens, 30% of employers are introducing anti-stigma campaigns, and 25% of employers are offering on-site behavioral health support to augment their Employee Assistance Programs (EAPs).
  • Virtual Care - Telehealth, behavioral health and other virtual care services are the top initiative in 2019 for half of large employers.
  • Engagement Platforms - By 2021, NBGH expects two-thirds of employers to use engagement platforms in order to aggregate and integrate discrete, fragmented point solutions and provide a simpler employee experience.

But Obstacles Abound

Each of these strategies presents big challenges, however. Employers say engagement platforms show promise in several areas but have a long way to go before delivering. While growing in popularity, telehealth is another fragmented employee experience that's underutilized; less than 20% of employers see 8% utilization or higher. Anti-stigma campaigns don't guide employees to the behavioral health resources they need when they need them. It's difficult for employers not only to identify employees who can benefit most from Centers of Excellence, but also to convince them to use the CoE benefit and prepare for the procedure. And despite the promise of accountable care, 90% percent of providers say they lack the resources to manage the administrative demands it presents. Facing these challenges and others, it's not surprising that 75% of employers are putting their faith in innovation - new solutions from Silicon Valley and elsewhere that will come along to disrupt healthcare and usher in a new era of efficiency.

Making it All Work Today

The most expedient and effective answer, however, is an approach to employee benefits that tackles these challenges head on and makes all of these strategies work today. It's a solution that:

  • Makes it easier for ACOs to improve health outcomes for a population by engaging with people even before they are patients, providing personalized healthcare support beyond the walls of healthcare, and coordinating with providers at every step of the way.
  • At the right time, identifies individuals who can benefit from a Center of Excellence, guides and influences them to take advantage of the benefit, prepares them to qualify, and coordinates care before, during and after the procedure or treatment.
  • Supports the whole person in the context of their life conditions, uncovering and addressing behavioral health issues as an integrated and standard part of personalized healthcare support.
  • Increases utilization - by 25-100% - of telehealth, second opinion, and all other point solutions.
  • Provides a single point of entry to all employee benefits, creating a unified and seamless experience for employees.

To learn more about the solution and how it works, read the papers today:

  • Personalized Advocacy: Compassion, Expertise and Technology Working Together to Engage and Influence Employees to Better Health at Lower Cost
  • Personalizing Population Health: Making Value-based Care Work for People and Employers

Source: 2019 Large Employers' Health Care Strategy and Plan Design Survey, National Business Group on Health