A growing number of large U.S. employers plan to focus more on how healthcare is delivered and paid for while still pursuing traditional methods of controlling costs such as cost sharing and plan design changes, according to a new survey.
As a result, more employees will have access to broader healthcare services including telemedicine, Centers of Excellence and onsite health centers during open enrollment while not experiencing major increases in their costs, according to National Business Group on Health’s (NBGH) Large Employers’ 2018 Health Care Strategy and Plan Design Survey.
Large U.S. employers project healthcare benefit costs to surpass $14,000 per employee in 2018, according to the survey.
The survey was fielded between May and June 2017. A total of 148 large employers participated in the survey. Collectively, respondents represent a wide range of industry sectors and offer coverage to more than 15 million employees and their dependents. Two-thirds of respondents belong to the Fortune 500 and/or the Global Fortune 500, and 42 belong to the Fortune 100.
“Our survey results will help managed care executives understand what employers are thinking about for 2018, and where they can be ready to assist employers ready to make a positive impact on supply-side initiatives,” says Alisa Ray, vice president, benchmarking and analytics, NBGH.
According to the survey, an increasing number of employers plan to adopt the following strategies:
1. Accountable care organizations (ACOs) could double by 2020. The survey found 21% of employers plan to promote ACOs in 2018 but that number could double by 2020 as another 26% are considering offering them. “Employers are slightly more confident about the ability of ACOs to improve healthcare quality beyond what the system does today, compared to reducing costs,” Ray says.
2. More employers will open health centers. More than half of employers (54%) will offer onsite or near site health centers in 2018 and that number could increase to nearly two-thirds by 2020. “These centers have a positive impact on business performance metrics, because they often result in decreased absenteeism and improved presenteeism,” Ray says.
3. Centers of Excellence (COEs) are embracing bundled payment arrangements. Almost nine in 10 employers (88%) expect to use COEs in 2018 for certain procedures such as transplants or orthopedic surgery. Bundled payments or other types of alternative payment arrangements will be used by 21% to 48% of COEs contracts, depending on the medical procedure or condition.
4. Telehealth utilization is surging. Virtually all employers (96%) will make telehealth services available in states where it is allowed next year. More than half (56%) plan to offer telehealth for behavioral health services, more than double the percentage this year. Telehealth utilization is on the rise, with nearly 20% of employers experiencing employee utilization rates of 8% or higher.
Employers have implemented various tactics to help combat rising costs, according to Ray. Some of the most effective tactics they pursued to rein in costs included:
• Two-thirds of employers indicated that pharmacy management techniques are their most effective tools for controlling rising healthcare costs. To help control surging specialty pharmacy costs, 44% of employers will have site of care management tactics in place in 2018, a 47% increase over this year. Seven in 10 employers will use more aggressive utilization management protocols.
• More than half of employers (54%) reported that implementing CDHPs as an option or going full replacement was one of their most effective tactics. Nine in 10 employers (90%) will offer at least one CDHP in 2018. In addition, nearly 40% of employers will offer a CDHP as the only plan option in 2018, compared with 35% this year.
• Tactics such as increasing employee cost sharing were ranked lower this year, while tactics such as high-touch concierge or navigator services were ranked higher this year compared to previous years. According to the survey, 66% of companies will offer medical decision support and/or second opinion services in 2018, an increase of 47% from this year. Additionally, the number of companies offering high-touch concierge services will jump from 28% this year to 36% in 2018.