The Future of Employer Health Benefits Is Connected Care

Rising healthcare costs remain an urgent concern for employers, while employees are increasingly concerned about what they pay for care. In fact, about 6 in 10 Americans say they're worried about the cost of healthcare. For employers, the challenge is finding sustainable ways to lower the cost of care without sacrificing quality, access, or the value employees expect from their benefits.

That means looking beyond traditional cost-containment strategies. Lowering healthcare costs is not a one-time project. It requires ongoing attention, thoughtful benefit design, better coordination, greater transparency, and a more connected approach to care that simplifies the healthcare experience and delivers greater long-term value. It also requires a clear understanding of which solutions are actually delivering results.

Health plans have an opportunity to help employers achieve those goals by connecting benefits, clinical programs, data, and personalized support in ways that makes healthcare easier for employees to navigate while giving employers better insight into what is working, where gaps remain, and how their healthcare dollars are being spent.

Four strategies can help employers create a more connected benefits experience while continuing to prioritize quality care, choice, and sustainable cost management:

1. Reducing Fragmentation Across Health Benefits

Many employers are looking for ways to reduce fragmentation across their health benefits to simplify administration, improve the employee experience, and reduce unnecessary costs. Multiple health plans, vendors, clinical programs, and administrative processes can create duplication for employers and make it harder for employees to understand where to go for help.

Seeking to reduce fragmentation can be especially valuable following mergers and acquisitions. One national employer in our business portfolio, after a recent merger, found itself supporting more than 200,000 employees covered by more than 100 health plans across four different plan providers. By simplifying that structure, the company brought provider networks, clinical programs, and care management together under a more coordinated approach.

The result was reduced administrative complexity, elimination of duplicate services, and a more consistent experience for employees navigating their benefits.

For employees, simplifying the healthcare experience matters just as much as reducing costs. When benefits are easier to understand, information is more transparent, and care is more coordinated, people spend less time navigating the system and more time focusing on their health. A more coordinated experience can also reduce the number of apps, portals, phone numbers, and points of contact employees need to manage.

2. Rethinking Plan Design

Employers are also responding to employees' desire for simpler ways to find care, greater transparency into what they'll pay for that care, and digital experiences that make healthcare decisions easier to navigate.

Newer approaches to plan design are combining broad provider networks with digital tools that make it easier for employees to identify high-quality, lower-cost care that matches their needs. Through a mobile app, employees can compare providers based on both cost and quality, understand what they'll pay before receiving care, and identify options that best meet their needs. The goal is not simply to provide more information, but to make that information clear and useful.

Some plans also encourage employees to take a more active role in managing their care. For example, members may receive financial incentives for choosing high-quality, lower-cost facilities for certain planned procedures. Paired with clear information about cost, quality, and available options, these incentives can help employees compare choices and lower costs.

As these plans continue to evolve, the opportunity extends beyond new benefit designs. The experience surrounding the benefit matters just as much as the design itself.

Future approaches may include more personalized digital experiences that help employees make informed healthcare decisions with even greater confidence.

3. Getting Smarter About Solutions for Complex Conditions

Many employers have invested in condition-specific or "point" solutions designed to address common health issues such as musculoskeletal conditions, diabetes, or behavioral health. These programs can deliver meaningful value, particularly for employees managing complex conditions that require ongoing monitoring and care.

As the number of available solutions has grown, employers are increasingly focused on a different question: Are these programs actually delivering measurable value? That means looking beyond adoption or engagement to assess their impact on health outcomes, member experience, and the cost of care.

Today, employers are asking tougher questions: Are employees using these programs? Are they improving health outcomes and lowering the cost of care? Are multiple vendors duplicating services or competing for the attention of the same employees?

Health plans have an opportunity to help employers answer those questions with evidence, not assumptions. They can help evaluate solutions based on utilization, health outcomes, member experience, and cost; identify unnecessary duplication; and integrate effective programs into a more coordinated benefits experience. That can reduce confusion while making it easier for employees to access the support they need.

The objective should not be to eliminate specialized solutions simply for the sake of consolidation. It should be to ensure that each solution serves a clear purpose, demonstrates value, and works as part of the broader healthcare experience.

4. Better Coordinating Medical and Pharmacy Benefits

Another strategy gaining momentum is better coordinating medical and pharmacy benefits. When health plan and pharmacy services work together, authorized care teams have a more complete picture of a person's health, including prescriptions, physician visits, diagnoses, and opportunities to close gaps in care. Used responsibly and securely, that broader approach can help reduce duplicate prescriptions, identify opportunities for earlier intervention, and guide members toward clinically appropriate, lower-cost treatments. Better coordination can be particularly important for people with complex conditions who may see multiple providers or rely on high-cost specialty medications.

The financial impact can also be significant. In a study of Elevance Health-affiliated health plan members with complex medical conditions, members with integrated medical and pharmacy benefits had medical costs that were more than $100 lower per member per month. The study also found the integrated benefits improved care coordination and helped employers manage high-cost specialty medications better.

This is connected care in action: bringing together data, benefits, and personalized support to improve health outcomes while helping manage long-term healthcare costs. The value comes not from integration for its own sake, but from what better coordination can deliver: fewer gaps in care, a simpler experience, and lower costs.

As employers continue searching for sustainable ways to manage rising healthcare costs, success will depend less on adding more solutions and more on connecting the ones that already exist and being disciplined about whether each one is delivering value.

By reducing fragmentation, rethinking plan design, evaluating condition-specific solutions more strategically, and better coordinating medical and pharmacy benefits, employers are changing how they provide health coverage. Health plans can play an important role by helping employers tailor these strategies to the unique needs of their workforce, simplifying the healthcare experience while continuing to prioritize quality care, transparency, choice, and measurable results.

Employers do not need a one-size-fits-all model. They need partners that can help them understand what is driving cost and complexity in their workforce, identify where better coordination can make a difference, and build a benefits strategy that balances cost, quality, access, and employee experience.

That is ultimately what connected care should deliver: a healthcare experience that is easier for employees to navigate and more effective for employers to sustain.