A growing number of large U.S. employers plans 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 an annual survey by the National Business Group on Health.
As a result, more employees will have access to services such as telemedicine, Centers of Excellence and onsite health centers during open enrollment while not experiencing major increases in their costs.
The Large Employers' 2018 Health Care Strategy and Plan Design Survey found employers project the total cost of providing medical and pharmacy benefits to rise 5 percent for the fifth consecutive year in 2018, growing from $13,482 per employee this year to $14,156 in 2018. Employers will cover nearly 70 percent of those costs while employees will bear about 30 percent, or nearly $4,400 in 2018.
"While employers continue to address costs through health care management and plan design efforts, they are also ramping up efforts to positively affect the supply side of the health care system by pursuing health care payment and delivery reform initiatives," Brian Marcotte, president and CEO of the National Business Group on Health, said in a statement.
According to the survey, an increasing number of employers plan to adopt the following strategies:
- Telehealth – which will be adopted by 96 percent of employers, with 56 percent planning to offer telehealth for behavioral health services, more than double the percentage this year. Nearly 20 percent of employers who have implemented telehealth experienced employee utilization rates of 8 percent or higher.
- Accountable Care Organizations (ACOs) could double by 2020 with 21 percent of employers planning to promote ACOs in 2018, but that number could double by 2020 as another 26 percent are considering offering them.
- Opening health centers – with 54 percent planning to 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.
- Centers of Excellence (COEs) embracing bundled payment arrangements – with 88 percent expecting to use COEs in 2018 for certain procedures such as transplants or orthopedic surgery.
- Value-based benefit design – nearly 40 percent of employers have incorporated some type of value-based benefit design in which employees receive reduced cost sharing or premium reductions when they take steps to manage chronic conditions or obtain higher-quality or more efficient care.
Also according to the survey, 66 percent of companies will offer medical decision support and second opinion services in 2018, an increase of 47 percent from this year. Additionally, the number of companies offering high-touch concierge services will jump from 28 to 36 percent.
"As employers look ahead, we expect them to increasingly focus on value purchasing opportunities within the delivery system and improving the experience for health care consumers," Marcotte added. "Finding solutions to the growing challenge of skyrocketing specialty pharmacy costs will also remain a top priority."