Today’s employers are faced with several challenges to attract and retain talent in today’s turbulent economy. Healthcare affordability, directing employees to the right care at the right time and, especially today, easier ways to access care are issues that impact not only the bottom line but healthy outcomes.
Finding affordable and sustainable solutions will only become more critical as we deal with the COVID-19 crisis.
According to a report by CMS, healthcare expenses are on track to rise an average of 5.5% over the next seven years, hitting 20% of the GDP by 2027. This trend just isn’t sustainable.
The cost of healthcare today is driving employers to seek out sustainable employee health and benefit programs that not only address the needs of their workforce but also work to wrangle in costs with improved outcomes and better access to care, even when we’re not dealing with a global pandemic.
These programs, which can be seen as more non-traditional solutions, are shifting healthcare from a population management approach to a health plan management strategy, where employers can more easily address and engage individuals in their overall wellbeing.
Routine healthcare can’t be put on pause while we wait for healthcare to catch up. Here’s how we expect to see healthcare shift in real time this year to accommodate employers and their employees in the midst of this global crisis:
Data-driven solutions will help to inform employee health and benefit programs.
Traditional healthcare models are built in a one-size-fits-all model, from network offerings to plan designs. But when you actually look at how these plans are designed, you’ll realize they don’t enable employers to contain costs, deliver personalized resources or proactively manage employees’ overall wellbeing.
Brokers and employers are on the hunt for health plan models that enable them to tailor plan designs and resources around their workforce. We’re seeing more solutions enter the market that arm employers with critical data, like insights into their most prevalent high-cost conditions or inappropriate ER visits, which impacts how effectively employers can manage benefit plans and the overall health of their workforce.
Data-enabled solutions like reference-based pricing and bundled services provide employers with actionable insights, allowing them to negotiate up-front costs and better understand the conditions impacting their workforce.
These actionable insights have led to a critical shift to design plans around the needs of the workforce (with the bottom line in mind) without sacrificing quality care or eliminating benefits.
Innovative access points will become the new normal.
The way people want to access care is shifting. According to a Maestro Health survey we ran in 2019, nearly 40% of respondents said they prefer the flexibility to seek out care from any doctor or hospital while nearly 30% of respondents are looking for a simpler way to access and manage their care overall.
Provider access like virtual primary care, telemedicine and on-site clinics are taking hold in the market as employers tap into more affordable and accessible care solutions. These emerging access models enable people to find the right care for their condition by connecting them with appropriate care sites, such as a quick, low-cost virtual care consultation for a sore throat instead of a more time and cost-intensive ER visit.
Alongside better access comes a need for better benefits navigation. Often, employees are left to find their own way through the healthcare system with little to no support, and usually when they’re already sick or stressed. Providing better navigational support, such as benefits consultants to walk people through their options, can make it easier for employees to find appropriate care.
We will continue to see more solutions hit the market that direct employees to lower-cost, high-quality options for both medical and pharmacy.
Overall wellbeing management will become a cost-control strategy.
Today, 6% of employees are driving 51% or more of the total cost of care for employers, with the majority of costs attributed to complex chronic conditions. Not only do these costs impact the employer, they’re often debilitating for the employee, impacting everything from from finances to emotional health to overall productivity.
Healthcare desperately needs overall wellbeing strategies that are designed to treat the whole person, not just their symptoms. As we see healthcare shift to a health plan management approach, the concept of overall wellbeing management (which includes both physical and mental health) is becoming a greater priority for employers to help keep employees healthy and control costs.
Most traditional health plans manage symptoms over causes or effects (like step counters or prescriptions). Health plan management encompasses an overall wellbeing approach that looks beyond the symptoms and aims to support the whole person, from physical health to financial stability.
Addressing the social determinants of health allows employers to further tailor their health plans to their employees. Determinants like financial income or geographic location can impact a person’s ability to afford medications on top of their typical living expenses or their ability to find local, quality care.
More solutions and strategies are entering the health and benefits market, like financial assistance, counseling and personalized health coaching. These strategies address more than just the “what” with employees—they’re helping them find solutions that fit their needs, from affording care options to finding an appropriate treatment plan for their acute or chronic condition.
Employee communication will transform into “edu-marketing”
In a Maestro Health survey from 2019, we uncovered some not-so-surprising stats about employee views on healthcare: consumers don’t think of their employer as a reliable resource when it comes to their benefits. And worse, they don’t understand the benefits available to them.
Most people aren’t paying attention to their health or benefits until it’s too late. Establishing consistent, targeted marketing tactics, using eye-catching headlines, and tying in relevant content can engage employees year-round so they’ll have the right resources at the right time.
The “old way” of delivering benefits and health information once a year during enrollment isn’t working. Generalized enrollment packets will never live up to the effectiveness of edu-marketing that’s targeted year-round and designed to appeal to human behavior.
Marketing tactics, such as targeted emails, interactive educational resources and dedicated mobile apps, are popular ways to engage employees using familiar technology and communication methods.
More brokers and employers today are on the hunt for solutions that support employees in their health journeys and control costs without sacrificing quality and access to care.
While these trends aren’t new, we anticipate they’ll really take hold this year as employers work to shrink the high costs of healthcare, regain control of the bottom line, and improve overall employee health and wellbeing.