As healthcare costs continue to skyrocket nationwide, employers continue to search for options that are affordable to both themselves and their workers.
For each active employee in the U.S. this year, employers will spend an average $13,243 in healthcare expenses, according to Statista — a 13% increase over the average $11,750 spent in 2015. And that average will rise another 6% next year, predicts Pricewaterhouse Cooper's Health Research Institute.
That trend is causing cost-conscious companies to look closely at nonconventional options for providing effective healthcare.
“Medical cost trend still outpaces general inflation,” notes PWC. “So more employers are taking matters into their own hands, becoming what HRI terms ‘employer activists.’”
In response, PWC recommends employers create lists of the key health benefits needed for their specific populations; shop for services with records of favorable outcomes and drill down into projected costs before signing on the bottom line.
One solution working for many is offering voluntary benefits together with high-deductible health plans (HDHPs). By using group buying power to offer affordable prices on supplementary healthcare policies such as accident, cancer or disability insurance, employers can help protect their workers without risking their own livelihoods. But others are looking beyond that option.
[Link here to “13 tips: Getting more value from your employee health insurance”]
“Take the driver’s seat to beat the market,” recommends PWC. “Join the ranks of employer activists pursuing new solutions to lower costs, improve access and enhance quality.”
In that spirit, here are options some employers are exploring that you may not have already considered.
- Choosing their own providers based on records of outcomes. On SHRM.com, Stephen Miller reports that 11% of employers (up from 3% last year) already contract directly for employee care with accountable care organizations (ACOs) and other high-performance networks, while 18% contract directly with centers of excellence. Such providers focus on high-quality care at cost-effective prices.
- Establishing their own clinics. A Mercer survey last year found that a third of U.S. employers with 5,000 or more employees were offering general medical worksite clinics, up from 24% in 2012. “Employers of all sizes and industries are finding they can effectively address the wide variations in quality and cost from local providers by offering clinics that are easily accessible, low- or no-cost to employees, high-quality medical services at or near the worksite, and that are not driven by the need to generate volume and fees,” notes Larry Boress, executive director of the National Association of Workplace Health Centers.
- Creating more virtual health solutions. Provided by most large employers, telehealth options now include lifestyle coaching, management of chronic conditions such as diabetes, surgical decision support, physical therapy monitoring and cognitive/behavioral therapy, according to Miller.
- Better controlling high-cost claims. Miller writes that 39% of large employers will adopt focused strategies for addressing them by 2020. For example, to control costs of the highly expensive specialty drugs that account for about half of employee prescription drug spending, employers may increasingly require prior authorization, step therapy and quantity limits.
- Imposing spousal surcharges. Miller projects that by 2020, 33% of large employers will be enforcing surcharges for spouses that could otherwise get coverage through their own employers (average amount: $1,200 annually). And 6% will decline insurance to spouses at all.
- Being more proactive about behavioral health. For example, some 30% of large employers will conduct in-house campaigns next year to reduce the stigma of treatment, Miller reports.
- Better optimizing manufacturers’ drug rebates and co-pays. Miller points to a need for closer monitoring of these assistance programs to better benefit both employers and workers.
- Fighting opioid misuse. Many employers are strategizing with providers on improving prescription patterns and access to alternative pain-relief therapies such as acupuncture, physical therapy and chiropractic care, according to Miller.
- Rewarding employees for comparison shopping. Some are enacting rewards programs through which employees are incentivized to choose cost-effective procedures and/or facilities.
Talk to the specialists at Ochs (651-665-3789) about other methods you may not have considered for getting the best possible value for your health insurance investments.