Employer Strategies from Insights & Analytics in Employer Health Data: Issue 57

Employee Health Trends according to Springbuk

Springbuk's 2024 Mid-Year Health Trends & Insights for the Workplace

Right off the top, I noted that pharmacy spend is increasing at a faster pace than overall medical spend of 13%. So in an effort to manage costs, a plan sponsor needs to drill into their pharmacy drug spending to figure out ways to reduce their claims and spending.

Beyond this, the report noted a few primary forces shaping healthcare spending increases:

• Brand name prescriptions
• Specialty drugs
• Surgical procedures

Here's an interesting note about the surgical procedures: the recommended age for colorectal screenings was lowered from 50 to 45 in 2021, which led to a huge increase in colonoscopies in 2022 and 2023 for 45-49 year olds (this is good spending as the screenings will have a positive long-term impact)

High-Cost Claimants

• Cancer is a common theme here across various thresholds, but the report noted increased prevalence of conditions like diabetes, psoriasis, rheumatoid arthritis, inflammatory bowel disease, and neonatal disorders

Prescription drug spending outpaces other costs

• Since 2020, pharmacy drug cost have increased 42% and now account for $131 per member per month. This trend has been driven by chronic conditions which require on-going treatments of high cost drugs
• 5 conditions account for 75% of the increased prescription drug spending, with obesity and diabetes at the top

GLP-1s are a common topic and the data tells an interesting story on who is using the drugs:

• 50% of spending can be attributed to people with both obesity and diabetes account, and this has remained constant over the last 4 years
• 16.5% of spend is now people with obesity but not diabetes, a quadrupling from 2020
• GLP-1 spend increased by more than $6.70 PMPM in 2023 from 2022, and $13 PMPM since 2020

The tradeoff here as a plan sponsor is whether their GLP-1 spending can help treat obesity and prevent conditions like diabetes and cardiovascular disease. If they can do so, then plan sponsors can see them as a worthwhile investment. And that investment has grown significantly:

• Spending on drug treatments for obesity are over 6x from 2020, with the average pharmacy drug spend per claimant nearly $400

Health data analytics point to one big, overarching theme: Addressing drivers of high cost claims and conditions is critical to effectively manage costs.

Plan sponsors must partner with health plan consultants (ahem) to take proactive, targeted approaches to managing diseases among their at-risk groups. And the only way you can do so is with data. At Acrisure , we have an in-house clinical team of nurses and healthcare experts to advise on clinical intervention strategies to improve population health and reduce spending on existing conditions and healthcare episodes.

The bottom-line is if you don't have healthcare data, you can't have a Competitive Advantage when it comes to your benefits.

?? Compliance & Employment Updates

The FTC’s “Good Faith” Exception to the Non-Compete Ban: Pending Legal Challenges Are Not a Basis for Non-Compliance: The FTC’s recently issued Final Rule banning non-competes for most workers prohibits an employer from (1) threatening to enforce a non-compete against a worker, (2) advising the worker that, due to a non-compete, they should not pursue a particular job opportunity, or (3) telling the worker that the worker is subject to a non-compete. Read more

U.S. Supreme Court Agrees to Resolve the Split Between the Circuits on the Burden of Proof for FLSA Exemptions: The U.S. Supreme Court agreed to review a case on appeal from the Fourth Circuit involving the burden of proof required for an employer to show that an employee’s job position is exempt from overtime under the Fair Labor Standards Act (FLSA). The high court’s decision will have a notable impact on the ability of employers to defend misclassification claims brought under the FLSA. Read more

Remember That Managers Can Be Individually Liable Under the FLSA! A case from the U.S. Court of Appeals for the Eleventh Circuit provides a good reminder that individual owners and managers, even those at a middle level, can be held liable for violations of the Fair Labor Standards Act. Read more

OSHA Unveils Text of Unprecedented Federal Heat Standard: On July 2, 2024, the Occupational Safety and Health Administration (OSHA) released the text of its highly anticipated proposed standard that, if finalized, would create the first federal standard aimed at protecting workers from exposure to heat hazards in the workplace, whether indoors or outdoors. Read more

EEOC Issues Anti-Harassment Guidance to Construction-Industry Employers: The EEOC issued its Promising Practices for Preventing Harassment in the Construction Industry. This guidance provides key recommendations that construction-industry leaders and employers should consider implementing to prevent and address harassment in the workplace, and avoid being the target of the EEOC’s enforcement efforts. Read more

Before the Emergency: Preparing Your Business for Disruptions: Coastal businesses are no strangers to disruptions caused by emergencies. With experts predicting an extraordinarily active hurricane season, it’s important to make time to update your company’s preparedness plan. Read more

California Enacts PAGA Reform; November Repeal Initiative To Come Off Ballot: California Governor Gavin Newsom announced last week that an agreement to reform the Private Attorneys General Act of 2004 (PAGA) had been reached by legislative leadership, labor organizations, and business groups. Prompted by a June 27 deadline to withdraw a PAGA repeal initiative from the upcoming November ballot, the California Legislature acted quickly this week to enact Assembly Bill 2288 and Senate Bill 92 containing significant changes to PAGA's penalty structure, standing requirements, cure provisions, and other features. Read more

Think You Aren't a Colorado Employer? Colorado Thinks Otherwise: Employers with employees, including remote workers, who live or work in more than one state have likely already faced the challenge of determining what employment laws apply, the work they apply to, and when. In recent years, the Colorado legislature has pushed to be on the cutting edge in this area, giving states that have traditionally been seen at the forefront of this topic, like California, a run for the title. Read more