Employers Embracing Innovative Solutions in Healthcare

Companies are frustrated with the pace of change in healthcare and are accelerating their direct involvement in the process. They are looking for partners and solutions that can be weaved into their health benefit strategies and that make a real impact to cost, access, quality and experience. That then allows them to potentially have a healthier, happier workforce.

At the same time, unemployment is near record-lows, hovering near 4%. So, employers are also looking for effective benefit solutions that help attract top talent. In a complex healthcare system, they want solutions that not just control costs, but offer convenience and simplicity for their employees. That means providing better access to care, ensuring high quality, and improving the experience for their employees and family members.  

Meanwhile, healthcare costs continue to outpace wage inflation, and it’s adding pressure to employer budgets. Annual premiums for employer-sponsored family health coverage rose to roughly $19,600 in 2018, up from 5% a year earlier, according to a yearly survey by the Kaiser Family Foundation. And since 2008, average family premiums have increased 55%. By another measure, medical costs will rise 6% for employers in 2020, according to an estimate by PwC. 

It’s not an easy task, but key trends continue to evolve that can be effective for employers to leverage. Below are six areas that are growing in use to help control costs and/or improve care.

1. Value-based care. Value-based care is a form of reimbursement that links payments for care to its quality. It serves as an alternative for fee-for-service reimbursement, which pays for services delivered based on billing and fee schedules. Put another way, value-based care centers on patient outcomes. As costs continue to rise for standard fee-for-service healthcare (think traditional PPOs), health plans also continue to set up these value-based care networks and/or products that are of higher quality and lower cost. 
2. Telemedicine. We live in a society where people want convenience, choice and speed. Telemedicine gives patients 24/7 care and answers on their own schedules, and it has become critical for health plans to offer it. About 86% of employers with 1,000+ employees now offer telemedicine, up from 11% in 2011, according to a 2018 survey by Willis Towers Watson of more than 550 employers. 
3. High-tech high touch point solutions. About 58% of companies with 500 or more employees now offer so-called “point solutions,” those that are “high-tech, high touch,” according to 2018 Mercer study. These could be programs designed to help members with specific health issues ranging from insomnia to infertility, to mental and behavioral health, Mercer notes. People today really get information from their mobile devices and online, and the receipt of services is just an extension of that. About 26% of employers were actively looking for the best new technology in 2018, according to a Willis Towers Watson study. And 65% were interested in technology that improves healthcare navigation or benefit experiences. 
4. Navigation solutions. Over the last five years, so-called navigation platform operators have gained an increasing role in helping employers and health plans provide that necessary human-based support. These companies are using a combination of sophisticated technology – such as artificial intelligence and machine learning algorithms – along with human decision-making to help patients better sort through and figure out their best health plan options for care. 
5. Worksite clinics. Some large employers are either opening worksite clinics or expanding them. About 38% of employers with 5,000 employees offered an onsite health clinic in 2019, up from 27% in 2014, according to PwC. Employers are going beyond occupational medicine to offer primary care, preventative medicine, alternative medicine and mental health (see next point), the report notes, and companies like Amazon, Apple and Tesla all opened clinics in 2018.
6. Mental wellness. More employers are interested in improving access to mental health and well-being. About 75% of employers offered programs for depression and mental health in 2018, up from 34% in 2014, according to PwC. Yet there’s still a disconnect: 81% of consumers with employer coverage didn’t seek out mental health services over the last five years, but 8% said they should have. More and more, employers want to be able to provide these services in a more comprehensive and seamless manner. As of 2018, 16% of large employers offered mental health services on site, according to PwC. 

These solutions are just the tip of the iceberg in terms of innovations that are evolving quickly and being offered to employers. Employers will continue to pressure test these solutions and demand results in the coming months and years. Those employers who incorporate the optimal mix of solutions with the right partners will be best positioned to sustain and create a healthier and attractive work environment.

Don Antonucci serves as the Senior Vice President of Employer Markets for Blue Shield of California.