Aug. 6, 2018
Dive
Brief:
- Employers
feel they've squeezed out all of the savings that can come from
high-deductible health plans and are seeking new ways to manage rising
healthcare costs and improve employee health, according to a new report by
Duke's Margolis Center for Health Policy.
- Finding
new ways to bend the cost curve isn't easy. That’s especially true since
most businesses don't have healthcare industry knowledge or resources to
launch new models, according to the report.
- Instead, most employers are
relying on third parties to manage population health and provide care for
people with chronic diseases. They're also getting help to create payment
reforms, identify high-value providers and help employees navigate
healthcare, researchers said.
Dive
Insight:
Nearly
half of all insured Americans have employer-sponsored health insurance. That
market share means employer-sponsored insurance can impact healthcare costs
more than individual insurance or the Affordable Care Act exchanges. However,
the market includes businesses with different finances, sizes and locations.
Employer-sponsored insurance may have trouble leading an effort to transform
care because there are so many players with different needs.
Over
the past decade, employers have tried to contain healthcare costs through
cost-sharing efforts, such as high-deductible health plans. These efforts have
helped keep costs for the companies under control. Mercer's recent National Survey of
Employer-sponsored Health Plans found that costs have increased
just 3% annually since 2012. That relatively modest increase followed a decade
of 6% or more yearly increases.
But
it's not all positive news for employers. That same report found that about
one-third of smaller employers faced double-digit health insurance increases in
2017. Plus, there's only so much cost-shifting employers can do before it
begins to negatively affect employee healthcare.
High-deductible
plans are supposed to shift costs, improve patient education and reduce
unnecessary or low-value care. However, rather than take on the added costs,
some consumers may avoid necessary care, which could result in higher
healthcare costs down the road.
High-deductible
health plans also haven't tempted people to become better healthcare consumers.
In fact, a recent HSA Bank survey found that 10% of human
resources executives interviewed aren't confident that employees understand
their health insurance options. Another 75% were "somewhat
confident" and only 15% said they were "very
confident" that employees understand their options.
This
has led to more employers, including big names like Walmart, Apple and
Boeing, working directly with providers and
sidestepping insurance companies altogether.
The
new report, which was supported by the Robert Wood Johnson
Foundation, found that many employers are relying on third parties to help
improve value. But those efforts are limited by finances, implementation issues
and navigating change management.
There
is a positive, though. Despite potential obstacles for employers, businesses
face fewer regulations than public plans. This means the employer market will
play an important role in developing new technologies, according to the report.
However, it cautions that "questions remain as to how this sector will
evolve as competition increases."
"As
innovation continues, special attention should be paid to identifying
high-value local providers and standardizing quality metrics to help ensure the
industry can continue to grow. With almost half of Americans insured by their
employer, innovation in this environment is critical for innovation across the
healthcare sector," the report said.
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