In Push to Innovate, Large Employers Seek Heath Plan, PBM Help

by Leslie Small

Large employers are increasingly leaning on their health plan and PBM partners to devise innovative solutions to health care challenges, according to the 2020 Large Employers' Health Care Strategy and Plan Design Survey conducted by the National Business Group on Health (NBGH).

In the 2019 survey, 32% of large employers said they would take a "defer to partners approach" to drive health system change — implementing what their health plan and PBM present as the latest developments. For 2020, that share rose to 41%.

NBGH attributes that trend to a number of factors, Ellen Kelsay, NBGH's chief strategy officer, said at a press briefing. One is that employers are "frustrated with the slow pace of change" in health care and are looking to their partners to speed it up. Most employers also lack the bandwidth to drive change on their own, she said.

What's more, "many employers are looking for a way to streamline and consolidate their offerings," Kelsay said, noting that the ecosystem of solutions that employers have at their disposal is "far too extensive."

Employers are also turning to their health plan and PBM partners to figure out how to finance and manage high-cost therapies, NBGH President and CEO Brian Marcotte said at the briefing. The survey revealed that such high-cost therapies — like Novartis' $2.1 million spinal muscular atrophy drug, Zolgensma — are employers' No. 1 concern when it comes to managing their pharmacy benefit plans.

So how can health plans and PBMs meet employers' desire for more help driving health care change?

They "can be proactive in reaching out to their clients to engage them on emerging trends and opportunities and propose solutions, rather than waiting for their clients to approach them," Marcotte tells AIS Health via email.

From Health Plan Weekly