Health
Care Current | August 27, 2019
By Sarah
Thomas, managing director, Deloitte Center for Health Solutions, Deloitte
Services LP
Keeping
employees healthy, happy, and active is essential for a productive workforce.
One of my favorite perks at Deloitte is our well-being subsidy. Each year,
eligible employees receive $500, which can be used for everything from gym
memberships, to bike tune-ups, to 5K registrations. There are other
health-focused features, too. If I don’t pack a lunch, our local cafeteria
offers a wide range of healthy options—and a lovely view of the Potomac River.
As a regular bike commuter, I really like having a secure room for storing my
bike and a locker room where I can shower and change after a summer-morning
ride. Although I haven’t used it yet, there is a new onsite fitness center on
the ground floor of our building—and steps from my office is a space dedicated
to meditation and yoga.
According
to new report from the National Business Group on Health (NBGH),1 a
growing number of large employers are doing more to address the physical,
mental, and financial well-being of their workers (see the August 20, 2019 Health Care Current).
This lines up well with our research and vision for the future of health.
Employers
are focusing on drivers of health/social determinants
I am well
aware that many hospitals, health plans,
and states are implementing or developing strategies to improve people’s health
by connecting them to services that address the underlying drivers of health
(e.g., housing, food, transportation). What I hadn’t realized is that large
employers also are making a significant push in this direction. Many of the
large employers surveyed for the NBGH’s report are interested in insurance
coverage that goes beyond the traditional definition of health care. For the
2020 plan year:
·
90 percent of respondents say they
are considering financial/economic issues to be part of their health and
well-being strategy.
·
84 percent are considering health
care access/literacy as a part of that strategy.
·
34 percent of employers are including
food quality and access in their well-being strategy for next year, and an
additional 60 percent expect to include it over the next year or two.
·
10 percent of employers are including
housing as a part of their well-being strategy for 2020, and 84 percent intend
to include it over the next year or two.
As health
plans begin to expand from funding community projects to designing benefit
packages that take on the drivers of health and well-being, it makes sense to
me that they might team up with their employer clients to address this issue.
If health plans, employers, and hospitals (along with state and local
governments) could work together on this issue—and leverage technology that can
help identify services and track whether people’s needs are met—the impact
could be powerful! One of the key takeaways from our smart health communities
research is that a multi-stakeholder approach can help ensure a sustained
impact.
Employers
see value in virtual care
Deloitte’s Center for Health
Solutions has been closely tracking the rise of virtual care, which
is an important component in the future of health. One of our recent surveys
found that consumers have a strong interest in receiving care virtually. This
technology could help reduce care costs, expand access, and extend the reach of
clinicians.
It
appears that employers are more aligned with this vision than I would have
thought based on some discussions I’d had with employers a couple of years ago.
Back then, employers were skeptical that employees would really take advantage
of these options. Fast forward to now: in the NBGH report, 63 percent of large
employers expect virtual care to have a “significant” or “very significant”
effect on health care in the future.
Some
strategies seem familiar
When I wrote about employer
strategies last fall, I noted that many employers are considering
ways to enhance primary care—mostly through onsite clinics. As a supporter of
primary care, I was heartened to see that employers have a strong interest in
advanced primary care models and accountable-care organizations (ACOs).
According
to the NBGH report, more than one-third of large employers plan to offer
on-site or nearby primary care in 2020, and another 18 percent said they intend
to offer it within the next year or two. Nearly 25 percent of employers said
they plan to offer products that steer patients toward physician-led
accountable care organizations, with another 34 percent planning to do so
within the next year or two. Both of these investments are backed by evidence.
Other research has found that physician-led ACOs have been more effective than
peer groups at controlling costs and generating better patient outcomes.2
At the
state level, recent research indicates that spending on primary care is
associated with better patient outcomes.3 Minnesota, which spends
more on primary care than any other state, has both lower rates of
emergency-department use and fewer hospitalizations compared to other states,
according to a July report from the Patient-Centered Primary Care
Collaborative. The report also notes that seven states have introduced or
enacted legislation—or issued executive orders—to measure and eventually
increase their investment in primary care without increasing overall health
spending. In California, three organizations launched a primary-care
improvement program using a grant from the US Centers for Medicare and Medicaid
Services (CMS)—and saved $346 million ($6 for every $1 invested) over a
four-year period (see news item below).
I
encourage readers to dig further into the results of the NBGH’s 2020 Large
Employers' Health Care Strategy and Plan Design Survey. There are some
interesting findings about expected health care cost increases and the use of
high-deductible health plans tied to a health account (still offered, but
employers are adding other options). The report also looks into how large
employers view the idea of Medicare for All. A majority of participants said
making Medicare available to everyone would likely lead to higher health care
costs, more taxes, and lower quality. However, more than half of employers said
Medicare should be expanded to people who are younger than 65, although they
disagreed on how young beneficiaries should be.
It is
also interesting to see waning interest in some of the strategies of the past,
such as the more traditional wellness programs and tighter provider networks.
We are in a relatively hot labor market, which might be pushing more employers
to view health as an integral part of their workforce strategy.
1 Large Employers' 2020 Health Care Strategy and Plan
Design Survey, National Business Group on Health, August 13, 2019
2 Half a decade in, Medicare accountable care organizations are generating net savings, Health Affairs, September 20, 2018
3 Investing in primary care: a state-level analysis, Patient-Centered Primary Care Collaborative, July 2019
2 Half a decade in, Medicare accountable care organizations are generating net savings, Health Affairs, September 20, 2018
3 Investing in primary care: a state-level analysis, Patient-Centered Primary Care Collaborative, July 2019
No comments:
Post a Comment