Virtual Care, Pharmacy Benefits Among Top Priorities of Health Benefits for Employers

With health care benefit costs expected to rise 5% over the next year, larger employers are focusing on implementing more virtual care services and better management of high cost claims to curb costs, according results of a recent survey.

The National Business Group on Health, a nonprofit organization, conducted the 2020 Large Employers’ Health Care Strategy and Plan Design Survey showed that health care benefit costs in 2018 grew by 3.6%. It is estimated that each employee and their respective dependents’ total cost of health care to the employer was $14642. The survey data results project that cost to increase to a total of $15373 per employee in 2020.

“One of the challenges employers face in managing their health care costs is that health care is delivered locally and change is not scalable. It’s a market-by-market effort,” said Brian Marcotte, president and CEO of the National Business Group on Health in a press release. “Employers are turning to market-specific solutions to drive meaningful changes in the health care delivery system.”

Survey data shows that 51% of employers plan to offer more virtual care programs in 2020— like behavioral health management via video chat, digital coaching, condition management, and sleep therapies.

“Of particular note is the growing interest among employers to offer virtual care for mental health as well as musculoskeletal conditions,” said Mr Marcotte.

The press release from the National Business Group on Health explained, “Virtual care for musculoskeletal management shows the greatest potential for growth. While 23% will offer musculoskeletal management virtual services next year, another 38% are considering it by 2022.

The second focus employers plan to prioritize is the managing pharmacy benefits and the high costs of specialty drugs and therapies. “Employers are very concerned about how to finance the high cost of new million-dollar drug therapies. Some of these therapies will cost more than what an employee will earn in a lifetime,” said Mr Marcotte in the press release.

Twenty percent of employers plan to implement a point of sale rebate program in 2020 and more than two-thirds “favor a model based on the net price of medications with no rebate as an alternative.”

While virtual care and managing pharmacy benefits are the top priorities, the survey also found that the number employers offering consumer-direct health plans is down 30% and will continue to reduce. More than 70% of employers also expressed resevations about the concept of Medicare for all.

The 2020 Large Employer’s Health Care Strategy and Plan Design Survey comprised of 147 large employers, supplying coverage to more than 15.6 million employees and their dependents.

—Edan Stanley

Reference:

National Business Group on Health. Large Employers Double Down on Efforts to Stem Rising U.S. Health Benefit Costs which are Expected to Top $15,000 per Employee in 2020 [press release.] https://www.businessgrouphealth.org/news/nbgh-news/press-releases/press-release-details/?ID=361. Published August 13, 2019. Accessed August 14, 2019.