How Employers, Payers Can Partner through the Workplace Transition

July 24, 2020 - More than six in ten employers said that they would be partnering with their healthcare payer in the workplace transition back to the office, an Optum survey found.

The survey revealed that only 16 percent of employers had achieved a full transition to the worksite.

“Although almost all organizations appear committed to completing their transitions by early September, there will be a need for sustained employee well-being support well beyond the 90-day window,” the survey reminded.

This leaves most employers still in an era of transition, during which 61 percent of employers said they expect to rely on their healthcare payer partners for return-to-work assistance.

Alongside payers (61 percent), 46 percent of employers said they would work with facilities management and real estate services. An equal percentage planned to partner with specialty occupational health providers. Lower numbers said that they would make use of population health services and benefits consultations.

Two-thirds of employers said that they were already prepared for the return to the worksite with regards to employee communications tools. Slightly fewer employers said that they had personal protective equipment and safety gear ready (63 percent).

However, just over half of the respondents (52 percent) said that they had emotional and behavioral healthcare resources in place for the transition.

According to Ben Isgur, Health Research Institute leader for PricewaterhouseCoopers (PwC) in the US, behavioral and mental healthcare services will be a key juncture for payer-employer partnership during the recovery.

“If you're an employer, you're really looking for: how can we help our employees better manage their mental health, in a way which also means they're going to better be able to manage other potential chronic conditions?” Isgur explained to HealthPayerIntelligence.

“For payers, this is a great opportunity. How can they make sure that there are more mental health professionals in-network? How can they use digital and virtual tools to get these services to businesses and ultimately to their employees?”

The need for behavioral and mental healthcare services could hardly be more clear than it is now. Mental healthcare utilization will be a prominent driver of medical cost trend in 2021 as many take on new mental health conditions or put off care and see their existing conditions worsen, a PwC medical cost trend report found.

The Optum survey underscored that this remains a key gap that payers can fill, as less than half of employers could boast of having certain mental and behavioral healthcare tools and resources in place.

Forty-three percent of employers said they already have established digital self-help options to help employees manage anxiety and depression. The same percentage also said they had additional behavioral healthcare resources in place as well as preventive care and financial health resources.

Other employers said that they were working toward implementing these services. Nearly four in ten employers were in the process of setting up behavioral, preventive, and financial resources and 30 percent were aiming to provide digital self-help solutions.

Moving forward, Isgur emphasized that the payer-employer relationship would hinge on reducing healthcare spending.

“We think one of the next big frontiers in terms of trying to help slow the growth of health costs is going to be on the price side,” Isgur said.

“Payers and employers have tried to reduce health costs through utilization and through more cost sharing, frankly, and those methods are starting to really run their course and there's a lot of dissatisfaction with them.”

Isgur predicted that this would primarily be achieved by narrowing networks.

“Can you put together a network of high quality providers and hospitals and health systems that are also very efficient and willing to have a very competitive, you know, price, and that will ultimately help you reduce healthcare costs?”

Employees tend to be discontented with narrower networks. They would rather pay more and have a broader provider network, in part driven out of a desire to keep their current provider in-network, according to a survey published in the American Journal of Managed Care.

Employers tend to follow suit. Nearly four in ten employers (39 percent) said that they would not narrow networks regardless of the savings.

However, the researchers for the Kaiser Family Foundation survey concluded that employers had two options: narrow their provider networks or place more of the financial burden on their employees.

“Other than increasing cost-sharing, this is the most (and maybe only) powerful cost-reducing tool that private plans have, but it is rarely employed,” the researchers stated.