Large Employers Focused on Quality and Variety for Open Enrollment

September 25, 2019 - Large employers are focused on quality improvement and expanding employees’ health benefit options this open enrollment season, a survey from the National Business Group on Health revealed.

“While most large employers are not planning major changes to their plan design, they continue to increase efforts to improve quality, access and convenience by providing workers with more plan choices and greater access to virtual care solutions and mental health services,” said Brian Marcotte, president and CEO of the National Business Group on Health. “Additionally, more employers are providing decision-support tools and technology to simplify their employees’ experience and help them navigate the health care system.”

NBGH foresees six major trends among employers for open enrollment 2020, based on the results of their Large Employer Health Care Strategy and Plan Design Survey.

First, large employers anticipate high-cost health benefits and they expect that these expenditures will outpace wage and economic growth. Large employers are preparing for a five percent increase in overall healthcare spending and say they will shoulder 70 percent of those employee health insurance costs.

Second, while many employers came to rely on offering health savings accounts (HSAs) and high-deductible plans in recent years, they are beginning to diversify their plan options again.

READ MORE: High-Deductible Health Plan, HSA Enrollment Reached 21M in 2017

An HSA is a tax-favored savings account used to cover medical needs and that is usually paired with a high deductible health plan. In 2018, 39 percent of employers offered solely high deductible health plans, meaning they did not offer a health plan with a low deductible.

That year, there were 23.4 million health savings accounts (HSAs) which, along with other consumer-directed plans, covered a third of the country’s employees at large companies.

However, employees want more options. The number of large employers who offer only high-deductible plans is expected to scale back by 14 percentage points, from 39 percent to 25 percent, adding more plan options such as preferred provider organizations.

In addition to plan choices, employers want to give employees more care options, outside of the traditional doctor room visit. Many are turning to virtual care. For example, sixty percent of employers will offer virtual weight loss programs.

Payers have already been buoying these kinds of programs by providing supportive technologies. Blue Cross Blue Shield Michigan’s Virtual Wellness program, for example, is a virtual wellness program that serves about 2,200 employers and 8,000 members. Through TEDx style live video sessions that last only 13 to 14 minutes, a virtual coordinator addresses various components of wellbeing. The program has received positive feedback from attendees so far.

READ MORE: Employers Focus on High-Cost Claims, Drug Spending into 2020

NBGH notes that there are a wide variety of potential applications for virtual care beyond wellness, including musculoskeletal care management, prenatal care and coaching, and sleep management.

As employers broaden employees’ options in both health plans and variety of care strategies, 78 percent will also offer tools to assist employees’ healthcare decision-making. Support includes both personal and virtual solutions.

Employers also recognize the critical need for mental health support in today’s workplaces.

A separate report by NBGH earlier this year revealed that 27 percent of employees desired more mental health support from their employers, second only to the need for greater financial health support.

“The message from employees to their employers on well-being is loud and clear,” Marcotte said at the time.  “Employees are looking to their employer to provide support on all areas of well-being – not just physical health programs focused on losing weight or understanding health risks – but those designed to help employees meet their financial, mental, community and social health goals.”

READ MORE: Employers Should Offer More Financial Health Support, Study Shows

Employers are listening. Nearly half of the large employers NBGH surveyed in their September report stated that they would be conducting campaigns to increase mental health awareness and support. Most plan to offer online resources and others are also incorporating manager training, onsite mental health counselors, and digital cognitive behavioral therapy.

Lastly, employers are using Centers of Excellence (COE), high performance networks, and primary care approaches to provide higher quality healthcare benefits to employees, NBGH found.

Employers’ use of COE to increase care coordination was expected to rise to 88 percent in 2019. In 2020, the focus is not only on how many employers will use COE but how those who already have COEs are expanding their usage. NBGH stated that 27 percent intend to increase the number of COE services to encompass conditions such as musculoskeletal diseases and fertility.

The quality and expansiveness of employees’ health benefit options has been at the top of the news cycle with the United Auto Workers strike on GM, motivated in part by unsatisfactory health benefits and healthcare costs. The good news, NBGH’s survey data reveals, is that it is at the forefront of many large employers’ minds as well.