Employers drive healthcare change through direct contracting, ACOs, combatting opioid epidemic
From direct contracting between employers and providers to campaigns aimed at reducing the stigma around mental health issues, employers are leading.
With the cost of ensuring employees sharply on the rise, employers are innovating now and planning for the future because they are frustrated with the pace at which the industry itself is driving change.
The Large Employers' 2019 Health Care Strategy and Plan Design Survey found employers are projecting a 5 percent hike in 2019 for the total cost of providing medical and pharmacy benefits for the sixth consecutive year. Taking into account premiums and out-of-pocket costs for employees and dependents, the total cost of healthcare is estimated to be $14,099 per employee this year, and on average, $14,800 in 2019. Employers blame costly claims, specialty pharmacy and certain illnesses as fueling the cost increases, and they will cover roughly 70 percent of those costs. Employees will bear about 30 percent, the survey said.
The survey was conducted between May and June 2018, with 170 large employers from a wide range of industries participating who collectively offer coverage to more than 19 million employees and their dependents. More than 60 percent of respondents belong to the Fortune 500 and 53 belong to the Fortune 100.
In light of these daunting findings, almost half of employers in the survey said they are either driving changes in the delivery system directly or through their health plan. This includes the 35 percent of respondents who said they are implementing alternative payment and delivery models such as accountable care organizations and high performance networks either directly or through their health plan. Also, 3 percent of respondents in 2018 said they were contracting directly with health systems and providers and that number is slated to grow to 11 percent in 2019.
Direct contracting between employers and Centers of Excellence is expected to grow from 12 percent this year to 18 percent next year. Cancer, cardiovascular and fertility COEs are experiencing the greatest growth, NBGH said.
Beyond driving change in the present, employers predict major change for the future, with 52 percent saying they believe virtual care will play a significant role in how healthcare is delivered in the future and 43 percent pointing to artificial intelligence as a future major player. Moreover, 51 percent of employers surveyed said it was a top healthcare initiative for 2019 to implement more virtual care options, a product of growing employer frustration with the pace of change in healthcare delivery.
"Virtual care has branched out well beyond physician consultations to include digital coaching, condition management, remote monitoring, physical therapy and cognitive behavioral therapy, all of which show the greatest potential for growth over the next several years," NBGH said.
There are also areas where employers see growing need and will be looking to innovate solutions, including mental health and combating the opioid epidemic. More than half of employers, or 55 percent, said they are "very concerned" over the impact of prescription opioid abuse on the workforce and are strategizing with partners to change prescribing patterns and increasing access to alternative therapies.
Also, three in 10 large employers said they will conduct campaigns to reduce the stigma surrounding mental health conditions and treatment next year and more than half will offer self-directed online resources.
Twitter: @BethJSanborn
Email the writer: beth.sanborn@himssmedia.com
