Employers concerned about health care affordability

Employers concerned about health care affordability

The recently released Large Employer 2023 Health Plan Strategy and Design Survey, published by the Business Group on Health, surveyed 135 large employers who covered more than 18 million people. Respondents were contacted between May 31, 2022 and July 13, 2022.

Here are some of the key findings:

Affordability of health care and medicines is a priority.

Affordability remains a major concern for employers. This is an issue that they have failed to address through remediation and negotiation efforts compared to other areas of patient engagement, including experience, access, and quality. Employers will continue to exert their influence in the marketplace by addressing affordability with their partners. However, they are also heavily focused on policy efforts around affordability. For this reason, reducing health care costs and spending on prescription drugs and making coverage more affordable are among employers’ top health care reform priorities (Figure 15). Employers are particularly concerned about the affordability of maintenance drugs and new gene therapies. A majority of employers believe that market-based and government-based interventions are the solution to escalating prescription drug costs. Affordability of mental health services ranks as a top area of ​​interest for 24% of employers, with many looking to low-cost or no-cost virtual health as an answer.

Employers are reassessing the fundamentals as pressures on prescription drug costs continue.

Ninety-nine percent of employers say prescription drug costs are a concern. Specialty pharmacy trends continue at an alarming rate and the pipeline is strong with expensive new treatments. In 2021, prescription drugs accounted for (a median of) 21% of employers’ healthcare costs. Additionally, employers noted that spending on specialty drugs accounted for 12% of health care costs, meaning that more than half of employers’ pharmaceutical spending was on specialties. While many employers have long focused on mitigation as part of their Pharmacy Benefit Management (PBM) programs, a growing number are also focusing on prescription drug spending as part of of their medical plans, where a median of 20% of pharmaceutical claims are processed.

The time to assess and improve virtual health has come.

Virtual health has permeated many aspects of employer health and wellness offerings. In fact, 74% believe virtual health will have a significant impact on how care is delivered in the future. Yet virtual health is approaching a critical crossroads. To impact the quality of care, 84% of employers believe the integration of virtual health and in-person care delivery is essential and the most important step their partners can take. Otherwise, the virtual health experience can lead to duplication of services, unnecessary care, unnecessary expense, and a fragmented care experience. Despite existing integration challenges, employers see virtual health as promising. This is evidenced by the anticipated growth of virtual primary care offerings from 32% in 2022 to 69% in 2025, and 57% of employers’ plans to add even more virtual health solutions in 2023. In sum, virtual health is here to stay, but improvements in quality, integration and market streamlining are needed before it can realize its full potential.

The long-term impacts of COVID-19 are becoming apparent, and more are expected in the years to come.

Long-term mental health issues are the primary impact resulting from the pandemic, both observed and anticipated. The increase in medical services due to the delay in care comes next – 43% are already seeing this and 39% expect these increases to occur. Twenty-one percent have witnessed an increase in disability claims due to the long COVID, and 24% expect to see an increase at some point. While an increase in advanced cancers has been seen by only 13% of employers, 44% expect to see these increases in the short term. Knowing that these impacts are happening now and are expected to continue, employers are keeping many pandemic-related health and wellness offerings in place for the foreseeable future. Ninety-four percent will continue to offer expanded telehealth and virtual health, and 85% will do so for mental health.

Dramatic increase in importance of health and wellness in workforce strategy due to many factors.

As COVID-19 has underscored the importance of the role of health and wellbeing in the workplace, the growing number of employers saying their health and wellbeing strategy plays a critical role in workforce strategy – from 42% to 65% – is the culmination of many factors that have accumulated over several years. These include the need to attract and retain talent through benefits and offers, as well as supporting the general health and well-being of employees and its impact on performance and culture. of the company.

Health equity remains a concern for most employers.

Health equity continues to be on the minds of employers; in fact, three out of four employers share concerns about inequities in their company’s health and wellness initiatives. Employers are also targeting 2024 and 2025 to have an impact on the social determinants of health, in particular racism, childcare, transportation and food access/insecurity. Healthcare and finance/revenue will be addressed by 80% and 75% of employers, respectively, by 2023. In 2023, employers will address health inequities in multiple ways, including offering or expanding coverage of transgender healthcare benefits (82%) and expanding benefits to support a neurodiverse population (78%). Reproductive health continues to be an aspect of health equity that employers are actively addressing. Over the next two years, employers will redouble their efforts to improve access to and quality of reproductive care, including extending fertility benefits to all types of families and promoting/covering group prenatal care and doula services. Overall, 85% of large employers will implement at least one tactic to address inequalities in women’s health and reproductive health. While the investigation was on the ground, the Supreme Court released its decision to overturn Roe v. Wade. Forty-four percent of employers have made changes to improve abortion access or are considering doing so. The most cited change was in the provision of financial assistance for travel and accommodation in order to receive services.

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