by Adam Beck
July 20, 2017
A shift in health insurance has been quietly taking place for one out of every two Americans. Employee health benefits have transformed from a payroll deduction that meant a plastic card sitting in your wallet to a dynamic and active range of offerings that engage employees to maximize their health and wellness.
Over the course of a century, businesses large and small have expanded their health benefit offerings while federal laws changed in ways that further facilitated enhanced benefits. Since Montgomery Ward began offering the first employee health insurance plan in the United States back in 1910, the large group employer market has remained stable and more employers are self-funding health plans. More importantly, companies of all sizes, together with their health plan administrators, have placed a premium on innovation. Health plans in these markets don’t just pay for patients’ medical bills. They have become partners in health.
Some of the recent employee benefit trends include:
Perhaps the biggest shift that underscores employers’ and their plans’ commitment to total health has been in the area of wellness programs. As health costs continue to rise and consume a significant part of company budgets, more plan sponsors are looking for ways to achieve cost savings by paying not just claims, but for the health of their employees. Wellness programs range from group fitness classes to nutrition counseling and cooking classes, to smoking cessation programs, fitness competitions, health assessments, behavioral health awareness and a host of other programs that improve health while demonstrating long-term value.
Today, nearly one third of large companies have opened on-site clinics to provide primary care. Services at these clinics range from flu shots to cancer screenings, chronic disease care, urgent care, and even behavioral health services.
Health plans increasingly rely on mobile applications to connect with their members and empower them with tools to improve their health. Mobile apps can help patients schedule visits, provide medication reminders, offer advice on nutrition and risk mitigation, and connect patients with specialists.
AHIP member Humana designs its apps around four core principles:
Today, nearly 60 percent of employer health plans cover telemedicine consultations, a two-fold increase since 2015. The cost savings can be substantial, with a mobile consultation costing around $40 compared to an office visit that can cost $125 or more, not to mention an Emergency Department visit that will cost at least $700. By 2020, it is anticipated that all employer plans will cover telemedicine visits.
More than one in three employers distribute wearable technology devices, usually fitness monitors, to promote better health. These devices, often used in connection with a wellness program, can help employees lower their health insurance premiums. As the capabilities of these devices expand, health plans will be able to ascertain more valuable data to proactively manage health conditions and control costs. AHIP member Oscar Health has plans that provide free fitness trackers to enrollees both as a means of incentivizing activity, but also for engaging in everyday health.
More employers are opting for a benefit design known as “full-replacement,” which includes high-deductible health plans paired with a Health Savings Account (HSA). The popularity of consumer-driven health products continues to grow: HSA participation has increased from 3.2 million in 2006 to 20.2 million in 2016.
These products empower the patient-employee, giving them greater responsibility for their health spending decisions. As this requires a new level of support and guidance, many include decision-support tools such as treatment cost information
Employer-sponsored plans recognize chronic conditions like asthma or diabetes, which usually involve expensive daily medications, account for the largest portion of health spending. By partnering with employees who have chronic conditions and their spouses and dependents, the plans can help patients adhere to their medications, encourage lifestyle and nutrition habits that improve health, and serve as a resource for increasing employees’ ability to live healthy lives. For instance, Cigna launched the Your Health First program recognizing each member as a whole person. The program has made strides in working with members living with diabetes, heart disease, depression, COPD, and other chronic conditions.
Adam Beck is AHIP’s vice president of employer health policy and initiatives.