Large employers plan to continue offering health coverage to workers, according to the 18th annual Towers Watson/National Business Group on Health Employer Survey, but the struggle to minimize costs continues. This year, the survey looks at how this challenge is taken up by employers that, of the 583 respondents, “are in the top tier of respondents whose costs have increased over four years at a much lower rate than the … median.”
| Companies that have controlled health costs well now plan to … | |
|---|---|
| Examine health care benefits, employee subsidies, and out-of-pocket costs in a “total rewards” framework | 39% |
| Manage company subsidy as part of a “total rewards” budget rather than a separate health plan budget | 30% |
| Increase employee contributions in tiers, with dependent coverage at higher rate than single coverage | 24% |
| Structure employee contributions based on employees taking specific actions | 23% |
| Adopt new payment methodologies that hold providers accountable for the cost of episodes of care, replacing fee for service | 22% |
| Offer telemedicine for professional consultations | 22% |
| Fund account-based health plans in accord with wellness or health management behavior | 22% |
| Offer specialty provider networks | 20% |
| Track outcomes quantitatively from all vendors | 20% |
| Contract directly with physicians, hospitals, and/or ACOs | 18% |
| Provide access to a private or corporate health exchange | 18% |
“The actions of our best performers may well provide a playbook that others can follow to achieve their goals,” the study says. “This is especially true for those whose strategies and tactics have led to less-than-desirable financial and health results.”
One thing the most successful companies are doing is “integrating their contribution strategy with their health management and wellness activities. Many more companies are tying their wellness incentive strategy to their [account-based health plan] contributions.”
More employers are not just taking the workers’ word for it regarding whether they’re making necessary lifestyle adjustments.
“More recently, companies have been expanding biometric outcomes to include achievement of specific body mass index levels and target cholesterol levels. Today, 16 percent of companies align their rewards/penalties with specific biometric targets (other than tobacco use), and another 31 percent are considering this strategy for 2014.”
| Wellness incentives to expand; requirements to be tougher | ||||
|---|---|---|---|---|
| 2011 | 2012 | 2013 | 2014 | |
| Use financial rewards for people who participate in health management programs/activities | 54% | 61% | 62% | 81% |
| Use penalties for people not completing requirements of health management programs/activities | 19% | 20% | 18% | 36% |
| Require employees to complete a health risk appraisal and/or a biometric screening to be eligible for financial incentives | 35% | 42% | 54% | 75% |
| Require employees to validate participation in healthy lifestyle activities to receive a reward or avoid a penalty (e.g., proof of fitness center use or engagement with a primary nurse case manager) | _ | 23% | 33% | 59% |
| Reward or penalize based on tobacco use | 30% | 35% | 42% | 62% |
| Reward or penalize based on biometric outcomes such as achievement of weight control or target cholesterol levels | 12% | 10% | 16% | 47% |
| Apply rewards or penalties and/or requirements under health management programs/activities to employees and spouses alike | 19% | 23% | 31% | 59% |
Source: “Reshaping Health Care: Best Performers Leading the Way,” Towers Watson/National Business Group on Health, March 2013
Paul Lendner ist ein praktizierender Experte im Bereich Gesundheit, Medizin und Fitness. Er schreibt bereits seit über 5 Jahren für das Managed Care Mag. Mit seinen Artikeln, die einen einzigartigen Expertenstatus nachweisen, liefert er unseren Lesern nicht nur Mehrwert, sondern auch Hilfestellung bei ihren Problemen.