What Employers Want For Employee Health Care

By Monica E. Oss, Chief Executive Officer, OPEN MINDS

Once again, Business Group On Health has delivered a survey full of valuable insights for health care executives. I came away with two big takeaways after reading the 2022 Large Employers’ Health Care Strategy And Plan Design Survey.

First, employers are concerned about the physical health and mental wellbeing of their workforce—and the health care costs of that workforce—in the post-COVID economy. And second, employers think that the priority for employees’ mental health issues is to have prompt access to services.

Why do these concerns matter? Because employers provide insurance for approximately 49% of Americans. They also help to shape innovations that eventually make their way to Medicare and Medicaid.

Employers’ number one concern (94%) is the pending ‘bubble’ in increased medical services to make up for delayed care during the pandemic. Over two-thirds (68%) were concerned about the growing prevalence of late-stage cancers due to delayed screening. And 76% are anticipating higher costs for managing chronic diseases, including the effects of “long haul” COVID. A recent workforce report put out by the U.S. military echoed some of these concerns—31% of people between the ages of 17 and 24 do not qualify for military service because of obesity and related conditions.

All of this translates into higher employee health insurance costs in the year ahead after a slight drop during the pandemic. This squares with my own experience as an employer—our health insurance rates were flat during the pandemic but have recently increased.

Another not surprising finding of the survey is that 91% of employers are concerned about the mental wellbeing of their employees, due to the mental health effects of the pandemic. When ranking how they will address these concerns, it was interesting that 76% cited access to treatment as the priority, with affordability the least important factor at 18%.

The survey’s findings present opportunities, as well as challenges, for specialty and primary care provider organizations. In terms of opportunities, employers are focused on chronic condition management and mental health—and by extension, assuring that health plans adequately serve employees with these issues. Developing niche health management solutions for employees could have some market traction.

But the mental health access issue is problematic for most executive teams of provider organizations. Rapid access dwarfs appropriate treatment, quality, and affordability for employers. And those survey results made me flashed back to a recent conversation I had with a health plan manager. I asked why their health plan had contracts with so many digital first provider networks—most of them in the behavioral health space. Her answer was refreshingly straightforward: “Employers are concerned about speedy access to a clinical professional and they don’t care where we get it. I’ll keep contracting with as many provider organizations as I need—digital or otherwise—to make access happen quickly.”

For specialty and primary care provider organizations to succeed in the employer health space (and I would argue, soon in the Medicaid and Medicare space), they need to invest in digital technologies and solutions that foster immediate access to services—whether that is virtual groups, synchronous peers and coaches, on-line screening tools, or other tech-enabled solutions that engage consumers sooner rather than later.

While many of my colleagues push back on these approaches due to the “quality issue”, I think that this shift in access models can be done without sacrificing quality. As several research studies have shown, speed to mental health service (any mental health service) decreases emergency room use and inpatient admissions. In addition, there are now algorithm-driven systems that quickly link consumers to appropriate treatment.

All payers—employers, Medicaid, Medicare, or military—have similar concerns about the health of our population—mental health, growing disability levels due to chronic health conditions, and the post-pandemic effects of delayed care. They also have the same perspective on the required types of solutions. For executive teams planning future clinical programming, a focus on addressing behavioral health and chronic conditions will continue to reap rewards.