Three Health Benefits Trends Employers Should Watch in 2019

Businesses that want to boost their bottom lines in 2019 need look no further than their employee health and benefits strategy. More than 50 scientific, peer-reviewed studies underscore the correlation between investing in employee health and improved financial performance.

Most recently, researchers found that companies with award-winning wellness programs also have award-winning stock prices, outperforming the Standard and Poor's Index by 7 percent to 16 percent annually. Even if employee health initiatives did not directly cause a company’s stock to rise, emphasizing these initiatives are associated with high-performing companies.

Just because your company offers comprehensive health initiatives, however, does not mean employees will immediately take advantage of them. Many employees have been conditioned to only use health insurance when they need it, waiting until they are showing symptoms of sickness before seeking care. Moving to a preventative care model requires a change in behavior and thinking. Employers must think strategically about their offerings and consider the most effective ways to encourage participation in evidence-based preventive care programs.

These are three health trends to watch in 2019:

1. High-value care

What it is: an approach designed to improve health outcomes by educating patients about the importance of proactively seeking appropriate care and making this care more affordable and accessible. A 2016 study in the Journal of the American Medical Association found that simply reducing spending on low-value medical services and unnecessary medical procedures could save employers millions. Low-value medical services are those that offer limited benefit to the patient but come at great expense to insurance companies and employers. In contrast, high-value care services often cost far less than some low-value care services, but offer significant long-term health benefits.

What employers can do: Employers have an opportunity to encourage benefits proven to make a difference. Examples of high-value care include preventive screenings, vaccinations, education about medication adherence and proper use, and chronic disease treatment. High-value care initiatives can be rolled out in conjunction with workplace wellness programs that offer free or reduced care for preventive services.

2. Direct payment primary care

What it is: an emerging model of primary care in which medical practices offer primary care services for a flat, recurring fee. Patients can visit their primary care provider as many times as necessary and receive vaccinations and other preventive services for free or at a reduced cost. Most individuals with direct primary care opt for a low-cost, high-deductible insurance policy that would cover any emergency or specialist care not provided through their primary care provider.

Patients benefit by being able to see their doctors at any time. Doctors are able to rapidly address evolving health concerns, reducing the number of sick days an employee might have to take and increasing on-the-job productivity. Many direct care practices offer direct phone or email access so patients can get immediate medical advice while avoiding unnecessary appointments.

What employers can do: While DPC is still an emerging model, both physicians and patients who have opted for it report higher rates of satisfaction and better outcomes for chronic disease prevention and management. Employers that wish to promote direct primary care could offer their employees a low-cost, high-deductible health insurance policy in addition to a healthcare savings account to offset the recurring fee. 

3. Value-based insurance design

What it is: a new approach to structuring health care policies that encourages employees to use high-value services with the greatest potential to positively impact their health. Currently, employees pay the same for all medical services under a given health insurance plan. As out-of-pocket costs continue to rise, employees are less likely to utilize high-value services essential to improving health outcomes. The result: Employers shoulder the cost of higher insurance premiums since care is sought after the fact (an employee is already sick or a chronic condition is not managed), rather than before the problem exists.

Value-based insurance design aims to change this by aligning out-of-pocket costs, like co-payments, with the value of services. In essence, this means that high-value services with the greatest potential to impact a patient’s health become more affordable while low-value services become more expensive. 

This principle can also be applied to prescription drugs. Under VBID, employee cost-sharing for higher-priced medications is aligned with the clinical value. This approach is especially beneficial for employees who are struggling to control a chronic condition like diabetes or heart disease and finding that lower-cost alternative medications are unable to adequately control their health condition. VBID recognizes that the same prescription drug could be of high value to one patient and a lower value to another and aligns costs accordingly to these clinical nuances.

What employers can do: Employers should consider ways to integrate VBID into their plans. VBID reduces cost sharing and encourages adherence to high-value services and providers.

Next Steps for 2019

High value care, direct patient primary care, and value-based insurance design are three innovative approaches to the decades-old problem: how can we control rising health care costs and improve patient-care outcomes? Watch this space in 2019 for more in-depth discuss of these employer health trends.

Scott Foster is president of Wellco, Royal Oak, Michigan, and recently presented at an event hosted by the Michigan CUES Council. Foster and Wellco have provided award-winning systems to measurably improve health conditions and costs. Wellco specializes in engagement, analytics and high-value care. Reprinted from “HealthTrendsBlog.com,” free, proven employer health strategies and market intelligence from Wellco. Copyright © by Wellco.