Employer Strategies to Reduce Health Costs and Improve Quality - PowerPoint PPT Presentation

Employer Strategies to Reduce Health Costs and Improve Quality Rabah Kamal Senior Policy Analyst Kaiser Family Foundation

Overview 1. Premiums 2. Cost-sharing 3. Eligibility, take-up, & coverage rates 4. Provider networks – what did our focus groups tell us they’re doing? 5. Takeaways

Quick Audience Poll Q: What changes have you made to coverage in recent months? A. Added behavioral health coverage B. Added a new contractor or third party vendor C. Expanded telemedicine coverage D. Increased employee outreach E. No change

From the survey: Trends in premiums

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From the survey: Cost-sharing trends

Figure 6 Health spending by and on behalf of families with large employer coverage, 2003-2018 Employer premium contribution Family premium contribution Family out-of-pocket spending $25,000 $2,889 $3,020 $20,000 $2,505 $2,618 $2,739 $2,837 $3,545 $3,742 $4,066 $4,310 $4,327 $4,380 $5,076 $4,706 $2,216 $2,370 $15,000 $1,502 $1,665 $1,745 $1,779 $1,936 $2,097 $2,381 $2,559 $2,744 $2,838 $3,060 $3,495 $1,356 $10,000 $1,231 $2,061 $2,238 $12,013 $12,158 $12,697 $12,899 $13,479 $13,722 $14,113 $15,159 $7,067 $7,838 $8,658 $9,090 $9,346 $10,008 $10,546 $10,400 $5,000 $- 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 Source: KFF analysis of IBM MarketScan Commercial Claims and Encounters Database and KFF Employer Health Benefits Survey, 2018; Kaiser/HRET Survey of Employer-Sponsored Health Benefits, 1999-2017

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From the survey: Eligibility, take-up, & coverage rates

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From the focus groups: Strategies in network selection

Figure 14 How can firms improve the value of their health spending? Address price of Address care utilization of care Wellness and Reconfigure Increase cost- health promotion provider sharing programs networks Direct employees Add alternative Restrict network to more efficient sites of care breadth providers

Quick Audience Poll Q: Have you ever reconfigured provider networks in any of the following ways? A. Added alternative sites of care B. Tiered networks C. Centers of Excellence D. Direct contracting E. Eliminated providers

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Figure 16: Alternative Sites of Care NOTE: For Retail Clinics and Telemedicine, firms were asked if their plan with the largest enrollment had these features. SOURCE: KFF Employer Health Benefits Survey, 2019

Figure 17: Tiered Networks * Estimate is statistically different from estimate for all other firms not in the indicated size category (p < .05). SOURCE: KFF Employer Health Benefits Survey, 2019

Figure 18: Centers of Excellence * Estimate is statistically different from estimate for all other firms not in the indicated size category (p < .05). SOURCE: KFF Employer Health Benefits Survey, 2019

Figure 19: Direct Contracting Test found no statistical difference from estimate for all other firms not in the indicated size category. NOTE: Large Firms have 200 or more workers. SOURCE: KFF Employer Health Benefits Survey, 2019

Figure 20: Eliminating Providers & Narrowing Networks * Estimate is statistically different from estimate for all other firms not in the indicated size category (p < .05). SOURCE: KFF Employer Health Benefits Survey, 2019

Figure 21: Wellness Programs

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Considerations and Challenges Benefits: • Lower costs • Improved quality of care • Alternative to raising deductibles Barriers: • Capacity • Lack of information • Employee considerations • Market conditions

Special thanks to Human Resource Executive (HRE) and the Society for Human Resource Management (SHRM)

Questions?

Thank you! www.kff.org www.healthsystemtracker.org Rabah Kamal rabahk@kff.org Twitter: @rubbah