There’s been an unexpected reversal in cost-sharing trends with health plans, according to a survey by Mercer. Sixty percent of employers say they won’t make plan changes to reduce expected health care cost increases. Instead of shifting costs to workers, employers are focusing on making health care more affordable for their workers, improving access to mental health care, and offering competitive benefits in a tight labor market.
Most employers have not raised deductibles or other cost-sharing while some have even reduced employees’ out-of-pocket spending. For small employers (50-499 employees), the median deductible for individual coverage in a PPO dropped from $1,000 to $900 in 2021. For large employers, the median individual deductible in an HSA-eligible plan dropped from $2,000 to $1,850 in 2021.
CDHPs and Traditional Plans
Forty percent of covered employees were enrolled in a high-deductible consumer-directed plan in 2021, up from 38% in 2020. However, 86% of large employers that offer a CDHP also offer a medical plan with a lower deductible.
Large employers did not increase employee premium contributions significantly in 2021. The average monthly paycheck deduction rose $7 for employee-only coverage (from $160 to $167) and $12 for family coverage (from $590 to $602) in PPO plans, which is the most common type of medical coverage offered.
Supporting mental health has become a business imperative. Expanding access to behavioral health care is a top-three priority for large employers; 74% rated it important or very important. It’s the number one priority for employers with 20,000 or more employees; 86% rated it important or very important.
Improving health equity will be an important priority over the next three to five years for nearly half of large employers and about two-thirds of those with 20,000 employees.
Centers of Excellence and ACOs
During the past two years, employers have been less able to drive members to quality providers like centers of excellence and accountable care organizations. Employers need to resume these efforts, but with a new emphasis on convenience, according to researchers. “Value starts with quality providers that achieve good outcomes, but convenience must be part of the equation, along with affinity. People want to get their care through the channels they are most comfortable with; that’s not always a doctor’s office. It might be a pharmacy, a retail establishment, or online,” says Tracy Watts, National Leader for U.S. Health Policy at Mercer.
Digital Health & Personalization
Telemedicine clearly got a boost during the pandemic. Sixteen percent of large employers now offer a virtual Primary Care Physician (PCP) network or service with 10% considering it. Twenty-eight percent of large employers and 43% of those with 20,000 or more employees offer a virtual behavioral health care network.
Twenty-five percent of large employers offer targeted health solutions to address conditions like diabetes or musculoskeletal issues. Twenty percent of larger employers are considering offering these solutions. These programs can save money by substituting care, such as online physical therapy for in-person visits.
Offering digital health solutions can be an affordable way to add variety and personalization to the benefits package. These can encompass fertility programs, online resources for parents of children with autism, or treatment of gender dysphoria. “Employers see this type of personalization as a way to even out the benefits available across onsite, remote, and hybrid workers,” said Watts. Eighteen percent of employers that expect more employees to work remotely have added voluntary benefits specifically for this reason.