In 2018, employers will work to improve their employees' experience with their health insurance benefits and will look for ways to transform healthcare delivery, according to the National Business Group on Health, a nonprofit association of 420 large U.S. employers.
And although NBGH companies largely self-insure, payers that want to remain competitive in the employer-sponsored insurance market should take note.
FierceHealthcare sat down with Brian Marcotte, president and CEO of the NBGH, to find out which trends are the most notable for insurers—and what to do about them.
Here’s his advice:
1. Make the case for network, delivery innovation
Employers are increasingly interested in looking at different network configurations, Marcotte says—whether they take the form of accountable care organizations or high-performance networks, which give members access to a limited number of quality providers.
But whatever form they take, Marcotte says the challenge for insurers is to explain to employers how they differ from the other types of plans already available.
“Employers aren’t just looking at this from a price perspective—they want to see a better integrated delivery model in the market, and for a health plan to be able to demonstrate that this delivery model can produce something better in that market,” he says.
In terms of delivery system reform, employers also want to see more bundled payments replacing fee-for-service in centers of excellence contracts, according to Marcotte.
“The reason why we’ve seen value-based arrangements move more quickly with centers of excellence is because these are discreet procedures or treatments, as opposed to a complete delivery system,” he says.
2. Pitch in to fight the opioid epidemic
A large share of NBGH members are concerned about the impact that the opioid epidemic is having on their workforce and their health benefits programs, according to Marcotte. They’re taking steps to offer sufficient coverage of treatment, counseling and other support services.
“But there’s also a role that health plans can play here in working with employers,” Marcotte says, “and that has to do more with the delivery system itself.”
For example, health plans can encourage physicians to communicate the dangers of opioids to their patients and help physicians who prescribe opioids more frequently than expected to change their prescribing patterns and consider alternative treatments.
Health plans can also work with employers to alter their plan design so that patients can obtain opioids only from a select network of pharmacies and providers, Marcotte says.
3. Help employers navigate a sea of vendors
Efforts to improve employees’ experience with their health benefits has led to the emergence of medical decision support tools, employee advocacy programs and high-touch concierge service, Marcotte says.
There are also an increasing number of solutions aimed at engaging employees on lifestyle and condition management.
The upshot of all that, he says, is “the employers are getting to a point where they’re overwhelmed by the number of choices, and they don’t have the bandwidth to work with so many different vendors.”
That’s where health plans can help by acting as an aggregator of sorts, Marcotte says. They can contract with a variety of solutions and allow employers to decide “which ones they want to turn on and turn off.”
“That could be a valuable role health plans can play as we look forward,” he says.