NBGH: 6 employer open enrollment trends to watch 

Stack of health insurance application forms with stethoscope on top
A new report from the National Business Group on Health examines trends to watch ahead of open enrollment. (Getty/vinnstock)

In the lead-up to open enrollment, the National Business Group on Health (NBGH) has identified six trends for employers to watch as workers gear up to choose their health benefits. 

Based on responses to the group’s annual survey of large employers on their health benefit strategies, NBGH projects that employers will be taking a greater focus on care quality this year, as well as expanding mental health benefits and use of decision support tools. 

“I think many employers are trying to do what they can to improve access as well as experience, so they’re looking at avenues outside of the more traditional pathways,” Ellen Kelsay, chief strategy officer at NBGH, told FierceHealthcare. 

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Here’s a look at each of the six trends identified by NBGH: 

1. Cost increases are likely modest—but still higher than wage growth 

NBGH’s survey estimates that the average total cost of health coverage for an employee and dependents will rise by 5% to $15,375. This projection includes premiums and out-of-pocket expenses. 

The business group notes this is not as dramatic an increase as has been seen in some years, but that the increase does outpace wage growth and overall economic growth. 

2. Employers are offering more plan choices 

As healthcare costs rise, many employers have been cutting back the number of plans they offer to steer patients into high-deductible health plans (HDHPs) that are paired with health savings accounts. These plans push greater costs on to the worker. 

RELATED: Large employers are playing more 'activist' role in healthcare costs, dialing back push to high-deductible plans 

However, NBGH’s report in 2018 found that employers were turning away from HDHPs, with just 38% of large companies offering only a high-deductible plan to their workers. In this year’s survey, that number dropped further, with only 25% of large employers solely offering an HDHP. 

NBGH said employers are responding to employee feedback by offering other plan options, frequently a preferred provider organization pla. 

3. There's a growing number of virtual care options 

Employers are looking beyond traditional telehealth services to provide new options to workers, NBGH found. For example, 82% of the large employers surveyed said they would offer mental healthcare virtually, and 60% said they would offer weight management supports through virtual tools. 

They’re eyeing expanded virtual services in other areas, too. Musculoskeletal care management, sleep management and prenatal care are among those that are promising for growth, NBGH said. 

Kelsay said arming employees with tools to navigate these service offerings remains a challenge, however. “How do you offer up all of these varieties of solutions—very well-intended solutions—in a way that doesn't feel overwhelming?” she said. 

4. The interest in tech extends to decision support 

More than three-quarters (78%) of the large employers included in the survey said they intend to offer medical decision support and second opinion tools to workers. In addition, 73% said they will provide virtual tools for claims assistance. 

The survey found that more than half of employers (60%) are taking this a step further and rolling out high-touch concierge programs to assist employees in navigating the health system as part of their 2020 benefits packages. 

5. Mental health benefits are expanding, too 

Employers said in the survey that reducing the stigma associated with mental health is a key focus in 2020, with more than half saying they intend to launch programs targeting those stigmas.  

RELATED: Large employers embrace advanced primary care in 2020, survey finds 

They’re combining that work with additional tools targeting behavioral health, such as on-site counselors and increased access to online resources—options favored by 33% and 69% of employers, respectively. 

6. Employers eye care quality 

Employers are taking a number of approaches to push workers to more high-quality care, including partnering with centers of excellence, offering plans with high-performance provider networks and investing in advanced primary care. 

NBGH found that 27% of large employers plan to expand the number of centers of excellence (COEs) they offer in 2020, including into orthopedics. They’re also mulling COEs for maternity and fertility care. 

“Employers are really looking at quality at every possible angle,” Kelsay said. “They’re architecting and curating programs and partnerships that assure and provide access to quality providers.” 

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