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

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

Quick Audience Poll

From the survey: Trends in premiums

Figure 1

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From the survey: Cost-sharing trends

Figure 6

$7,067 $7,838 $8,658 $9,090 $9,346 $10,008 $10,546 $10,400 $12,013 $12,158 $12,697 $12,899 $13,479 $13,722 $14,113 $15,159

$2,061 $2,238 $2,381 $2,559 $2,744 $2,838 $3,060 $3,495 $3,545 $3,742 $4,066 $4,310 $4,327 $4,380 $5,076 $4,706 $1,231 $1,356 $1,502 $1,665 $1,745 $1,779 $1,936 $2,097 $2,216 $2,370 $2,505 $2,618 $2,739 $2,837 $2,889 $3,020

$- $5,000 $10,000 $15,000 $20,000 $25,000

2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018

Employer premium contribution Family premium contribution Family out-of-pocket spending

Health spending by and on behalf of families with large employer coverage, 2003-2018

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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Figure 19 Figure 13

From the focus groups: Strategies in network selection

How can firms improve the value of their health spending?

Reconfigure provider networks Add alternative sites of care Direct employees to more efficient providers Restrict network breadth Increase cost- sharing Address utilization of care Address price of care Wellness and health promotion programs

Figure 14

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

Quick Audience Poll

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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 16: Alternative Sites of Care

* 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 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

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 19: Direct Contracting

* 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 20: Eliminating Providers & Narrowing Networks

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!

Rabah Kamal

rabahk@kff.org Twitter: @rubbah

www.kff.org www.healthsystemtracker.org