How Research Can Drive Healthcare Value for Employers Paul - - PowerPoint PPT Presentation

How Research Can Drive Healthcare Value for Employers

Paul Fronstin, Ph.D.

Director, Health Research and Education Program @pfronstin September 20, 2019

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Paul Fronstin

Disclosures

Rela latio ionship ip Company ny(ies es) Speakers Bureau Advisory Committee University of Michigan V-BID Center Board Membership National Alliance of Healthcare Purchase Coalitions; Emeriti Consortium for Retirement Health Solutions Consultancy Review Panel Honorarium Ownership Interests

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About the Employee Benefit Research Institute (EBRI)

• Nonpartisan tax-exempt membership
• rganization created in 1978.
• Our mission is to contribute to sound

employee benefit programs and public policy through independent, objective, fact-based research and education.

• We bring together all facets of the

employee benefits ecosystem, resulting in well-informed publications and events, along with unparalleled networking experiences.

info@ebri.org Employee Benefit Research Institute (EBRI) Twitter @EBRI LinkedIn Employee Benefit Research Institute

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Employers Will Make Health Plan Design Decisions Based on Sound Research

• HSA-plan affected lower

income workers disproportionately:

• Specialist visits
• Flu vaccines
• Breast cancer screenings
• Emergency department

visits

• Inpatient admissions
• Findings resulted in employers

front loading HSA for lower income workers

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• Rising HSA balances resulted

in higher use of health care services

• Primary care visits
• Specialist visits
• Chiropractic visits
• Physical therapy
• Psychotherapy
• Blood tests, X-ray, CT scan, MRI
• Employers discussing raising

deductibles, adding higher deductible plan as a choice, education around benefits of long-term savings

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Sometimes Employers Get Caught Up in the Hype: Employer Interest in HSAs in 2004

Likelihood of Offering a High-Deductible Health Plan with an HSA

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Then They Don’t Follow Through

Percentage of Employers Offering HSA-Eligible Health Plan/HRA, by Firm Size, 2010–2016, with Projections Through 2019

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The Hype Around Private Health Insurance Exchanges: Sometimes They Don’t

Consultant Estimated Enrollment By Year EBRI 5-6 million (5%) 2015 Accenture 40 million 2018 Oliver Wyman 39.1 million 2018 Goldman Sachs 35 million 2019 EBRI 13-15 million (10%) 2020 Consumerdriven, LLC & HSA Consulting Services, LLC 75 million 2020

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What Happened? Still Too Many Unanswered Questions

• Are expenses more predictable?
• Will it increase competition?
• Will increase choice be positive for

consumer?

• Will employees shop intelligently and

choose highest value plan?

• What happens to wellness programs?
• Will it reduce administrative costs?
• Do lessons learned from retirement

benefits apply?

• Does employee choice add costs?
• How does moving to fully-insured model save

money?

• If plans are standardized, how do they compete?
• Does risk-adjustment mitigate need to compete?
• Why would insurers invest in people if they can

easily move to another plan during open enrollment?

• If employers aren’t pooled, what does it mean to

be in an exchange?

• If employers self-insure, what does it mean to be

in an exchange?

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Thank You!

Paul Fronstin, PhD Director, Health Research and Education Program @pfronstin September 20, 2019