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

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 2

About the Employee Benefit Research Institute (EBRI)  Nonpartisan tax-exempt membership organization created in 1978. info@ebri.org  Our mission is to contribute to sound employee benefit programs and public Employee Benefit Research policy through independent, objective, Institute (EBRI) fact-based research and education.  We bring together all facets of the Twitter employee benefits ecosystem, @EBRI resulting in well-informed publications and events, along with unparalleled LinkedIn networking experiences. Employee Benefit Research Institute 3

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 4

• 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 5

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 6

Then They Don’t Follow Through Percentage of Employers Offering HSA-Eligible Health Plan/HRA, by Firm Size, 2010–2016, with Projections Through 2019 7

The Hype Around Private Health Insurance Exchanges: Sometimes They Don’t Consultant Estimated By Enrollment 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 & 75 million 2020 HSA Consulting Services, LLC 8

What Happened? Still Too Many Unanswered Questions • How does moving to fully-insured model save • Are expenses more predictable? money? • Will it increase competition? • If plans are standardized, how do they compete? • Will increase choice be positive for • Does risk-adjustment mitigate need to compete? consumer? • Why would insurers invest in people if they can • Will employees shop intelligently and easily move to another plan during open choose highest value plan? enrollment? • What happens to wellness programs? • If employers aren’t pooled, what does it mean to • Will it reduce administrative costs? be in an exchange? • Do lessons learned from retirement • If employers self-insure, what does it mean to be benefits apply? in an exchange? • Does employee choice add costs? 9

Thank You! Paul Fronstin, PhD Director, Health Research and Education Program @pfronstin September 20, 2019 10