- Healthcare premiums rose 3.5% in 2018, but employers passed on a lower increase in premiums of 2.2% to employees by absorbing some costs, according to an actuarial analysis by Aon. Furthermore, the firm forecasts premiums will increase by another 3.5% in 2019, based on benefits and healthcare data from Aon's Health Value Initiative database of 497 large U.S. employers.
- In a written statement, Stephen Caulk, senior vice president and chair of Aon Health's Trend Committee, said "it's not a suprise" employers are shifting their focus away from passing on health premium increases to employees and towards uncovering the causes of the increases and managing costs. Cost-cutting strategies cited by Aon include helping patients find local, high-quality, cost-effective care with access to digital health and telehealth services; adopting high-performance networks focused on chronic health conditions; and exploring value-based care.
- According to the analysis, employers are also looking into drug costs with the aim of seeking pricing structures that are more transparent — by determining how and when rebates are passed on to plan participants, for example. Aon said it anticipates increased transparency from market participants like pharmacy benefit managers (PBMs) and drug manufacturers.
Aon's analysis lines up with the findings of others in the employer-sponsored healthcare space, namely that employers are playing a more "activist" role in the effort to bring down costs. That includes shedding traditional ways of paying for healthcare and focusing on treatment outcomes, more efficient delivery of care, and better access to services through centers of excellence, performance networks and accountable care organizations (ACOs).
Some larger organizations have taken things a step further by bringing healthcare under their own roof, providing access to onsite (and near-site) health clinics. According to a recent Mercer survey, one-third of employers with 5,000 or more workers offer general medical worksite clinics, up from 24% in 2012, while the same trend has slowed for onsite clinics that focus on occupational health only. Mercer researchers indicated that this could mean employers are looking to expand the capabilities of such clinics to include primary care and similar services, bringing basic healthcare services under one roof.
The end goal of these efforts, however, is to make healthcare more accessible and effective while curbing costs and preventing and treating chronic health conditions. Experts have also seen employers involved in directly negotiating prices, bypassing insurers in order to do so. It may be safe to expect even more prominent examples to emerge beyond this year's open enrollment season.