Employers Interested In Exploring Stricter Rules Around Health Benefits And Reference-Based Pricing As Part Of Their Health Strategy

While employee cost shifting remains the most prevalent technique in employers’ health strategies today, there is growing interest in adopting new health tactics to mitigate cost and improve population health in the future, according to recent research from Aon Hewitt. The Health Care Survey found that 52 percent of employers said their current health strategy is focused on traditional trend mitigation approaches, such as employee cost shifting. However, just 21 percent said this would be their preferred approach in three-to-five years.

Instead, employers are considering new tactics that are more requiring of employees to take action. In the next three-to-five years, more than 60 percent of employers plan to “gate” employees to richer designs, where employees are required to complete a “task” to access richer design options. About one in five employers gate their employees today.

“Gating strategies are becoming an increasingly attractive incentive technique among employers as they look to improve the health of their employee populations,” said Jim Winkler, chief innovation officer of health and benefits at Aon Hewitt. “For example, employers may offer a basic high-deductible plan to their entire workforce, but make a richer PPO option available to those employees who complete a health risk questionnaire or biometric screening.”

In addition, 68 percent of employers plan to adopt reference-based pricing—where employers set a pricing cap on benefits for certain medical services for which wide cost variation exists with no discernible differentiation in quality. Just 10 percent of employers have adopted reference-based pricing as a health tactic today.

“Despite the long-term promises of innovative strategies, employers are still gravitating towards existing cost control tactics because they can see immediate benefits,” added Winkler. “However, these traditional cost-sharing approaches will not be as effective in the future, and employers will need to adopt multiple strategies to improve the foundation of how benefits are delivered, including funding, design, clinical and provider system changes.”

Additional plan design strategies. According to Aon Hewitt’s survey, employers also are considering implementing the following tactics to mitigate health costs in the next three-to-five years:

• 72 percent of employers are or will be reducing subsidies for dependents;
• 52 percent of employers anticipate using unitized pricing—where employees pay per person and not individual versus family—up from 5 percent today;
• 42 percent of employers are considering offering high-deductible health plans as a full replacement plan, up from 15 percent today;
• 24 percent of employers plan to offer employees tools to guide decisions in plan selection and utilization, up from 19 percent today; and
• 92 percent plan to offer cost transparency tools, up from 49 percent today.

“The fundamentals of health care still matter, but employers are increasingly realizing that traditional approaches to mitigate health care cost trend need to be advanced,” said Tim Nimmer, chief health actuary for Aon Hewitt. “Over time, plan design strategies will evolve to be more requiring of employees, and individuals will be held more accountable for their health and for using health care. At the same time, we see that employers are increasingly committed to providing employees with decision support tools that provide greater transparency around the cost and quality of care, so that individuals can make more informed health decisions for them and their families.”

The survey contains responses from more than 1,230 employers covering more than 10 million employees. For more information, visit http://www.aon.com.

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