The Affordable Care Act (ACA) has helped more Americans obtain health insurance than ever before. Most of the discussion around issues with the ACA has focused on the individual market and the cost of insurance obtained on the government healthcare exchanges. However, employers still carry the largest burden in insuring Americans. A study by the Urban Institute found that through March 2016, 82-83% of workers were offered employer-sponsored insurance.
The ACA mandates that employers with 50 or more full-time or full-time equivalent employees offer minimal essential coverage to at least 95% of their full-time employees. And the cost of providing that insurance to employees is expected to continue to rise in 2018.
The National Business Group on Health (NBGH) recently conducted the Large Employers’ 2018 Health Care Strategy and Plan Design Survey and found that the total healthcare (medical and pharmaceutical) costs this year will be $13,482 per employee. Of that total, about 70% falls on the employer; 30% or $4,400 on the employee. By 2018, the employers surveyed are projecting an increase of 5% to $14,156 per employee. For the second consecutive year, large employers ranked specialty pharmacy as the greatest source of increased costs.
Not surprisingly, the survey found employers looking toward new options to provide healthcare for their employees for better value for the money spent. NBGH found that in applicable states, 96% of large employers will turn to telehealth services, including virtual health options, while 56% will utilize telehealth for behavioral health services. That’s more than twice the total from last year. In addition, more employers will invest in accountable care organizations (ACOs). These ACOs, which are groups of doctors and hospitals who coordinate their care efforts to reduce redundancy and added expense, are expected to be promoted by 21% of employers in 2018. More than half of employers are looking to offer access to health centers either on-site or near their company offices. The survey also found that 66% of companies will offer medical decision support and second opinion services in 2018, an increase of 47% from 2017. These are merely a few changes that employers plan to adopt.
Amid all this information, one trend is clear: as employers look at ways to manage increasing costs, those efforts will not necessarily translate into a poorer experience for employees. “As employers look ahead, we expect them to increasingly focus on value purchasing opportunities within the delivery system and improving the experience for health care consumers. Finding solutions to the growing challenge of skyrocketing specialty pharmacy costs will also remain a top priority,” said aid Brian Marcotte, president and CEO of the National Business Group on Health.
