Health insurance costs, virtual care programs on rise

Dive Brief:

  • Companies expect health insurance costs to rise 5% in 2020, from $14,642 to $15,375 per employee, and they're preparing to use more virtual care programs to keep their costs from rising above those numbers, survey results released Tuesday show.
  • Companies typically pay about 70% of these costs, so the expected company share of the costs this year and next for each employee are $10,250 and $10,763, respectively.
  • The number of companies that believe virtual care will play a big role in how health care is delivered continues to grow, according to the survey of 150 large companies conducted by the National Business Group on Health.

Dive Insight:

Two-thirds of the companies say they'll offer more virtual care programs next year, up from about half this year, and nearly all companies say they'll offer over-the-phone telehealth services for minor, acute services.

The biggest use of virtual services, in which patients talk to health service providers using video conferencing or other online communications, is expected to involve management of musculoskeletal problems. These include ailments like carpal tunnel syndrome, tendinitis and others that tend to be a problem for people who spend a lot of time on computers.

Almost 25% of companies will offer musculoskeletal management virtually next year, and another 38% are considering it for 2022, if not sooner.

Mental health consultations are expected to be another big use of virtual care.

"Virtual care solutions bring health care to the consumer rather than the consumer to health care," said Brian Marcotte, president and CEO of the National Business Group on Health. "They continue to gain momentum as employers seek different ways to deliver cost-effective, quality health care while improving access and the consumer experience."

Also on companies' radar is developing advanced primary care strategies, in which patients pay an overall fee for a basket of services rather than a separate fee for each service.

About half of companies plan to pursue these types of strategies, and another quarter are planning to do so by 2022. "Advanced primary care models move away from fee-for-service, encounter-based reimbursement to more comprehensive, patient-centered population health management," Marcotte said.

Other strategies to keep costs contained include alternative payment and delivery models, including accountable care organizations and high-performance networks.

Accountable care organizations are groups of doctors, hospitals and other health care providers that come together voluntarily to give coordinated, high-quality care to their patients. High-performance networks are groups structured to reward physicians for delivering efficient, outcome-driven care that has been shown to improve patient health outcomes.

Nearly one-third of companies plan to implement either or both strategies in 2020, and that percentage could nearly double to 60% by 2022.

Two other findings:

Fewer companies offer full-replacement, consumer-directed health plans. The number of companies offering these plans will shrink to 25% in 2020, down from 30% this year and 39% in 2018. Instead, employers will offer more plan choices like a preferred provider organization (PPO) plan. 

Most companies have reservations about Medicare for All. Although 72% of companies said Medicare for All will reduce the number of uninsured, 81% said it will lead to higher taxes, according to the survey.

Berita Tekait