More people rely on employer-sponsored insurance (ESI) in the U.S. than any other type of health coverage. 180 million Americans count on it to access high-quality, accessible care – and employers spend a significant amount of money on health benefits.
ESI currently accounts for $1 trillion of health spending each year, but health outcomes have not kept pace with steadily increasing costs, as is clear when you look at health metrics across the U.S. population. According to research from the Commonwealth Fund, when compared to other high-income nations, we experience the lowest life expectancy at birth, the highest death rates for avoidable or treatable conditions, the highest maternal and infant mortality and among the highest suicide rates.
To advance progress in understanding this cost and quality imbalance, Morgan Health worked with Milken Institute to collect insights from a representative sample of employers about ESI, accountable care, and how their organizations evaluate benefit offerings for their employees and dependents.
The anonymous survey was completed by 72 employers across size, sector, and industry types and uncovered key opportunities to improve the value of care and drive investments towards areas that deliver a higher ROI for both employers and patients.
We are at an inflection point – employers want (and deserve) higher quality care for their respective insured populations.
The full survey can be found here.
Key takeaways that were focusing on.
- Employers are increasingly deploying value-based care – signaling a more concentrated focus on quality of care and patient outcomes.
Adoption of value-based care has historically been low within ESI. Government programs have done more to drive financial accountability based on patient outcomes. For example, fewer than 17% of commercial insurance payments in 2022 were tied to two-sided financial risk for improvements in health outcomes – while that number is 34% in Medicare. It is a warning signal to the commercial market, when you consider that costs per patient have slowed significantly in the last decade while ESI costs have continued to rise.
Employers are demanding higher levels of financial accountability when it comes to their benefit spend. According to the survey, one-third of respondents are currently integrating value-based care strategies today – while an additional one-third are working to best understand what strategies will work for their insured population.
- Employers consider preventive and primary care as the most important tenets of value-based care.
Surveyed employers ranked expanding preventive care and increasing access to primary care as the most critical priorities – when it comes to prioritizing quality over volume.
For example, in August 2022, JPMorgan Chase & Co., apree health, and Central Ohio Primary Care launched five on-site and near-site advanced primary care centers in Columbus, Ohio, for 35,000 JPMorgan Chase & Co. employees and their family members. More than 6,000 patients have completed 9,000+ appointments for various health services, with 33% returning for added care and consultation. apree’s net promoter score is 86.1, which is a true testament to the quality of care offered.
- Employers are increasingly focused on cost management.
Unsurprisingly, reducing the cost of care is a key priority for both employers and employees. High premiums, deductibles and out-of-pocket costs make coverage unaffordable for many. In a challenging labor market, employers are hesitant to pass rising costs on to employees.
Survey respondents demonstrated a notable emphasis on cost-related considerations – including a reduction in overall costs. Respondents also highlighted the importance of a broad network of providers and service options, reflecting a commitment to accessibility.
Innovative models like Centivo are anchored around relationships with leading care providers with a proven history of delivering high-quality, cost-effective care. Through this approach, employers can offer health benefit plan options that include free adult and pediatric primary care for all visits, no deductibles, predictable copays for all non-primary care, enhanced patient access and integrated virtual primary care.
- Mental health will remain a focal point for employers
Within ESI, the need for mental health services continues to grow – and the severity is often disproportionate across race, sexual orientation and income level.
Over 20 percent of respondents say they intend to enhance these resources in the next 2-3 years. Additionally, mental health resources were offered by 63% of respondents through an Employee Assistance Program (EAP), with 36% offering caregiver support and resources.
- Most organizations are not measuring health outcome disparities.
The measurement of disparities in health outcome requires additional investment and attention. In fact, just a subset of self-funded and jumbo employers reported measuring health outcome disparities annually. This underscores the challenge of having limited data available regarding health disparities in ESI.
