This year will see some major transformations in healthcare benefits. In the past, employers would complain about annually increasing premiums but would nevertheless sign on the dotted line. My suspicion is that this year — and this decade — will see much less of that.
That’s mostly because some of the biggest and most beloved brands — Amazon, Apple and Walmart, for example — have already taken the lead, showing employers of similar stature that they can choose a different path and take healthcare into their own hands.
Now, smaller employers like Pacific Steel & Recycling and Great Lakes Auto Network are acting on that very same realization. I have no doubt that we will see even more companies follow suit regardless of their size, industry or region.
For the benefits advisers keenly interested in how they can prepare for this shift, I’ll share three specific predictions.
First, younger generations will push us toward newly imagined health plans.
The majority of the workforce is now made up of millennials, the generation of individuals born between 1981-1996, according to Pew Research. As such, millennials are the employees benefit plans have to please.
So, what do they want? Short answer: Not the status quo.
The traditional employer-provided family health plan costs an average of $20,576 per person and relies on a severely flawed fee-for-service system. It’s a system that sets prices for procedures and services arbitrarily, has overburdened yet well-intentioned clinicians, and has prompted people to wait long periods of time for frequently low-value care.
Millennials are sick of it, having seen how technology can streamline processes and make life much easier. They want convenience and affordability and they want it now.
That’s why wise benefit advisers will find and address pain points by exploring new tools — especially modern primary care, identifying lower-cost providers and incorporating both into a new health plan. It’ll be a worthwhile investment, as Generation Z (those born after 1997) isn’t one to grin and bear it.
Second, those health plans will be open source, higher-quality and less expensive.
Other health plan attributes benefits advisers will have to consider are transparency and accountability. One of the hottest topics of 2019 was surprise medical billing, which often happens when a patient goes to an in-network provider but receives out-of-network care, thanks again to the fee-for-service system. Even the most diligent beneficiaries have stories of shocking price tags.
Understandably, this left a bad taste in the mouths of many, especially when juxtaposed with stories of people having to ration their insulin due to its high cost, and reports of patient safety seeing minimal improvement. These revelations have created a sense of distrust and prompted consumers to demand transparency and accountability, not just from their healthcare providers, but from their health plans.
Beneficiaries want to know what price they will pay and what kind of care they can expect for that price. Employers feel similarly. They want to know whether their benefits adviser may be partial to certain insurance carriers or providers because they receive commissions or bonuses. Benefits advisers should be prepared to answer this question, plus have the data to back up why the health plan’s preferred providers are worthwhile.
Finally, saved dollars will be best spent on connected community issues.
The best benefits advisers know that there’s no such thing as a good one-and-done health plan. They strive to make frequent adjustments and improvements, and even break away from the annual benefits renewal cycle. The top advisers have proven that the best way to slash healthcare costs is to improve health benefits.
It turns out that when previously squandered healthcare dollars are spent locally, additional health improvements — and therefore savings — can be seen. Opioid addiction and increasing benzos addiction are huge public health issues, and if an employer’s savings are used to support community services for those struggling with addiction, such an investment could reap significant rewards for their organization.
The start of a new decade is the perfect time for benefits advisers to take a moment to think about what’s been trending and use these predictions to inform their future efforts. Change is inevitable, after all, and the best among them will be the ones who embrace it.
