The cost of healthcare in the United States is rapidly rising with no end in sight, and this cost problem is hitting the American worker’s pocket in a more profound way than ever in history. Healthcare in the U.S. is now at 18% of US GDP at a cost of over $10,000 per person annually. To put this into perspective, healthcare costs in 1960 were 5% of U.S. GDP ($170/person). 

Here’s what not everyone knows: on the other side of this problem of rising healthcare costs are pockets of people effecting serious change—these people are employers.

Forward thinking employers and the HR leaders responsible for making their healthcare decisions are thinking outside of the box to find health care models that are more effective at keeping employees healthy. These are people who are rejecting the traditional benefits model of disjointed, piecemeal solutions. Instead, these employers are using data to form a comprehensive strategy to ensure their healthcare dollars are keeping members healthy.

Consider the following developments in 2018 alone as an indication of the trends we’re seeing in the employer market:

• Solution Scale: Amazon, Berkshire Hathaway and JPMorgan Chase announced in early 2018 their formation of a healthcare alliance to tackle finding more effective care models for their combined employee base of 1.2 million people.
• Accountability: The National Drug Purchasing Coalition (NDPC), whose members include employers like PepsiCo and ExxonMobil, has partnered with Express Scripts to form a fully-transparent model where the NDPC pays what Express Scripts pays for prescription drugs. In turn, Express Scripts will administer a pay-for-performance clinical care model that shifts the financial risk previously borne by employers onto the prescription drug plan administrator.
• Emphasis on Health Outcomes: GM announced a deal with the Detroit-based hospital system Henry Ford Health System for a direct contracting healthcare model for its 24,000 employees and family members
• Using Data to Guide Health Strategy: Morgan Stanley recently announced that they have created a chief medical officer role to oversee their use of HR data and analytics. Said Morgan Stanley’s Chief Human Resources Officer Jeff Brodsky, “Harnessing our HR data, we can achieve better wellness for our employees and address rising healthcare costs.”
• Making Healthcare Easier for Employees: Amazon and Apple have joined the 30% of employers that offer onsite medical clinics for employees and their families.

If your company is looking to help to effect change in this healthcare revolution, here are a few ways to start:

1.     Shift financial risk. Seek partners who are willing to step outside of the traditional fee-for-service healthcare models that currently put the highest financial risk on the employer (and in turn, employees). Instead, shift financial risk to care providers and other partners who directly impact health outcomes. Direct primary care is a great example of this type of accountable care model. 

2.     Gain data transparency. Get access to timely and ongoing data to drive your healthcare benefit decisions. It is easy to get inundated by mountains of complex data and trying to aggregate it with location and other benefits data, so we recommend that employers assign a strategic data subject matter expert to drive the discussion. This is what the team at BetaXAnalytics does—as data scientists with clinical, pharmacy and wellness expertise, our deep-dive into employer data is more comprehensive than any data platform on the market today.

3.     Remove barriers. Think about ways to remove the barriers that prevent employees and their families from getting the care that they need—the financial barriers, the time constraints and convenience barriers. Onsite clinics and telemedicine are just a couple of examples of strategies to make healthcare convenient and inexpensive for employees.

“Employers taking healthcare into their own hands is the most meaningful way we can change healthcare in this country”

~Bret Jackson, president of The Economic Alliance for Michigan, a member of the National Alliance of Healthcare Purchaser Coalitions

This week we presented at the Strategic HR Conference at Mount Washington to Chief Human Resource Officers and HR leaders throughout the Northeast to share best practices on how HR leaders can use data to drive their health and benefits strategy in a way that maximizes their healthcare budget. If you’re interested in learning more, email me.

Who pays for healthcare in the U.S.? We all do. By way of taxes and out of pocket premiums, we all contribute to these costs that flow largely through the government and employers. And the more informed the people are who are paying for healthcare become, the more we can effect change.

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About BetaXAnalytics:

If you’re an employer who feels there’s got to be a better way to control health care costs, you’re on to something. And we can help. BetaXAnalytics partners with employers to use the power of their health data “for good” to improve the cost and quality of their health care. By combining PhD-level expertise with the latest technology, they help employers to become savvy health consumers, to save health dollars and to better target health interventions to keep employees well. For more insights on using data to drive healthcare, pharmacy and wellbeing decisions, follow BetaXAnalytics on Twitter @betaxanalytics, Facebook @bxanalytics and LinkedIn at BetaXAnalytics.

As a healthcare data technology company, the most common question we hear from employers is, “how can we lower our healthcare spending?” The high cost of healthcare has a significant impact on employer expenses. The Milliman Medical Index projects that in 2018 the average premium for a family of four is $28,166. While the magnitude of health costs is a reality for our employer clients, finding an effective way to manage these high costs is often their first priority.

When we drill down into cost-drivers, we consistently see a startling theme across employers—that only 5% of people are driving 51% of healthcare spending. A very small group of people with chronic conditions (such as diabetes, rheumatoid arthritis, or cancer) are contributing to half of the total health spending. While this disproportionate spending is a reality within employer populations, according to the Kaiser Family Foundation Medical Expenditure Panel Survey, this also holds true for Americans as a whole.

As a way to manage the rising cost of healthcare, nearly 40% of adults are covered by what is known as a high-deductible health plan. Under this model, employees share in a greater share of their health expenses, responsible for on average $5,248 of out of pocket medical costs each year. The thinking behind this way of cost-sharing with employees is that when employees are responsible for paying a greater share of their health expenses, that they will become better healthcare consumers by shopping for the best prices and avoiding unnecessary procedures. 

Unfortunately, in many of these cases the high out-of-pocket medical costs cause financial hardship on many people. A survey from the Kaiser Family Health Foundation found that 1/3 of adults have trouble paying their medical bills, and 73% have cut back on spending on food, clothing or basic household items to pay their medical bills. The Report on the Economic Well-Being of U.S. Households, an annual survey conducted by the Federal Reserve Board, found that 44 percent of adult Americans claim they would not have $400 in case of an emergency without turning to credit cards, family and friends, or selling their own possessions. When those who are financially strapped have mounting healthcare bills, the consequences can be personally devastating. A 2015 poll by the Robert Wood Johnson Foundation and the Harvard T.H. Chan School of Public Health found that 26 percent of those who took part in the survey claimed medical bills caused severe damage to their household’s financial wellbeing.

Because the impact of high healthcare deductibles causes such a financial hardship for individuals and their families, many recent studies have shown that this type of health plan causes individuals to delay necessary healthcare. Researchers from UC Berkeley and Harvard studied the results of a large employer’s choice to offer a high deductible plan over 2 years. Instead of finding evidence to support the theory that high-deductible plans make people take more charge of their health spending, they found no evidence to show that employees were comparing costs or cutting unnecessary services once they had a high healthcare deductible. They cut low-value health services at the same rate as they were cutting important medical services, causing the employer to question whether members were making the right choices for their long term health. Additional studies have found that the danger of high deductible health plans is that their members with the highest health risks have shown that they avoid necessary care and medications due to cost. 

On the other side of the phenomenon that 5% of people drive 51% of health costs, we see another theme that is equally surprising—half of plan members contribute to only 3% of total health spending. That’s right—a large proportion of costs come from a small number of people, yet a large number of people contribute very little to overall costs. Why is this? 

At BetaXAnalytics, when we look at employer utilization of health services we consistently find that between 10%-20% of members never see their doctor. These are the employees who either feel they simply “don’t have time” to see the doctor or “don’t have the money” to spend into their annual deductible. But it’s within this group of people who are not driving costs today where an employer’s greatest healthcare risks can lie. 

The answer for employers? Make it as easy as possible for members to get the care they need. One effective way to ensure that people aren’t avoiding necessary care is to remove the traditional financial and convenience barriers that prevent employees from seeing the doctor. Hooray Health provides a template for employers to solve this problem. They afford first dollar coverage for preventative, basic and urgent care visits with $0 deductibles, and $25 copays for all in-network visits. Their innovative network consists of over 2,400 retail clinics and urgent care centers across the country with extended hours and no appointments necessary. They also provide access to telemedicine visits via phone 24-hours a day, 7 days a week at no cost which makes getting necessary care quick and easy, even when work and family schedules make it difficult to go into a doctor’s office. Their app-based tools and live medical concierge are available 24/7 make finding care easy and convenient. As an added benefit to address employee concerns about prescription costs, Hooray Health offers a prescription discount card to ensure employees that they are receiving competitive prices for their medications.

Hooray Health removes financial and convenience barriers that prevent people from getting the care they need by making access to necessary care easy, convenient, and free for employees. This type of solution is particularly useful for employers with high deductible health plans where high out of pocket costs may deter employees and their families from seeking the necessary care that they need. While solutions like these remove barriers to care, they also save employers money by providing an affordable alternative to many of the care services needed by their members. Providing easy-to-use concierge-based access to a network of retail clinics, urgent care centers and telemedicine doctors ensures that employee health won’t neglect their health due to lack of money or lack of time. You can learn more by contacting them at info@hoorayhealthcare.com. 

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About BetaXAnalytics:

If you’re an employer who feels there’s got to be a better way to control health care costs, you’re on to something. And we can help. BetaXAnalytics partners with employers to use the power of their health data “for good” to improve the cost and quality of their health care. By combining PhD-level expertise with the latest technology, they help employers to become savvy health consumers, to save health dollars and to better target health interventions to keep employees well. For more insights on using data to drive healthcare, pharmacy and wellbeing decisions, follow BetaXAnalytics on Twitter @betaxanalytics, Facebook @bxanalytics and LinkedIn at BetaXAnalytics.

About Hooray Health:

Since its founding in 2017, Hooray Health has been committed to disrupting the health insurance industry by providing employers, individuals and their families with the assurance that their basic healthcare needs are covered. Here at Hooray Health, we believe that healthcare should be simple, honest, and affordable, that’s why whether you apply online or over the phone, the process is always simple, and acceptance is guaranteed. Partnered with over 2,300 urgent care and retail clinics, and a 24/7 medical concierge team, Hooray Health members know that no matter where they are or what time it is, their healthcare is there for them. Starting plans have a low monthly cost with no annual deductible, an affordable copay, and no surprise balance bills. Every day, Hooray Health is smashing the industry norms and bringing healthcare to all.