High healthcare cost impact

Rising health care costs have far reaching impact with 93 percent of employers expressing concerns about their ability to remain competitive and 89 percent noting that it may lead to further shifting of costs to employees. These are among the findings from the latest purchaser survey conducted by the non-profit Midwest Business Group on Health (MBGH).

The study conducted with the National Alliance of Healthcare Purchaser Coalitions and sister coalitions gauged concerns and approaches of employers to address the workforce environment, women’s health, obesity management, mental health, equity, pharmaceutical drug and hospital prices, high-cost claims, fiduciary strategies and potential health reforms.

“With so many moving parts across the health care and health benefits spectrum, employers must always be a step ahead,” said Cheryl Larson, president and CEO of MBGH. “Between unsustainable cost increases, the economy and employers ensuring they are meeting their fiduciary responsibility, it’s no longer about just controlling costs. Our annual employer survey provides a roadmap for employers to achieve true cost transparency, identify ways to request and receive their claims data and hold vendors accountable.”

Key findings include:

• Health care affordability threats – The most significant threats to the affordability of employer-provided care are drug prices (98%), high-cost claims (82%) and hospital prices (74%).
• Managing PBM vendors – Over half of employers said they are under contract with one of the “Big Three” firms and another half said that they are considering changing their PBM vendor in the next 1-3 years due to concerns about cost and transparency.
• Drug strategies – More employers are focused on the promotion and inclusion of biosimilars on their drug formulary (67%) and while only 37 percent include cell and gene therapies, another 33 percent are considering adding in the future.
• Health equity – Almost 44 percent said they analyze claims based on geographic locations; 24 percent place accountability for health equity in service provider contracts; and 26 percent are collecting qualitative data on their programs and employee needs through focus groups.
• Women’s health – 86 percent of respondents are offering parental leave and 83% offer maternity support services; 67 percent offer reproductive health care and fertility services; and 33 percent are offering menopause support and services.
• Mental health – While the biggest area of mental health focus is offering programs to educate people on stigma and bias, 63 percent of respondents are evaluating and promoting cultural competency and diversity with 49 percent establishing vendor accountability through actions such as performance metrics.
• Obesity management – A significant majority (88%) offer lifestyle programs such as exercise and nutrition; 63 percent cover branded GLP-1 medications, and 68 percent cover other anti-obesity medications.

SOURCE: www.mbgh.org

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