If companies are spending 5% to 6% more annually to sponsor health care for employees, they should also be seeing improved health outcomes and increases in productivity. (Photo: Shutterstock)
Health care in the United States is broken. The COVID-19 pandemic has further magnified that our system is not working for anyone–consumers, providers, care systems nor the employers who sponsor health care for millions of Americans. The pandemic has also led to a rapid breakdown in barriers to telemedicine delivery across state lines, a silver-lining development that could be applied to other areas of the health care system that are mired in legacy silos.
Some have started calling for a New Deal mindset post-pandemic as we encounter what will be significant economic and health system recovery. I believe that employers have an important role in leading how the U.S. navigates what's ahead. It's time to do things differently.
|Why employers?
Employer-sponsored health care provides health insurance coverage for nearly half of Americans. This puts employers squarely in the health care system mix whether they want to be or not.
As business leaders of all sizes consider how to bring employees back to safe working environments and in good health, we will also need to prepare for a surge in surgeries and chronic disease management care that has been on the backburner for months. The health of employees is more critical than ever. The scale of employees needing to access health care benefits is massive.
Even before the pandemic, the cost of keeping a workforce insured and healthy had been careening towards unsustainable year-over-year, with increases for nearly two decades. In one recent study, large employer-sponsored health plans expected to see a 6% rise in costs if they didn't make any changes. And if they did plan to implement some form of cost management, they would still be looking at a five percent increase. In many cases, the cost management would take the form of employees and their families picking up more of the health plan cost.
This approach shifts the cost burden around and does not address the root cause of the health care system's inefficiencies to bend the cost curve more effectively for employers and employees over the long haul. And as many employees face realities like furloughs or additional health care costs related to COVID, shifting the burden to employees is even less favorable.
Employers should do right by their people.
|New deal for employer-sponsored health care: invest in health & benefits, demand better outcomes
As we begin to examine costs and outcomes, if companies are spending 5% to 6% more annually to sponsor health care for employees, they should also be seeing improved health outcomes and increases in productivity annually. Unfortunately, studies continue to show that Americans spend more per capita than any other country yet have some of the worst outcomes. In 2018, we spent just over $11,000 per American compared to $5,200-$7,300 per capita in other industrialized countries, according to the Peterson-Kaiser Family Foundation Health System Tracker.
And for more than double the per-capita spend, American health outcomes greatly lag other countries. We continue to have a lower life expectancy, higher chronic disease burden and one of the highest rates of obesity.
Employers should be aware of the "second hit" of the pandemic coming – an expected surge in need for health care services that could not be obtained over the past few months. Employers should be aware that COVID-19 is expected to continue to hit different pockets of the country in waves and could again necessitate drastic changes in how we work and live for periods of time.
To keep workforces healthy, safe and able to work through these uncertain times we cannot ask more from an already broken health care system. We can only ask for different.
Right now the siloed nature of accessing and receiving health care puts a significant burden on the individual consumer. For those with employer-sponsored health insurance, it can be a daunting task to understand what is and is not covered by insurance. While Explanation of
Benefits and insurance policy plans are getting somewhat easier to read, many employees feel overwhelmed in navigating the system and making sure their procedures are covered or understanding the true cost to them. And with the expectation of the second hit, employees will have a host of new questions related to COVID-19 benefits.
As someone who develops intelligent technology platforms to support care teams that work directly with over 1.5 million people in the American workforce, I know we must and can do better with how we deliver health care. Better outcomes start with developing a relationship with the employee as health care consumers, partnering closely with providers, and harnessing the power of technology and machine learning to provide smarter, more personalized care.
Employee health matters more than ever right now and employers are in the driver's seat when it comes to making health plan and benefits decisions. As we get ready to restart the economy now is the time for a comprehensive clinical solution to help all people return to work in a safe environment, keep them healthy and productive. It's possible and it's time to do things differently.
Rajeev Singh is currently the CEO of Accolade, a market-leading personalized advocacy company for employers, health plans and health systems.
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