Large employers assess impact of COVID-19, identify areas of focus for 2022 and beyond
In 2021, health care trend is predicted to increase by 6%. Here's what's driving it.
The past few years have been a roller coaster ride for employers. A normal year in 2019 was followed by the pandemic year of 2020 and a hybrid mix of remote and onsite work in 2021. No wonder it is so difficult to plan for the year ahead.
The Business Group on Health recently took the pulse of 136 large employers in its “2022 Large Employers’ Health Care Strategy and Plan Design Survey.”
“We have seen a slight decline of 42% versus 45% last year of employers who view health and well-being as integral to workforce strategy,” said Ellen Kelsay, president and CEO of the organization. “That on the surface is a bit surprising, because we certainly know that employers have done a lot to support the health and well-being of their workforce in these pandemic times.
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“When we stepped back and thought about it, a lot of what employers did was about the immediacy of the pandemic and workforce. They really weren’t tied to a long-term strategy but were meeting acute needs. We anticipate that in coming years we will see that topline number tick back up again.”
The survey found several five key areas of focus for employers heading into next year:
COVID-19’s potential long-term impact on employees. Staying at home during numerous lockdowns meant that doctor visits and preventive screenings were delayed or missed altogether. Social isolation and uncertainty because of the fluid nature of the pandemic proved to be an impetus for depression, anxiety and substance-use disorders. As a result, employers anticipate seeing an increase in medical services, late-stage cancer diagnoses, greater numbers of people with long-term mental health and substance use issues and other adverse effects. These could last well into future years.
“Employers accelerated many activities in light of the pandemic,” Kelsay said. “Probably not surprising, what stands out are the areas of improving mental health access and services, as well as expanding access to virtual health service and promoting health equity.”
Focusing on social determinants of health as a gateway to increasing health equity and promoting systemic change. Employers are initiating programs and benefits to improve the circumstances that employees and their families are born into and live, which have an impact on their ability to live healthy and fulfilling lives. By zeroing in on these circumstances, employers can tackle the underlying social and economic challenges that influence overall well-being, with the goal of bringing about systemic change.
“Many employers are viewing efforts related to social determinants as being a gateway to an overall health-equity focus and driving a long-term climate of change,” Kelsay said.
Expanding access to mental health care is a top employer priority. The pandemic accelerated progress in reducing stigma by laying bare challenges all employees were facing and notably shifting to more open discussions about mental health. In fact, 2022 will be the first time that a majority of employers have an anti-stigma campaign. As these concerted efforts continue into 2022, a top priority for employers is to expand access to mental health services.
“The most common response was around mental health access,” said Brenna Shebel, vice president of the association. “That’s the ability of the employee to get the treatment or support they need. Seventy-six percent of large employers said access will be a top focus area for the coming year, followed by stigma.“
Virtual health received a boost from the pandemic, but there still is a role for on-site clinics. As a result of the pandemic, 76% of employers accelerated telehealth and virtual health offerings and plan to keep these options in place over the long term. But employers also see a role for on-site clinics, both to manage COVID-19 testing and vaccinations and to help employees manage chronic conditions. Although the percentage of employers that have on- or near-site clinics declined between 2020 and 2021, it is expected to return to pre-pandemic levels in a couple of years.
“The conversation we are hearing from our members is that virtual care really is here to stay,” Shebel said. “We have been hearing that virtual care is not just a standalone thing on the side but is becoming integrated into the care experience. We expect this number to remain steady or even increase in coming years.”
Health care trend was 0% in 2020, but costs are expected to rebound in 2021 and 2022. In 2020, some employers experienced a negative trend. In 2021, health care trend is predicted to increase by 6%. In 2022, cost trend is expected to decline slightly to 5.8% after plan design changes are made.
“Before the pandemic, we saw that about 58% of employers had at least one onsite clinic,” Shebel said. “We saw a slight drop in the number of employees offering onsite clinics between 2020 and 2021. We expected that number to increase this year as more employees return to the worksite, but it really stayed steady. We have had a lull but expect it to rebound by 2024.”
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