Quality health plans first: Employers want results, but many believe their plans fall short

Employers were more likely to agree that their health plan shares quality and safety data in 2022 than in 2020.

Quality is the most important factor for employers when evaluating health plans, according to new report from the watchdog organization, The Leapfrog Group.

“We were a little surprised at how clearly the findings showed that employers care first and foremost about quality of care,” says Leah Binder, the group’s president and CEO. “They want results. The report points to specific issues that appear to disappoint employers and what successful health plans do to earn their trust.”

Employers have been critical of health plans since Leapfrog conducted the same survey in 2020. When asked to assign letter grades to their health plan based on its ability to provide high-quality health care to employees, most employers gave their plans a “C” grade, although there was considerable variation among plans. The average grade given to health plans was slightly worse than in 2020, decreasing from a 2.57 GPA to 2.29, which demonstrates significant room for growth across all categories surveyed.

More than half of respondents say their health plans care about the quality of care that their employees receive, are committed to reducing unnecessary costs and prioritize improving employee health. Employers were more likely to agree that their health plan shares quality and safety data in 2022 than in 2020, but employer satisfaction with alternative payment model offerings appeared to have declined in the two years between surveys. “It is critical that health plans improve transparency of data,” Binder says.

Overall, the survey suggests that employers remain disappointed in many aspects of health plan performance in achieving their goals for high quality, cost-effectiveness, value, transparency and service. This poses serious challenges as employers navigate the new Consolidated Appropriations Act, which enhances their fiduciary responsibilities under ERISA. Employers now bear more legal responsibility for assuring that the benefits they provide are cost-effective and high quality, so the dissatisfaction in this report should be an urgent priority for health plans.

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“Our findings indicate that while employers generally believe health plans are aiming for quality and value, employers perceive significant room for improvement across all categories surveyed,” the report concludes. “This also presents a competitive opportunity for health plans that mobilize to improve quality of care, as quality stands out as the most important factor for employers that give their plans high marks. Health plans should look for opportunities to partner with business groups on health and employers and other purchasers to better achieve these shared goals.”