Hybrid care, affordability, behavioral health are shaping benefits plans in fast-changing environment

Providing employee health insurance solutions that are effective and affordable has become a moving target. The lingering effects of the pandemic, a sluggish economy and an evolving workplace environment means employers and brokers must understand and respond to emerging trends.

Evernorth recently surveyed more than 3,000 consumers with employer-sponsored insurance, 575 employers and 75 health plan leaders. The research revealed three major insights regarding workplace health benefits.

There is an increased risk of gaps in care without hybrid care models, including virtual and in-person options. Over the past several years, care has continued to evolve and expand beyond traditional settings, accelerating the availability of hybrid solutions that combine the best qualities of both virtual and brick-and-mortar care models. While consumers and plan sponsors both actively embrace virtual options, as well as more advanced health care technology, there is an opportunity to establish a more-cohesive patient experience. Specifically, consumers are voicing a need for care that’s more efficient, effective and economical. Key takeaways:

• By coordinating initiatives to improve awareness, plan sponsors can help educate consumers, informing them about all of the care options available to them, including both virtual and brick-and-mortar care.
• Education efforts will be critical to arming consumers with the information required to access the care they need for greater productivity, better outcomes and a more cohesive experience.
• Growing technology options can provide consumers with a stronger connection to their health offering solutions to the fragmentation shaping the health care landscape.

Rising costs and challenges to access are increasingly shifting dynamics as they relate to consumers’ care. As prices of prescription drugs continue to rise, even consumers with employer-sponsored health insurance are finding their resources strained. More than 7 in 10 consumers express concern about the unaffordable cost of medications, while 6 in 10 say they are worried about whether they can even access less-expensive prescription drugs. Key takeaways:

• Plan sponsors have made efforts to reduce barriers to health, especially rising costs, and understand they have a role in addressing and supporting access to care.
• To maximize the potential of generic and biosimilar drugs, it will be important to educate both consumers and providers about these new drugs’ availability and value.
• Both employers and health plan leaders view health equity as a standalone strategy, with health care as the top area where they believe they can have an impact.

Acknowledgment and investment don’t immediately yield a solution to behavioral health challenges. Both consumers and plan sponsors remain deeply invested in behavioral health, with tools and practices reaching a mainstream audience. For example, 31% of consumers say they or someone in their family sought behavioral health care in the past 12 months. Key takeaways:

• Consumers report a significant decline in their mental health over the last year. It will be important for plan sponsors to address consumers’ changing needs.
• Younger consumers appear to be participating in efforts to address their behavioral health and are much more likely than older consumers to report challenges.
• When it comes to implementing future behavioral health resources, plan sponsors may want to consider age-specific outreach and education efforts.

Related: Collaborating with communities to deliver affordable health care

“The disruption and fragmentation that have characterized health care over the past year are clearly reflected in the perspectives of both consumers and plan sponsors,” the study concludes. “Their sentiments suggest a rich opportunity to provide a more-cohesive care journey, as well as a higher standard of health care benefits delivery.”