3 health plan enhancements that are here to stay

It’s no surprise that health plan options rank as one of the most important and most highly utilized benefits that employers provide their employees. Employers across the country are looking to optimize their plans by improving access and ease of care while lowering costs.

Here are some top trends on the horizon for employers and their benefits advisors to consider as they look to optimize benefits for employees this year and beyond.

1. The continued rise of virtual-first plans 

Many industries are adopting a digital-first mindset to match consumer demand and increase accessibility, and health care is no different. The COVID-19 pandemic rapidly accelerated the adoption of virtual care services, with forecasts showing almost 40% of the population will be  telehealth users in 2023. In addition, wait times to see a mental health professional are averaging 48 days nationally, as demand for mental health care continues to outpace provider volume. This presents a unique opportunity to connect these digitally enabled consumers with a more accessible care platform. In 2023 and beyond, virtual-first plans will transform access and convenience for consumers by meeting people where they are, whenever they need care. 

Adding a virtual-first plan option to a benefit offering can give employees more access to care. More medical services are available virtually than ever before and virtual plans allow for a consistent relationship to form between patient and provider. Often, appointments for virtual PCP and behavioral health care are available at convenient times (day and night) for $0 out of pocket, increasing accessibility for those that may be putting off care due to location, scheduling conflicts or cost. Providing a virtual-first plan option can help employees save on out-of-pocket costs while helping employers support employee retention targets in today’s highly competitive job market. 

2. A concierge approach to health engagement and navigation 

We are all facing some decision fatigue as life and systems become more complex. This challenge is particularly present in health and benefits, where studies show most employees are confused by their benefits. That confusion has led to a drop off in engagement with the benefits employers are curating for their workforce. For example, engagement with employer-sponsored employee assistant programs (EAPs) usually hovers around 5%. But driving up clarity and engagement can feel like a daunting task. Adding a best-in-class health navigation and advocacy solution can improve employee engagement, simplify the benefits experience, and increase plan savings — all while providing some resource relief for busy HR teams. 

Navigation and advocacy solutions are designed to connect your employee population to a single team of health advocates who are trained to guide employees through the health care system and their benefit plan. This concierge-style approach to health and benefits engagement maximizes engagement and employee satisfaction, while guiding employees to high-quality health care services. According to a recent report from Savanta, access to this resource has been shown to drive 90% employee satisfaction with 98% of employees saying having a health advocate positively impacts how they view their employer.

3. Value-based care models

Value-based health care is one of the top trends when it comes to tackling the rising cost of health care. This model between payer and provider is a fundamentally different way of care reimbursement, where providers are compensated based on patient health outcomes versus volume. Value-based care shifts the economics of health care, as it requires collaboration across the health care ecosystem to deliver patient support throughout their entire health journey. Insurers become more embedded in physicians’ workflows, staying in sync with the care model to help patients get and remain healthier. Providing value-based care can improve overall patient health and lower costs for employers and their employees. Provider-sponsored health plans are on the leading frontier of this trend being uniquely positioned to integrate and innovate technology, systems, and patient experience to improve outcomes. 

Optimizing your benefits program to fit the needs of your workforce and your budget is no small undertaking. Prioritizing these trends in decision making will ensure your benefits package stays on the cutting edge for the health of your employees and your business. 

Alicia Coronas is vice president, Employer Solutions Product and Marketing at Priority Health, where she leads the organization’s development of market-leading innovative products for the commercial insurance line of business, serving small and large companies across Michigan.