Employers have the power to make health care more affordable: Milken
Employer-sponsored insurance covers approximately 180 million people and accounts for more than $1 trillion in health-spending annually, says a new Milken Institute survey, which highlights the need for employers to explore opportunities to improve health outcomes.
The institute noted that health care is one of the top policy issues in the U.S., but that attitudes among employers about ESI are not widely known.
“This is pioneering work out of our public health team,” said Sarah Wells Kocsis, director of the Center for Public Health at the Milken Institute and one of the paper’s authors. “We felt that this was an unmet need that we could address. We were really pleased to have 72 employers of different sizes and sectors represented in this sample.”
Well Kocsis said the study put an emphasis on accountable care and found that more than one-third of respondents were integrating accountable care strategies that pay for quality over service volume.
“Accountable care is really moving away from a volume-driven model to one that is based on value for the investment or cost,” she said. “The study sought to understand attitudes and perceptions related to accountable care… and where there are opportunities for employers to make some headway.”
A system with room for improvement
The report noted that ESI costs are rising steadily. This model of insurance covers approximately 180 million people, the authors wrote, or roughly half the U.S. population, and accounts for more than $1 trillion in health-spending annually. The average health insurance premiums increased by 7% for single coverage and close to 25% for families. “This represents a 22% average increase in family premiums since 2018 and 46% since 2013,” the report said.
Despite the amount of resources being spent on health care, the outcomes do not measure up to peer countries. “Research by the Commonwealth Fund revealed that among high-income nations, the U.S. has the lowest life expectancy at birth, the highest death rates for avoidable or treatable conditions, the highest maternal and infant mortality, and among the highest suicide rates.”
Respondents said that many cost-related challenges plague the U.S. system, with geographic limitations leading to inconsistent health offerings, complexity that affects access, and issues with benefit integration.
The push for accountable care
The study said businesses described areas such as expanding preventive care, increasing access to primary care, and focusing on whole-person health as the top three tenets of accountable care.
Wells Kocsis said that many employers are looking at accountable care as a better model for addressing quality and cost, but many factors, including type of business, resources, leadership that play into how far along they are with the model.
“We know that a number of employers want to integrate accountable care, but I do think that there are different stages of readiness, depending on the type of organization, their resources, their leadership; there are different factors that would determine at what stage they are with integrating accountable care,” she said. Top issues for employers
Not surprisingly, cost was on the mind of employers when it came to ESI. Wells Kocsis said when researchers asked respondents to list their top concerns, reduction in overall costs was at the top of the list. Other things respondents wanted to address included utilization disparities, health disparities, and improvements in beneficiary understanding of benefits.
“Employers want to be able to have choice and accessibility and balance that with reduction in overall costs,” she said. “These issues are important to employers, but they’re also important to the beneficiaries, who have to deal with cost sharing and out-of-pocket costs.”
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Wells Kocsis also emphasized that employers are taking a broad view of health benefits. The survey’s findings about employer interest in preventive care and whole-person health was indicative of a recognition of the importance of addressing “upstream” health care. The survey also found a focus on mental health, with more than 20% of respondents saying they were committed to enhancing those resources in coming years.
“[Interest in those areas] really speak to what employers are hoping can help advance progress and change,” Wells Kocsis said.