Advanced primary care: More employers adopting to curb high hospital bills

U.S. employers may be more interested in controlling hospital bills by improving primary care than by negotiating contracts directly with hospitals.

When the National Alliance for Healthcare Purchaser Coalitions asked employers about six hospital cost control strategies they might adopt within the next three years, advanced primary care strategies came in first.

Only 22% of the 188 employers that participated in the latest NAHPC survey said they have advanced primary care strategies in place now, but 54% said they may adopt advanced primary care strategies soon.

Advanced primary care practices use online scheduling systems, telemedicine systems, statistical analysis and other high-tech strategies to try to provide primary medical care and behavioral care as efficiently as possible.

Related: Advanced primary care: Employees see doctors regularly, without driving up costs

Putting hospitals in tiers, with some hospitals preferred over others, came in second in terms of next-three-years heat: About 18% of the survey participants have tiered hospital networks now, and 46% could add a tiered hospital network strategy soon.

Two other much-discussed cost-control strategies, referenced-based pricing and direct provider contracting, lagged far behind.

An employer plan with a reference-based pricing program favors providers that agree to accept the prices the plan wants to pay.

An employer plan with a direct contracting program negotiates its own prices with the providers.

About 17% of the employers participating in the NAHPC survey now contract directly with hospitals, and 8% use reference-based pricing.

But just 40% of the participating employers are thinking about adding reference-based pricing soon, and just 26% are thinking about adding direct contracting.

The survey: The National Alliance for Healthcare Purchaser Coalitions is a Washington-based group that represents organizations like the Purchaser Business Group on Health, the Economic Alliance for Michigan and other benefits buyer groups.

The coalitions’ members provide health coverage for about 45 million people.

NAHPC conducted the employer survey online. About 76% of the participating employers had more than 1,000 employees.

Reasons: Advanced primary care practices may have buzz partly because they are popular with investors and have cash they can use to promote themselves.

Last spring, for example, Elevance Health agreed to back apree health and Millennium Physician Group, two advanced primary care firms owned by Clayton, Dubilier & Rice, a private equity firm.

Google may have given the advanced primary care strategy extra publicity this summer, by announcing it was shifting on-site care from one advanced primary care provider, Amazon One Medical, to another, Premise Health.

Other findings: NAHPC also asked the survey participants about a wide range of concerns and cost control strategies in addition to hospital spending.

• When asked to rank nine possible concerns, participants ranked drug prices as the top concern and benefits broker or consultant conflicts of interest as the concern of least interest.
• About 14% of the employers that cover Wegovy or other GLP-1 agonists for obesity use Found Health, Vida or another vendor to manage GLP-1 agonist access, and 53% could add a GLP-1 agonist access vendor within the next three years.
• Only 62% now use stop-loss insurance to manage high-cost claims, but 30% could buy stop-loss insurance within the next three years.