In one of its most significant findings, a recent survey revealed that the number of employers offering workers a consumer-directed health plan (CDHP) as the only health benefits option is expected to surge by nearly 50 percent next year.
The survey found that employers are making numerous changes to their benefit designs in an effort to control costs.
In 2015 employers are planning actions in the following areas:
- Consumer engagement tools.
Companies will add or expand tools to encourage employees to be better health care consumers (cited by 73 % of respondents). For instance, in 2015 price transparency tools for selecting care providers based on cost and quality ratings, and online decision-support tools for comparing plans and estimating costs. - Consumer-directed plans.
Many employers will implement or expand account-based CDHPs (57 %) next year. Almost one-third (32 %) say they will offer a full-replacement CDHP as their only benefit plan option. Thirty percent plan to eliminate one or more high-cost plans from their available options, while 10 % plan to adopt a defined benefit health care model. - Wellness programs.
Adding or expanding wellness program incentives or disincentives (53 %). - Spousal coverage.
Some companies plan to reduce spousal subsidies or implement spousal surcharges (37 %). Next year, 29 % will have in place a surcharge for spouses who can obtain coverage through their own employer, 3 % will require spouses to purchase health insurance through their own employer when available, and an additional 3 % will exclude spouses if the coverage offered through their own employer is essentially similar. - New delivery models.
Over 25% of respondents are adding or expanding efforts to encourage employees to use high-performance networks (also known as “narrow networks”), accountable care organizations, designated centers of excellence or similar delivery models (27 %). Twenty six percent plan to include a narrow network in at least one of their plans next year, for example. - Specialty pharmacy benefits.
Most employers (74 %) will require step therapy—first trying less-expensive medications to manage the employee’s condition—before authorizing high-cost specialty pharmacy medications. Also pervasive are utilization management programs (72 %). On the rise: one third (33 %) will use a freestanding specialty pharmacy to cover these prescriptions next year, while 29 % will only approve coverage for a 30-day initial supply to see if the medication is effective. - Weight management.
Seventy three percent will cover surgical interventions for the treatment of severe obesity next year while 41 % will cover FDA-approved medication, both slightly up from this year.
