Employers are also looking at private health insurance exchanges. Some 30% responded that they are considering private exchanges as an option for their active employees sometime after 2014. Private HIX can be used by employers to transition to a defined contribution strategy where the employer puts a cap on how much to spend on employee healthcare benefits.
Private exchanges are being developed by consulting firms, such as Aon Hewitt, Mercer, and Towers Watson, as well as retailers, such Walgreens, and insurance brokers. Aetna and Cigna have announced plans to develop proprietary exchanges.
Darling says employers are tentatively embracing the new payment models introduced through healthcare reform, including accountable care organizations and patient-centered medical homes. Noting that health plans play important roles in both ACOs and PCMHs, she said self-insured employers will have to figure out how to participate in these opportunities.
Employers identified wellness initiatives (58%), consumer-directed health plans (52%), and increased employee cost sharing (41%) as their three most effective tactics for controlling costs.
Employer interest in CDHPs has remained steady in recent years with almost three-quarters of employers (72%) offer at least one CDHP. However, some employers are moving exclusively to CHDPs. Some 22% plan to offer only a CDHP in 2014. That is up from 19% in 2013.