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6 Open Enrollment Trends to Watch in 2020

By Jack O'Brien  
   September 25, 2019

The National Business Group on Health identified six major trends surrounding open enrollment packages heading into next year.

Weeks ahead of the start of the open enrollment period for 2020, the National Business Group on Health (NBGH) has identified six major trends that deserve the attention of provider executives.

The narrative for healthcare benefits heading into 2020 is mostly positive for employees, according to Brian Marcotte, CEO of NBGH.

Heading into 2020, large employers are increasingly focused on providing additional choices for plan benefits, such as through expanded virtual care solutions and mental health coverage.

Marcotte spoke to HealthLeaders to further explain some of the trends NBGH is keeping an eye on during the upcoming open enrollment period.

Related: Medicare Advantage Premiums Fall 33% in Q1

  1. Modest cost increases:

    - Total cost of health benefits is expected to rise 5% in 2020, reaching an average of $15,375.

    - The deductibles and out-of-pocket maximums aren't changing much from 2019 to 2020, according to Marcotte.

    - Large employers will continue to cover about 70% of costs, but the rate increase will outpace both economic and wage growth.

  2. More health plan choices:

    - While 39% of employers offered high-deductible health plans in 2018, only 25% are expected to offer high-deductible plans in 2020.

    - "Employers are reintroducing choice, which has largely been driven by employee feedback," Marcotte said. "But it's also driven by the excise tax, the 'Cadillac Tax,' getting perpetually kicked down the road and possibly even being eliminated. Employers are less concerned about triggering that tax, which is fueling the acceleration of movement to high deductible plans for providers."

    Related: 13.3M Americans Spent More than 10% of Income on Premiums

  3. Additional virtual care options:

    - "As employers continue to look for more virtual care solutions for their employees, that's to provide more access and convenience," Marcotte said. "Traditionally, healthcare has been about consumers going to seek care as opposed to care coming to them."

    - Surveyed employers overwhelmingly (82%) expect to provide mental health services virtually, and 60% will provide weight management services virtually.

    - Given its scalability, Marcotte expects virtual care to play a "significant role" in how healthcare is delivered in the future, especially as it relates to chronic care management.

    Related: Unsubsidized Household ACA Premiums Top $1,400 Per Month

  4. Greater access to decision support tools: 

    - Similar to a recently released Willis Towers Watson report, a primary focus for employers is offering medical decision support tools and second-opinion services.

    - "There's a real opportunity for providers to play that concierge role on a local basis," Marcotte said. "[Organizations] can help navigate and steer people to efficient providers, help people understand how to walk through the delivery system because consumers don't know where to start."

    - Marcotte added that delivery system reform has to happen on a market-by-market basis.

  5. Expansion of mental health benefits:

    - Mental health services by the numbers:

    - 69% will offer online resources

    - Nearly half of employers will conduct campaigns to reduce mental health stigmatization

    - 47% will provide manager training to identify mental health challenges among employees and guide them to necessary resources

    - 33% will provide onsite mental health counselors

    - 28% will offer digital cognitive behavioral therapy

  6. Increased focus on quality: 

    - More than a quarter of employers will expand their centers of excellence services, with an emphasis on addressing orthopedics and musculoskeletal conditions.

    Marcotte said one element that's missing from the survey is the growth in advanced primary care solutions, as employers embrace direct contracting or push their respective health plans to work with advanced primary care models.

Related: ACA Marketplace Open Enrollment Finishes Higher Than Feared

This article was updated September 27, 2019.

Jack O'Brien is the finance editor at HealthLeaders, a Simplify Compliance brand.

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