Employers Commit to Health Benefits as Pandemic Sows Uncertainty

Private buyers of healthcare say they're open to government reforms and new payment strategies.

A solid majority (71%) of the nation's employers are holding firm or accelerating health benefit strategies for their workers, even as the coronavirus pandemic and the ensuing economic downturn disrupts business as usual, according to a new poll from the National Alliance of Healthcare Purchaser Coalitions

Employers are even more receptive to healthcare reforms on a variety of issues including drug price regulation (94%), hospital price transparency (90%), surprise billing regulation (81%) and hospital rate regulation (79%).

Half of employers (50%) said a Medicare public option could be very or somewhat helpful, while 21% felt it could be very or somewhat harmful. When asked about Medicare for All, 46% of employers indicated that would be very or somewhat harmful," the survey found.

The online poll was conducted in August and September with 165 employers that are members of coalitions affiliated with the National Alliance.

"Employers are maxed out as to what they and their employees and family members can shoulder for healthcare costs and they continue to be concerned about the sustainability of privately-sponsored healthcare," said National Alliance President and CEO Michael Thompson.

"Looking forward, they are working to shift market dynamics to get better value for their healthcare dollars through delivery-based strategies such as advanced primary care and centers of excellence, and there is also an increasing openness to government action," he said.

The survey also found that:

• Caregiving benefits such as leave (30%) and protected time to support employee caregiving (28%) have tripled since the start of the COVID-19 pandemic.
   
• Some employers are considering expanding allowances for emergency day care (13%) and home tutoring or teachers (12%).
   
• Respondents said these market forces present a significant threat: drug prices (90%), lack of transparency (73%), hospital prices (71%), surprise medical bills (58%), and overuse of low-value services/waste (53%).
   
• The top delivery and payment reform strategies employers include reducing waste and inappropriate care (61%) and narrow networks (47%).
   
• Strategies over the next two years include hospital quality transparency (44%), hospital pricing transparency (43%), regional centers of excellence (39%), and advanced primary care (36%).
   
• The most prevalent medical and pharmacy drug strategy employers now use is medication therapy management (49%). One in three will be considering strategies in medical and pharmaceutical drug transparency and pass through pricing (33%) the next two years.
   
• Health and wellbeing strategies now being implemented include flexible work week (65%), total person health and wellbeing (63%), navigation and advocacy services (55%), and enhanced mental health support (49%).
   
• Most employers are encouraging community volunteerism (71%) and engagement in community improvement (70%), and 58% said they are offering anti-racism education and cultural competency training (52%).
   
• Over the next two years, 40% said they are considering programs for transparency and education for healthcare disparities, and access to aggregate health data by race/ethnicity.

Elizabeth Mitchell, president and CEO of Pacific Business Group on Health, said the survey illustrates that "rising healthcare costs continue to burden our businesses and employees, and they are crowding out jobs, wages, and in the age of COVID, our economic recovery."

"The results of this survey reinforce employers' justified concerns about how high drug and hospital prices, surprise medical bills and continued overuse of low-value healthcare services threaten the health and economic security of American businesses and workers," Mitchell said.

"Employers well understand that healthcare is broken and that they can no longer wait for the system to fix itself."