Managing healthcare costs without cost-shifting

The role of HR is constantly evolving. Not only are HR leaders facing the biggest fight for talent in recent history, but they’re also grappling with the huge challenge that is rising healthcare costs. While healthcare costs increase year over year, CEOs are looking at HR to find a solution.

Looking back at cost-shifting methods

When taking a look back at the last few decades, HR has deployed many tactics to help lower their organization’s healthcare costs. However, plan design has been the primary tool for a cost-management strategy. In the 1980s we saw the emergence of HMOs. The idea behind the HMO was that an employee would pay a small copay for everything and the health plan would help manage their care by navigating them to specialists as needed. By the 1990s HMOs were widely popular. As HMO renewals started to come in more organizations began making the move toward network-heavy PPOs. 

In the 2000s the U.S. saw some major changes in the healthcare system, which included rising costs. HMOs became less prevalent as PPOs took center stage when it came to employer-sponsored healthcare. The following decade welcomed the consumer-driven health plan (CDHP) and the concept of healthcare consumerism.

In truth, these plan design modifications have shifted costs down to employees. And, they’ve noticed the impact it’s had on their wallets. According to research from the Kaiser Family Foundation, the average family coverage premium has increased 22%. Over the last ten years, that same premium has seen a 54% increase. 

Employers have reached the cost-shifting ceiling

With organizations fighting harder for top talent and the market limitations of shifting healthcare costs, many HR leaders have recognized that the cost-shifting ceiling has been reached. So, they’re re-strategizing. 

A study by Mercer shared the new ways employers are prioritizing their health benefits strategy and found:

• 80% are focused on monitoring/managing high-cost claimants
• 71% feel managing specialty pharmacy costs are important
• 48% are looking at improving patient empowerment
• 42% want to address healthcare affordability

The market is responding

There has been a big response from the employee health and benefits industry, especially in the HR technology sector. In fact, HR technology has become a billion dollar industry. In 2018, HR technology capital reached $3.1 billion – triple the amount invested in 2017.

This has created a sea of point solutions that are now available to employers, all offering to solve specific health and benefit concerns. In the end, HR leaders are finding that this isn’t necessarily solving the problem. 

In fact, adding more point solutions has created a more confusing experience for their employees. And the employee experience is more important than ever.

• 80% of employees feel benefits are more important than salary
• 58% of organizations report employees don’t know which health benefits they’re entitled to
• 63% report employees don’t know how to access their benefits

Employers are taking the healthcare delivery model back

In order to bridge the gap in the market that is disparate and confusing, HR leaders are using a more holistic approach to employee health and benefits. They’re improving the experience with an end-to-end platform that streamlines the employee experience with a health operating system (OS).

Similar to the way a CRM platform like Salesforce works for a sales team, a consumer experience (CX) platform brings everything related to health and benefits onto one platform. This streamlined experience provides employees an easier route to the resources they need, when they need them.

There are four key features of a CX platform:

• Comprehensive digital platform: consolidates all systems and programs associated with health and benefits
• Proactive and preventive engagement: designed to start on day one with an employee
• Employee guidance: through the healthcare system via tools like immediate live chat support
• Data and insights: used to personalize the employee experience throughout the healthcare journey

Dive deeper into what this means for HR

In the upcoming webinar, “An HR leader’s guide to managing healthcare costs without cost-shifting,” Chief People Officer, Kim Tabac, and Mike Christie, founder of Christie Advisory will be going deeper into this topic. Join these industry experts for insights on how to assess your cost-sharing ceiling and the impact it can have on your benefits ROI.