2021 planning: 10 key questions to get you started

I know it’s only January, but it’s never too early to start planning for next year. This is especially true now that many employers feel they’ve maxed out on healthcare cost-shifting to plan members. And, more than ever, they realize the need to address all the dimensions of wellbeing – physical, mental, emotional, financial and purpose. Here are some questions and ideas to get you started with your 2021 strategy.

  1. What do you really know about your population and their needs? The one-size-fits-all approach to benefits may not work when we are trying to meet the needs of five generations in the workplace, especially in today’s tight labor market. It’s a good time to do focus groups, conjoint analysis, or a persona analysis to drill down on what your employees need and value.

  2. How well do your benefits address the real, everyday life challenges workers are faced with, including mental and emotional health and financial wellbeing? It might be time to take a closer look at your EAP and what it is doing for your people. Do you need it to do more? 

  3. Is healthcare affordability a concern? If so, you are not alone. Health care affordability consistently ranks as a top stress area for workers. Employers are offering more medical plan choices to meet varying needs. Check out these blog posts on helping employees afford care in January when their deductible accumulator is re-set to $0, and what to do when faced with an expensive medical bill.

  4. How well are your vendor partners delivering “whole person” care? Point solutions have made their way into many employers’ programs, and we’ve realized that our vendor partners need to work better together to address consumers in a more holistic way. Consider hosting a vendor summit and having an open dialogue on business rules and how to coordinate better. Sharing information about your population (the results from #1 above) is a great way to start the conversation.

  5. Have you considered new options for care delivery? Alternative care delivery options – including text-based visits and virtual primary care that can effectively triage and refer members to local, high-quality specialists – are gaining traction. Explore options for virtual behavioral health to resolve the challenge of increased market demand and constrained provider capacity.

  6. What do you know about healthcare quality in the locations where your employees live? We are seeing more employers embrace provider disruption if it leads to better health, quality and outcomes. This shift requires continued focus on cracking the engagement challenge to help drive members to higher quality providers. We may see the role of the primary care provider shift from “care quarterback” to “master of referrals” as employers contemplate limiting provider choice to improve healthcare quality and outcomes. In addition, we’re starting to see some employers eliminating out-of-network benefits altogether.. 

  7. Are you prepared to handle the risk and expense associated with new therapies? New gene therapies and specialty drug treatments for rare, extreme conditions force coverage decisions that benefit few, yet change/save lives. As a result, we are seeing renewed focus on managing, and insuring, the risk of high cost claims.

  8. Who owns your claims data? Clearly define your right to your plan data with your vendor partners. Employers are pushing to have complete access and distribution rights. 

  9. How transparent are your fee arrangements with your vendor partners? Variable fees charged by carriers are under scrutiny to determine if the value delivered is aligned with employers’ expectations. 

  10. How inclusive are your benefits? Consider what you can do to ensure that benefits programs are inclusive to avoid any unconscious bias inherent in the design and coverage.

Many years ago I worked with someone who was known for saying “we are fixing to get started.” So if that is where you are in your strategic planning for 2021, hopefully these questions will be just the “fixing” you need to start your planning! This is the beginning of a series of blog posts from our subject matter experts with strategic planning ideas for you. There’s more to come, so watch this space.

Tracy Watts
by Tracy Watts

Senior Partner, National Leader for U.S. Health Policy

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