Healthcare Cost & Quality
| Mar 01 2019

How Hospitals Turn Their Employees into Customers

The role of benefits in supporting an organization’s business objectives has never been more acute than it is today: getting and keeping the right employees, staying competitive in a tight labor market, adapting to diverse needs of a changing workforce. And nowhere is this truer than with hospitals, which are navigating changes in how they compete, how they are paid and who they need to deliver newer services at high quality. Mercer’s 2018 National Survey of Employer-Sponsored Health Plans again surveyed hospitals on the unique aspects of their healthcare programs: leveraging their expertise for the benefit of their employees and incenting those employees to increasingly use the hospital’s own, domestic, services.

Not surprisingly, over 90% of hospitals surveyed use incentives to encourage domestic use and keep their spending “at home”—primarily for facility-based care and for professional services. As a result, roughly 60% of claims, on average, do come in-house. But there is opportunity to do even more. Only 37% incent employees to use onsite clinics, one of the fastest-growing areas today and one hospitals are ideally suited for. And, just 29% of hospitals use in-house support for cancer screenings, where both access and cost can be made better than market.

A hard reality is that even domestic care doesn’t come free. Even with incentive designs, by far most hospitals still ask for meaningful employee cost sharing, e.g. a $600 median deductible among the 73% using one. Over half (52%) use an inpatient copay and nearly all have a copay for the ER. When employees use non-domestic network providers, medians are much higher: double the deductible and about 50% higher for office visit copays. For drugs, an ever-increasing source of spend, nearly four out of five open their in-house pharmacy to employees. Fully half mandate the use of that pharmacy for maintenance drugs or specialty drugs, or both.

As care delivery changes, hospitals have kept in step. About a third (34%) have developed population health programs for the community, which are now being applied to the employee plan. And, in stride with perhaps the fastest-growing new service over the last four years, more than a third (35%) support a telemedicine service with internal clinical resources.

If you’d like to know more about hospitals as employers and the health benefits they provide, there’s much more data to explore from Mercer’s 2018 NationalSurvey of Employer-Sponsored Health Plans.

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