According to the U.S. Census Bureau, more than 178 million Americans currently have employer-sponsored health insurance, surpassing the number enrolled in Medicare and Medicaid and dwarfing the number covered in the individual market. But despite the breadth of employer-sponsored health coverage, it’s often ignored in policy debates.
Employers health plan sponsors are more than mere intermediaries. They play a critical role in the healthcare system, leveraging purchasing power, market efficiencies and plan design innovations to provide comprehensive health coverage at a fraction of the cost to government compared to federal programs. Nevertheless, some policymakers subscribe to the myth that employers don't feel the need to manage their own healthcare spending. That they don't seek more cost-efficient health plans. That they don't work to ensure quality of care. That they don't innovate.
In fact, employers have been innovating since they first began providing health benefits. To demonstrate the many ways that employers are seeking to enhance value and improve outcomes for employees, Mercer and the American Benefits Council have collaborated on a paper that showcases some of employers’ most innovative strategies: Leading the Way: Employer Innovations in Health Coverage.
Mercer has identified four areas where change is most needed to create a more rational healthcare marketplace, called the “Vitals for Change.” The innovation success stories contributed to the paper by Council members and Mercer clients, together with trends from Mercer’s National Survey of Employer-Sponsored Health Plans that show progress among employers across the country, show how employers are helping to drive change in all four vital areas:
- Pay for value
- Drive to quality
- Personalize the experience
- Embrace disruption
Among the many stories in the paper, you’ll read how one employer set up ACOs to address poor care coordination and achieved better outcomes, higher member satisfaction and improved financials; how a custom care coordination model incents plan members and plan carriers if lower cost, high quality providers are chosen, with projected savings of 4% of total medical claims; and how a custom maternity management program increased engagement by a factor of four, contained cost, and led to happier parents and healthier babies.
Employers recognize that helping their employees to thrive is not only the right thing to do, but has a measurable impact on virtually every aspect of their business. And when they invest in innovative strategies to provide their own employees with effective and sustainable health coverage, they make the healthcare system better for everyone.