Health Benefit Directions

Transcription

1 An MBGH Employer Benchmarking Survey Health Benefit Directions November 2016 Copyright (c) 2016 MBGH 1

2 Survey Overview Survey was sent to all employer members of business coalitions Responses from 81 organizations Survey sent in August-September 2016 Copyright (c) 2016 MBGH 2

3 Industry of Respondents Transportation, 2% Wholesale, Automotive, 1% Real Estate, Food, 2% Communications/Infor mation services/media/publish ing, 2% Holding company, 1% Technology, 4% Pharmaceutical manufacturer, 4% Non-profit/coalition, 7% Manufacturer/packagin g, 35% Government, 4% Chemical manufacturer, 1% Health care provider, 5% Education, 6% Service, 2% Wellness provider, Insurer, Retail, 7% Financial Services, 7% Copyright (c) 2016 MBGH 3

4 Size of Employer Respondents % % % % <250 6% Copyright (c) 2016 MBGH 4 0% 5% 15% 25% 30%

5 Populations Eligible for Benefits in 2017 and % 90% 80% 100% 92% 100% 97% 100% 96% 87% 84% 87% 77% 95% 89 91% 78% 100% 75% 70% 60% 50% 40% 30% 0% Copyright (c) 2016 MBGH 5

6 Plan options offered in 2016 and intended for 2017 and 2018 PPO HDHP - Health Savings Account HDHP - Health Reimbursement Account HDHP - No account HMO EPO Using a private exchange for all coverage 82% 8 39% 80% 51% 22% 48% 2 22% 3 32% 29% 7% 7% 7% 1% 1% 1% 0% 30% 40% 50% 60% 70% 80% 90% Copyright (c) 2016 MBGH 6

7 Level of challenge to comply with the ACA requirements 100% 90% 80% 70% 60% 50% 40% 30% 0% 1% 76% 14% Employer mandate Offering essential benefits 9% 12% 1% 4% 1% 5% 3 50% 6055/6056 reporting 2 4 4% 5% 70% 12% Avoiding the excise tax 14% Health insurance marketplace notices and responses 30% 3 1% 0% 6% 6% 6% 50% 39% 4% Eligible Upcoming IRS employees compliance who may have taken a subsidy 42% 6% 8% 3 11% 0% Future Compliance A major challenge but are compliant A major challenge, still addressing Not yet compliant or achieved A minor challenge, but are compliant A minor challenge, still addressing Copyright (c) 2016 MBGH Don t Know 7

8 Addressing 6055/6056 reporting requirements 100% 0% 1% 90% 80% 1 70% 60% 50% 40% 75% 77% 66% 30% 0% 2 18% 14% Handled in-house Out-Sourced to Vender Don t Know Copyright (c) 2016 MBGH 8

9 Sample estimates of employer spend on 2016 ACA compliance: Reporting fees, staff time, PCORI fee, Transitional insurance, etc. 7 Number of respondents Copyright (c) 2016 MBGH 9 Cost estimates

10 Current and planned cost sharing (ER-EE) ratio for 2017 and % 41% 41% 40% 35% 37% 36% 34% 32% 30% 25% 24% 15% 5% 15% 5% 12% 9% 8% 0% Don t Know Copyright (c) 2016 MBGH 10

11 Charging for dependent coverage separately 70% 66% 6 60% 50% 50% 40% 30% 39% 28% 28% 30% 24% 36% 3 0% 2% 5% We Charge We plan to do charge No, we won t or don t charge Don t Know Copyright (c) 2016 MBGH 11

12 Surcharges in 2016 and what will apply in % 70% 67% 71% 67% 60% 55% 50% 40% 45% 45% 40% 30% 25% 5% 4% 0% Won't do Don't know Spousal/partner surcharge for those who can get coverage elsewhere Tobacco surcharge for smokers Copyright (c) 2016 MBGH 12

13 Pharmacy benefit tiers and cost-sharing applied Copyright (c) 2016 MBGH 13

14 Current and future involvement with drug formulary design 80% 70% 68% 66% 67% 60% 50% 40% 30% 0% 21% 19% 19% 7% 8% 4% 4% 5% We accept the drug formulary of our plan/pbm We review and ask for changes in the formulary We create our own formulary We don't have a formulary Copyright (c) 2016 MBGH 14

15 Priority in in addressing health benefit management activities Managing Specialty Drugs Creating a culture of health Improving communications Avoiding 2020 ACA excise tax Offering telemedicine Offering price &quality tools Integrating data to manage pop. health Contracting for Ctrs of Excellence Contracting on outcomes Aggregating all data Coordinating vendor programs Measuring productivity Adopting reference-based pricing Moving to bundled payments 6 61% 57% 48% 38% 32% 29% 28% 2 28% 29% 41% 34% 29% 41% 24% 32% 07% 2% 16% 28% 28% 26% 9% 7% 0% 7% 7% 4% 19% 26% 28% 24% 17% 38% 22% 15% 34% 34% 16% 7% 24% 38% 30% 7% 29% 32% 0% 30% 40% 50% 60% 70% 80% 90% 100% Copyright (c) 2016 MBGH High Priority Medium Priority Low Priority No Priority 15

16 Priority in in addressing worksite wellness activities Increasing engagement 61% 1 2% Offering fitness challenges 26% 26% 14% 8% Offering engagement incentives 25% 34% 9% 9% Providing effective weight mgmt 2 32% 16% 2% Offering stress resources 2 29% 19% 7% Offering targeted wellness prog 2 32% 17% 7% Reducing tobacco use 22% 26% 5% Offering onsite clinic 22% 17% 16% 24% Offering outcomes incentives 19% 16% 21% Determining wellness ROI 17% 21% 24% 14% Offering healthy food choices 16% 24% 9% 11% Expanding behavioral health services 15% 2 26% 15% 0% 30% 40% 50% 60% 70% 80% 90% Copyright (c) 2016 MBGH High priority Medium Priority Low Priority No Priority 16

17 Other employer challenges Identifying best in class vendors Remaining ACA-IRS compliant moving forward Direct contracting with providers Decoding prescription plan rebates and guarantees Finding high-value networks Using cost-effective approaches to healthy management of musculoskeletal issues Staying on top of nationwide issues Finding ways to increase purchasing power to change the delivery system Copyright (c) 2016 MBGH 17

18 For more information on this survey or the topics covered.. Larry Boress President and CEO Midwest Business Group on Health Copyright (c) 2016 MBGH 18