The health care landscape is continuously changing and growing. Staying informed of emerging trends can help businesses provide the right benefits and keep employees healthier. When businesses have an understanding of the local health care landscape, they are able to make informed decisions for their employees. Here are five health care benefit trends identified by two Nebraska experts to aid decision makers in 2019.
1. Generational differences
Workplaces in 2019 include employees from across the demographic spectrum. With everyone from near-retirees to Generation Z sharing the workforce, it’s critical to understand how people of different ages approach their health care benefits.
“The workforce is both older and younger at the same time, and each of those groups has a different perspective on what they want from health care,” says Dr. Joann Schaefer, executive vice president of health delivery engagement at Blue Cross and Blue Shield of Nebraska (BCBSNE).
The two largest generational groups are baby boomers and millennials. There are some sharp contrasts for how each approaches health care.
“Boomers are looking for consistency, and people they know – relationships,” Schaefer says. “When they need to see a specialist, they ask for referrals. Those referrals may or may not be based on quality or cost.”
Millennials are more comfortable with retail-type locations and technology.
“It’s a different model, really. It’s not just that they don’t fear technology, there’s an expectation for it. That includes consumer or patient reviews and price information. They crave it,” Schaefer says.
Services like telehealth and cost estimator tools can be appealing to employees wanting more price information and faster access.
2. Right care, right place, right time
With all the options available for patients to get care, employers looking to reduce their company’s health care costs want to know how they can help employees choose the right place and time to get the best care at the best price.
Helping employees know when and where to go for appropriate care can decrease emergency room (ER) visits and reduce costs. BCBSNE equips members with tools to help them know when an ER visit may be needed, or when it might be better to go to an urgent care clinic or make an appointment with their primary care provider. Those everyday decisions can add up.
Knowing which providers are in network is the other component for picking the right place. A few moments of checking if a doctor or facility is in network can reduce cost and potential confusion.
The “right place” may also be virtual. Nebraska is a geographically large state with a significant rural population. Using telehealth services can span that distance and reduce costs.
“The cost of a telehealth visit is less than an office visit, and much less than an urgent care,” says Brad Utoft, director of group sales at BCBSNE.
“Half the battle is getting employees to register for telehealth services,” he says. “Once you get them to register, it’s a lot easier when they need to use it.”
BCBSNE helps group leaders encourage employees to register, including several “live and local” in-person events at workplaces.
3. Value-based care
“Wouldn’t it be great if you could find out the best place to go – with high-quality marks – and know what your out-of-pocket expense will be? That’s what medicine is striving for.”
That is how Dr. Schaefer describes the larger benefits of value-based care. Value-based care is not a passing idea, but an important trend in 2019. It places emphasis on quality, efficiency and outcomes.
The point, broadly, is that “doing more things” is not always better. Better health care is doing the right things at the right time. What does it mean financially for groups and individuals?
“It’s better to pay for the right thing once than a bunch of the wrong things before you get to the right thing,” Schaefer says.
Utoft agrees. “Employers know they cannot keep just shifting cost to employees. They’re asking: What are you going to do to help my people improve their health, which as a consequence, is going to lower costs?”
4. Using data
In 2019, everyone collects and uses data. For health benefits, collecting quality, timely information and getting it in the hands of physicians can help the right care happen sooner.
Not having both pharmacy and health benefits integrated is a method some companies see as a potential for reducing costs. But that may be short-sighted in a more data-rich world.
“We believe and are seeing that having pharmacy and health benefits both integrated is actually the best mechanism for reducing employer costs, because we’re able to see the whole picture,” Utoft says. “When you start building silos, it’s hard for everyone – care management teams, providers – to know everything that’s going on with that individual.
“By putting that data in our modeler, we are able to identify not only persistent high-needs individuals but also emerging persistent high-needs. We can equip any of our nurse care management teams with that data as well as any of our value-based care providers.”
Schaefer echoed the need for data integration. “Integrated pharmacy makes a huge difference in care. We work to get data to doctors and help them pay attention to these folks because they’re sick or they need help or are struggling. With pharmacy integrated with medical benefits, we get the whole picture of the member’s health care needs. We are then able to pass this information along to the physician, which allows them to better treat the patient.”
She referenced a common scenario. “If a person has a serious issue, like a respiratory or pulmonary issue, we can see the medications – all the refills – and so the doctors can know what’s happening, and we can help keep people out of the ER.”
5. Screening and prevention
In 2019, there is still great truth in the adage, “An ounce of prevention is worth a pound of cure.”
Schaefer is passionate about the need for increased screening. For Nebraska, colon cancer screening is lower than the national average, but the incidence of cancer is higher.
“It’s really just sad. That is ultimately one of the most detectable and treatable forms of cancer. There is even a home screening now,” she says.
Schaefer emphasizes the need to demystify and encourage screenings for all cancers. “The HPV vaccine works, and it prevents cancer,” she says. “Those are the life-saving and cost-reducing steps that everyone can be doing.”
According to Utoft, the prominence of account-based higher-deductible plans is worth noting. Those plans put members in more control of their health spending, and put emphasis on preventive care, regular checkups and health screenings.
“Those continue to be a very popular option, offered alongside a traditional copay option,” he says.
Preventive steps can also be taken when members manage their health. With the Wellframe* app and nurse health advocates, BCBSNE members have a simple and free way to do so.
“Engagement is a buzzword. But what does that mean? In our case, we know we have a tool that can really help,” Utoft says, pointing out that member engagement with the app is up 400% this year, according to BCBSNE data.
