Matthew is an associate editor of The American Journal of Managed Care® (AJMC®). He has been working on AJMC® since 2019 after receiving his Bachelor's degree at Rutgers University–New Brunswick in journalism and economics.
In a webinar moderated by Thomas Parry, PhD, president of the Integrated Benefits Institute, an employer panel discussed value, application, and barriers to strategies involving the integration of employee needs and interests into benefit programs.
Beginning the webinar titled “Integrating Employer and Patient-Centered Approaches to Benefit Design & Delivery,” moderator Thomas Parry, PhD, president of the Integrated Benefits Institute (IBI), noted that “over the past several years, the patient’s perspective has received a growing focus both by practitioners and researchers.”
“Given that employers cover the healthcare for about 60% of all non-elderly adults, it is clear that employers have an important role to play in supporting patient-centered care and better aligning programs with patient needs,” said Parry.
To understand whether and how employees’ needs and goals are factored in when designing and implementing benefit programs, IBI and the National Alliance of Healthcare Purchaser Coalitions (National Alliance), on behalf of the Patient-Centered Outcomes Research Institute, both surveyed over 200 employers on their design of their medical, pharmacy, disability, well-being, absence, and other health-related benefits.
In addition to speaking about the study results, Parry included employer input from 4 panelists:
When analyzing what employers desire to achieve from their health programs, Parry highlights that the study’s highest chosen result, at 91%, “helping employees improve and sustain good health,” is a distinct change from a common answer of the past, “manage healthcare costs.”
While this may suggest that health programs enacted by these employers would align with these ambitions, further study results revealed that only half or less reported being “very confident” that they were achieving the desired outcomes. Additionally, when asked if their programs helped employees improve and sustain good health, only 40% were “very confident” that their medical benefits and 30% of their wellness/wellbeing programs achieved this goal.
The disconnect between what employers aspire to accomplish and what is concretely delivered in regards to incorporating patient-centered goals was further shown by the data used to measure benefits success, where medical claims (89%), prescription claims (84%), and disability claims (70%) were the top 3 sources chosen, with employee surveys (69%), health risk assessments (52%), and staff interviews (25%) following suit.
“I think the biggest issue is that our collective experience with the healthcare system is documented in claims data that employers receive, and as such, we don’t really have a way of understanding patient-centered goals other than what we receive in claims data,” said Sherman. As subpopulations may require different needs than what is accentuated in a corporation’s aggregated claims data, providing mechanisms to outline these groups is warranted, noted Sherman.
This reliance on claims data can also hinder employers when delineating what patient-centered goals are being completed, especially as new programs oversaturate the information considered when analyzing findings. As Evans notes, Southwire decided to stop adding programs and to instead “focus more on developing the opportunity to put that information in front of people where it can benefit them the most.”
As Southwire is in its beginning stages of analyzing patient-centered data on health and wellness services, the corporation is currently forming goals and innovations to efficiently derive information. “One of the goals that we have is trying to implement some type of app or opportunity for employees to engage at whatever level they’re comfortable with and having info pushed back to them at pivotal points in either their health, treatment, or willingness to hear about,” said Evans.
Sifting through the plethora of information available to employers is no easy feat, as Becker, recently retired from Xerox, highlights that “data about health and healthcare is not transparent.” Understanding this issue is key to addressing these roadblocks as their attributable solutions were noted by Becker as 2 sides of the same coin.
“The work every year was to figure out new and creative solutions to getting more efficient, taking barriers away from employees, and trying to get them the right care at the right time, the first time,” said Becker.
At US Steel, Kusti highlighted an issue that many employers may encounter, which is explaining the importance of increased healthcare benefits to senior figures in large corporations. “We try to provide education and try to have the teams understand what we’re trying to do and why we’re trying to do it,” said Kusti.
As large healthcare spending may in itself convince corporations to better address issues in benefit design, exhibiting how prioritized employee health may benefit output and revenue growth can further stress this need. “We try to build a business case to show the benefits of whether its process improvement in the healthcare setting or a program that would make navigation of the healthcare system easier for our members,” said Kusti.