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Employers Increasing Virtual, Behavioral Health Coverage Amid Pandemic


Based on findings of the Business Group on Health’s 2021 Large Employers' Health Care Strategy and Plan Design Survey, employers have increased funding in virtual care and behavioral health amid the coronavirus disease pandemic.

Based on findings of the Business Group on Health’s 2021 Large Employers' Health Care Strategy and Plan Design Survey, employers have increased funding in virtual care and behavioral health amid the coronavirus disease 2019 (COVID-19) pandemic, said Ellen Kelsay, president and CEO of the Business Group on Health.


AJMC®: Hello, I'm Matthew Gavidia. Today on MJH Life Sciences’ Medical World News, The American Journal of Managed Care® is pleased to welcome Ellen Kelsay, president and CEO of the Business Group on Health. Can you just introduce yourself and tell us a little bit about your work?

Kelsay: Sure, thanks so much for having me! Yes, I am president and CEO of Business Group on Health, and we are a nonprofit representing the largest employers in the world: Fortune 500 employers on a variety of health and well-beingrelated challenges.

So, we work with them and on their behalf, and alongside industry stakeholders to discuss and address and hopefully make progress and advance on some of the more challenging health and well-beingrelated issues that are present in the American and global workforce today.

AJMC®: Can you speak on Business Group on Health’s 2021 Large Employers' Health Care Strategy and Plan Design Survey?

Kelsay: I'd be happy to. Yeah, it’s a piece of work that we're very proud of. We have been launching this and fielding it every year now for a number of years, and it is an insight into the perspectives of those large employers on health and well-being strategies–their perspective on the changing landscape of health care within the United States, but then also foreshadowing some of their strategies for the upcoming year and beyond.

This year's survey was fielded in May and June, and it represents the perspectives of over 122 large employers that represent over 9 million covered lives.

AJMC®: Just to build off on that, were there any trends you were especially interested in learning more on?

Kelsay: There were a number of trends. At the beginning of each year before we field the survey, we forecast what we anticipate the trends to be for the upcoming year, and when we fielded the survey, we were interested in seeing if those trends were validated, if they were underscored, or certainly in light of the pandemic this year, if new trends and strategies really emerged to the forefront.

What we found in the survey was really nothing but an underscoring of the trends that we anticipated at the outset of the year, namely, in a few areas. First, certainly around mental health and emotional well-being. We know that is an issue that our members and many employers around the world have been keenly focused on for a number of years. Second to that issue was certainly the expansion of virtual and digital health solutions. We're also focused on the pandemic itself and the impact the pandemic had on employer strategies, new offerings, as well as what the pandemic meant in terms of their overall plan costs.

Then, lastly, one trend that we were very interested in observing through these survey findings was what impact does the pandemic have on employers’ efforts to move towards delivery system and payment transformation. That has certainly been an effort and a focus area for many of our employers, and certainly for us organizationally for a number of years. And we wanted to see what impact the pandemic had on both employers’ desires to move forward in that area, but then also their partner's ability, whether that be providers, health systems, or health plans, to continue moving forward in that focus area as well.

So, many key findings and trends that we were tracking prior to the survey, and the survey certainly gave us some good, robust data and some nuanced perspectives on those issues, as well.

AJMC®: As something you just referred to, increased funding of virtual care, as well as behavioral health, is a major takeaway from this survey. Can you first speak on why greater need for these services are warranted and how they can benefit overall health care cost?

Kelsay: Sure, I'll start first with virtual. We have seen, certainly in health care, a massive amount of innovation for many, many years now and an explosion of new start-ups and new solutions coming to market.

Many employers have been implementing these solutions for a number of reasons. First, they do address cares, or gaps, in their current ecosystem of solutions that they offer to their employees. Then, certainly they meet the need from a consumer perspective. Consumers like the ease and convenience of these solutions, and from a care delivery perspective, they're more apt to seek care in a virtual environment in many instances.

Sometimes going to the actual doctor, going to an office, is prohibitive from a work schedule perspective or for other reasons. So, when you can make services available at a much more convenient forum and different modality, employees are more apt to pursue care that way.

Certainly with the pandemic, we have seen, because of shutdowns and stay-at-home orders, many people simply could not see their physician in person even if they wanted to. So, these virtual solutions have really emerged to be, out of necessity, a very optimal way to deliver care at a time when care could not be delivered in person. It would have been many, many years ago that if your doctor's office was closed, you just simply didn't talk to the doctor, see the doctor, until they open the office again.

In the pandemic environment, many physicians have deployed telehealth and virtual models, and so their comfort and receptivity has increased, and certainly, as I said before, we know that consumers prefer it in many ways. We also see that virtual solutions are sometimes more effective in many ways, such as for musculoskeletal treatments. Many people used to go see surgeons when they had back and spine issues, and we know that most of many musculoskeletal issues can be effectively addressed, at least in the early stages, via physical therapy, and that in some instances physical therapy can be delivered effectively through a virtual solution.

So, there are some conditions like that for which virtual is a really viable alternative, and it is a much more cost-effective alternative to seeing an in-person physician or surgeon for some of those services.

When it comes to mental and emotional health, we know that those have been issues for a long time coming in society. There has been a lot of stigma associated with individuals seeking out care for those solutions. So, employers have been long on the path to do what they can to both break down some of the cultural and stigma issues associated with mental health, but then also to make solutions available to their employees that are more accessible and perhaps a little less intimidating quite honestly.

So, if an employee can access therapy or coaching and counseling via an app, via video, versus going into a counselor or therapist office, they might be more willing to do that. Then certainly with, again, the pandemic, there are very many people. You'd be hard pressed to find anybody who has not felt some period of stress, isolation, or anxiety in this pandemic environment. So, the number of people who are accessing services for mental and emotional well-being has certainly grown exponentially in the past many months as well, making again those virtual services even more desirable for more people within the population.

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