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Survey Reveals Trend in Lower-Cost, Higher-Value Employer-Provided Health Care Delivery Models


A recent survey of employers revealed a current a shift in organizations working to adopt lower-cost, value-based health care models.

A recent survey of employers revealed a current a shift in organizations working to adopt lower-cost, value-based health care models.

Willis Towers Watson’s 2020 Health Care Delivery Survey found that 73% of organizations intend to adopt more value-based health care delivery models, as well as expand them, over the next 3 years.

Possible expansion tactics included implementing centers of excellence (COEs), high-performance narrow networks (HPNs), and telehealth services, as well as applying network, provider, and condition-based strategies.

The survey looked at responses submitted from August 11 through September 9, 2020, by 397 US organizations and 7.1 million employees. Of those organizations, 47% were publicly traded for-profit companies, 34% were private for-profit companies, and 16% were governmental or nonprofit organizations.

Employers’ main concerns were access to comprehensive and high-quality mental health services (84%) and substance abuse treatment (77%), in addition to the affordability of specialty drugs (85%), mental health services (78%), and specialty care medical services.

They also indicated the impact of a health plan or network change on employees (61%) and the required time and resources needed to implement measures that address new vendors and focused solutions (43%) as barriers to adopting policies, despite their concerns. In addition, 53% are currently using health plans that offer access to COEs for their members, with that access being optional at 70% and mandatory at 21%; 82% believe that COEs are an effective way to reduce annual health care costs per employee; and 92% say COEs can be an effective way to increase quality of care for their members.

Further analysis revealed that 90% of employers offer or plan to offer an HPN, which connects members to a narrow network of higher-value, lower-cost providers, and 59% of employees presently have or will have access to one in the near future. Twenty-two percent of employers also reported using network and provider strategies that reduced out-of-pocket costs for high-value services, while 33% are planning to implement similar policies to help manage costs.

For condition-based strategies, employer respondents said they implemented third-party digital, virtual, or coaching solutions for mental and behavioral health (51%), metabolic syndrome and diabetes (37%), maternity care (29%), and musculoskeletal (19%), and cardiovascular conditions (19%).

Third-party interventions also reduced costs and improved health care quality for the areas:

  • Mental/behavioral health: 32%
  • Metabolic syndrome/diabetes: 51%
  • Maternity: 47%
  • Musculoskeletal: 45%
  • Cardiovascular: 45%

Telehealth and virtual care services were also used by employers to improve access and affordability, with 84% of employers offering telemedicine through their insurance carrier and 21% through a third-party vendor.

For tele-behavioral health services, 66% of employers provided them to members through an insurance carrier, 14% via a third-party telemedicine vendor, and 10% through a third-party behavioral health vendor.

The coronavirus disease 2019 (COVID-19) pandemic played a large part in directing employer focus to telemedicine and virtual care services, with 81% saying their employees had easy access to virtual care in 2020. When asked about how telemedicine and virtual medicine will fit in to their organizations post-COVID-19, more than half (52%) of employers reported they think these services will continue to be priorities in their organization’s health care going forward.


2020 health care delivery survey. Willis Towers Watson. October 16, 2020. Accessed November 2, 2020. https://www.willistowerswatson.com/en-US/Insights/2020/10/2020-health-care-delivery-survey

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