Employer-Sponsored Health Plans Call for Regulation, Transparency

Employers called for healthcare price regulation and transparency to ensure employer-sponsored health plan affordability in the annual Pulse of the Purchaser survey conducted by the National Alliance of Healthcare Purchaser Coalitions (National Alliance).

The survey, which was conducted online during August and September 2020, was designed to collect insights on best practices and benefit reform. The data is based on responses from 165 employers from across the country.

Drug prices are of great concern for employers, with 90 percent indicating that unregulated drug prices are a threat to the affordability of employer-sponsored health plans. Consequently, 94 percent of respondents indicated that drug price regulation would be very or somewhat helpful.

Forty-nine percent of employers are currently using medication therapy management, making it the most commonly used medical and pharmaceutical strategy.

Another issue of concern for employers is surprise billing. Eighty-one percent of respondents called for surprise billing regulation, while 58 percent said that surprise medical bills are a threat to the affordability of employer-sponsored health plans.  

Additionally, 90 percent of those surveyed called for hospital price transparency and 79 percent called for hospital rate regulation. Hospital prices were said to be a threat to the affordability of employer-sponsored health plans for 71 percent of respondents, while 73 percent said lack of transparency is a threat.  

Overuse of low-value services/waste was also a concern for employers with 53 percent of respondents indicating waste as a threat to affordability of employer-sponsored coverage for employees and their families. Sixty-one percent of respondents said that reducing waste is a top delivery reform strategy. Steerage within networks is a top reform strategy for 47 percent of employers.

Due to the economic decline and current healthcare service disruptions caused by COVID-19, most employers are either staying the course or accelerating their health benefit strategies for 2021 and 2022 (71 percent and 63 percent, respectively). One in five employers is reevaluating their health benefit strategy.

Half of employers surveyed said that a Medicare public option could be very or somewhat helpful, while 21 percent felt it could be very or somewhat harmful. Additionally, 46 percent of employers indicated that Medicare for All would be very or somewhat harmful.

Looking to the future, employers are considering several different delivery and payment reform strategies.

In the next two years, 44 percent of employers are considering hospital quality transparency and 43 percent are considering hospital pricing transparency as strategies in order to promote value-based care for their employees. Additionally, 39 percent of employers are considering regional centers of excellence in the next two years. Advanced primary care is a strategy that 36 percent of employers are looking into over the next two years.  

Many employers are addressing issues of racial inequity in their workplaces. Fifty-eight percent of employers are currently doing anti-racism education programs and 52 percent are doing trainings in cultural competency.

Respondents indicated that promoting community engagement is important to their organization. Seventy-one percent of employers indicated efforts to encourage community volunteerism programs. Similarly, 70 percent of respondents support engagement in community improvement projects and initiatives.

Employers are focusing on health and wellbeing strategies for their employees. Sixty-five percent have implemented a flexible work week schedule and 63 percent promote total person health and wellbeing. Fifty-five percent of employers have implemented navigation and advocacy services and 49 percent have begun to provide enhanced mental health support (49 percent).

Special caregiving benefits such as leave have tripled since the onset of COVID-19 and 13 percent of employers are considering granting employees these benefits. Additionally, 28 percent of employers have started offering “protected time” to support employees with caregiving needs since the outbreak of COVID-19 has transitioned many school systems to at-home learning.