Cost Containment Health Benefit Trends for 2017

Recent studies, such as the 2017 Health Plan Design Survey conducted by the National Business Group on Health (NBGH), report that employers will be focusing less on plan design and more on optimizing employee health care access and delivery options. Read on for highlights of three popular cost management options discussed in the survey results by NBGH, a coalition representing the health care interests of very large employers.

Health care is moving toward more employee consumerism and telehealth (or telemedicine) is becoming a popular option to controlling rising health care costs. The NBGH survey showed that 90% of employers will offer telehealth services next year compared to 70% this year. Telehealth services help employers and employees to save money. For example, plan participants have more convenient access to see a doctor, which helps them to catch health conditions in the early stages when they are more manageable and less costly. 

PCMI is now offering Doctor on Demand, a telehealth program, as an additional option to your existing health plan. Look for more communications in the coming year about this valuable service.

Prescription Drug Programs
The NBGH health survey also reported that nearly a third of the employers interviewed (representing 15 million covered Americans) believed specialty pharmacy was the number one driver of their overall health care costs, and 80% said it ranked in the top three. This a significant uptick from the 6% of employers who previously said specialty pharmacy was the top driver of health care costs in their 2014 survey. See our earlier article on specialty costs. To help combat skyrocketing costs, more self-insured companies are hiring a Pharmacy Benefit Manager (PBM) to provide cost control features such as formularies, clinical programs, drug utilization reviews and specialty pharmacy programs. 

PCMI launched its own PBM, PinnacleRx Solutions (PRxS), in 2014, and it has been a successful option for many clients looking to rein in pharmacy spending.  For more information on PRxS, you can download more information here. 

Workplace Wellness Programs
Workplace wellness programs are becoming a standard for many large companies, and within these programs, more employers are implementing health risk assessments and biometric screenings. A health risk assessment is a questionnaire that is used to evaluate an employee’s medical history and lifestyle choices for potential health risks and a biometric screening measures an employee’s risk of diabetes, heart disease, hypertension and other chronic conditions.  

According to the annual 2016 Employer Health Benefits Survey, conducted by the Kaiser Family Foundation, 59% of employers interviewed said they are offering health risk assessments and 53% are offering biometric screenings.

In 2014, Pinnacle launched its own health management company, Pinnacle Health Management, which can help employers implement a care management program, coordinate health screenings and wellness challenges, and distribute educational materials including a seasonal wellness newsletter. To see these services and more, download our overview flyer here.

Important for 2017. Please note that the new Equal Employment Opportunity Commission (EEOC) rules for employer wellness programs  take effect on the first day of the plan year starting January 1. Be sure to review your wellness program components, if you offer a wellness program, to ensure compliance with the new rules.