● Average health benefit cost rose 3.4% in 2020 to reach $13,674
per employee
● Large employers reported a 1.9% cost increase – the lowest
increase in more than two decades – as plan members avoided care
due to the pandemic
● Employers are prioritizing strategies addressing behavioral
health, voluntary benefits and virtual care/telemedicine
Total health benefit cost rose 3.4% on average in 2020 (Fig. 1),
reaching $13,674 per employee among all US employer health plan
sponsors with 50 or more employees, according to the annual Mercer
National Survey of Employer-Sponsored Health Plans 2020.
Large employers (those with 500 or more employees) reported a
cost increase of just 1.9%, their lowest increase since 1997, as
plan members avoided health care facilities due to the pandemic
(Fig. 2). Large employers typically self-fund their plans, which
means they may see costs fall as utilization falls, unlike fully
insured employers that pay a fixed premium. Survey results suggest
that many large employers plan to use money saved in 2020 to invest
in programs to support and engage employees in 2021.
“The need to minimize exposure to the virus and ease the strain
on overloaded health facilities caused many people to forgo care
this past year, which translated to slower cost growth in 2020.
Heading into 2021, that’s allowed employers to avoid cost
management tactics like shifting cost to employees,” said Tracy
Watts, a senior consultant at Mercer. “Instead, we’re seeing many
focus on supporting employees with additional resources to help
keep them engaged, productive and healthy during these tough
times.”
Employers address concerns about low utilization of
behavioral health care
A Mercer claims analysis found that fewer employees are
receiving behavioral health1 treatment than last year – a serious
concern given that the pandemic has intensified issues with
work-life balance, isolation, sleep disorders, alcohol consumption
and financial stress, and has worsened the opioid crisis. Mercer’s
database of claims information (based on over one million members)
shows that from March to May of 2020, the number of individuals
with newly diagnosed behavioral health problems was down 25% from
the same timeframe last year, despite the likely greater need.
This is an increasingly urgent concern for employers. In the
survey, out of 11 possible priorities for employee well-being,
behavioral health was ranked first by a wide margin, with 75% of
large employers calling it a priority (Fig. 3). More than
one-fourth (29%) have already provided managers with formal
training to support their employees’ emotional and behavioral
health needs, and another 24% are planning to. About one-fifth
(19%) say they plan to add programs or services to expand access to
behavioral health services next year.
Many working parents face additional sources of stress due to
disrupted school schedules and lack of childcare. While 40% of all
large employers are permitting flexible schedules to allow parents
to care for children during daytime working hours, relatively few
offer child care benefits (Fig. 4). Even among very large employers
(5,000 or more employees), just 17% provide a financial subsidy for
in-home childcare, and just 14% provide a back-up child care
benefit.
Many employees are substituting virtual care/telemedicine for
in-person visits – and employers see that continuing
Utilization of virtual care and telemedicine services2 were low
prior to the pandemic; in 2019, large employers reported that just
9% of eligible employees or family members used their telemedicine
service at least once. In 2020, however, the utilization rate
jumped to 14% within the first six months – by the end of the year
it will likely climb still higher (Fig. 5). To encourage employees
to use telemedicine services, many employers waived copays: where
82% charged a copay before the pandemic, just 48% did so this
summer.
Employers were largely pleased with the performance of their
telemedicine provider in terms of customer service and wait time
during the pandemic: 74% were very satisfied or satisfied and only
2% were dissatisfied, while 24% didn’t have enough feedback to say
(Fig. 6). Given the wider adoption of telemedicine during the
pandemic, it’s not surprising that 80% say it will play a larger
role in their programs going forward (Fig. 7).
“As employers begin to plan for a larger role for virtual care
in their programs, they’ll need to think about how to incentivize
employees to use the right modality for the service they need – AI,
telemedicine, a virtual visit with their own provider, or an
in-person visit,” says Ms. Watts. “Getting the pricing right for
the different levels of care – or even moving to a bundled payment
model -- will determine whether virtual care ultimately helps
control healthcare cost as well as add convenience.”
With workers dispersed, employers seek new ways to engage
employees
More than half (56%) of large employers say they are “extremely”
or “very focused” on the employee experience, and, in 2020, 40%
report that their organization’s mission statement explicitly
supports creating a healthy workplace culture – up from 23% three
years ago in 2017. But employers now face the challenge of engaging
both employees at their worksites and those working remotely.
Surveyed in the summer, only 57% of large employers expected that
all or most of their employees would be back at their worksites by
this January; given the resurgence, these timelines might be
further delayed (Fig. 8).
More than a third of all large employers offer a health
navigator service, either a telephonic service (29%) or an
AI-powered digital service (6%), to help employees find the right
provider and offer assistance during episodes of care, and another
16% are considering it. Nearly one-fourth (23%) of those with 5,000
or more employees will add new targeted health solutions –
typically with a digital component -- in 2021 to help employees
better manage health conditions on their own or help them improve
their health habits (Fig. 9).
Almost a quarter of all large employers (23%) say they will add
or expand their voluntary benefit offerings in 2021. These include
supplemental health insurance, such as cancer or critical illness
insurance and hospital indemnity plans, but also coverage to
protect employees from a variety of unexpected expenses, such as
pet insurance.
“Employers understand the value of an engaged workforce. Virtual
programs allow employers to reach employees wherever they are. And
because employees can select benefits that meet their own
particular needs right now, voluntary plans help strengthen the
employee’s connection with their employer,” says Ms. Watts.
Survey Methodology
Mercer’s National Survey of Employer-Sponsored Health Plans
included 1,812 public and private employers in 2020. Based on
responses from a subset of employers in a national probability
sample in combination with a non-probability sample, survey results
have been weighted (using employer size and geographic
stratification) to represent the approximately 246,000 employer
health plan sponsors across the US with 50 or more employees. These
organizations employ about 125 million full- and part-time
employees.
The full report on the Mercer survey, including a separate
appendix of tables of responses broken out by employer size, region
and industry, will be published in March 2021. For more
information, visit www.mercer.com/health-benefit-trends.
About Mercer
Mercer believes in building brighter futures by redefining the
world of work, reshaping retirement and investment outcomes, and
unlocking real health and well-being. Mercer’s more than 25,000
employees are based in 44 countries and the firm operates in over
130 countries. Mercer is a business of Marsh & McLennan (NYSE:
MMC), the world’s leading professional services firm in the areas
of risk, strategy and people, with 76,000 colleagues and annual
revenue of $17 billion. Through its market-leading businesses
including Marsh, Guy Carpenter and Oliver Wyman, Marsh &
McLennan helps clients navigate an increasingly dynamic and complex
environment. For more information, visit www.mercer.com. Follow
Mercer on Twitter @Mercer.
Source: Mercer National Survey of Employer-Sponsored Health
Plans, 2020
1havioral health includes not only ways of promoting well-being
by preventing or intervening in mental illness such as depression
or anxiety, but also has as an aim preventing or intervening in
substance abuse or other addictions.
2raditional telemedicine visit is not the same as a virtual
visit with one’s personal primary care physician or specialist –
while both have a role in healthcare delivery, they differ in terms
of patient experience, cost, and likely the overall value of the
visit.
View source
version on businesswire.com: https://www.businesswire.com/news/home/20201208005257/en/
Micaela McPadden +1 212 345 0806
Micaela.mcpadden@mercer.com
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