Texas employers say their biggest challenges in 2014 will include employee engagement, evaluating public and private health exchanges, and dealing with the lack of healthcare price transparency.
Texas Business Group on Health, an employer-sponsored healthcare coalition, sent a survey to 345 Texas employers and received 73 responses, most of which came from Dallas-Fort Worth.
The survey found five primary concerns regarding health benefits:
More than half mentioned the challenge of creating outcomes-based wellness incentives, meaning they would like to reward measurable health improvements rather than participation in wellness activities. A 2013 survey by Towers Watson and the National Business Group on Health found that nearly three out of four U.S. employers planned to increase incentives for non-smoking employees by 2016, up from 32 percent in 2013. More than two out of three said they were planning to link incentives to biometric outcomes—such as body mass index, blood pressure, and cholesterol levels—by 2016, up from 12 percent in 2013.
About 42 percent said they wanted to improve employee engagement in their health and wellness. Nearly eight in 10 employers in the Towers Watson survey said lack of employee engagement was the biggest obstacle to changing behavior. Participation was less than half of employees for health-assessment appraisals and well below 20 percent for other programs such as weight management and tobacco-cessation programs.
About 42 percent identified lack of healthcare price transparency. Wally Gomaa, chief executive officer of Dallas-based ACAP Health Consulting, told a Dallas-Fort Worth Business Group on Health audience in 2013 that the chargemaster rates for cardiac imaging in Dallas-Fort Worth range from $1,361 to $9,219, compared with a Medicare rate of about $700. Similarly, he said a major joint replacement billed rates range from $28,263 to $160,832 locally, compared with a Medicare rate of slightly more than $15,000.
About 40 percent cited evaluating the impact and opportunities afforded by private exchanges and the insurance marketplace created by the Affordable Care Act. Private health insurance exchanges are expected to change how insurance is purchased by the 170 million U.S. employees who have employer-sponsored insurance. By 2017, about 1 out of 5 Americans will buy health insurance on exchanges that are not run by the government. Meanwhile, businesses continue to weigh whether they should continue to offer employees defined benefit health plans or send them to the public exchanges and pay the penalty.
About 38 percent named focused employee education on personal health and becoming well-informed healthcare consumers. More companies and their insurance carriers are providing online tools and resources—and attempting to get employees to use them to make more informed choices about their healthcare. Transparency tools include calculators for estimating out-of-pocket costs and tools for comparing doctors, care centers and hospital facilities based on quality and cost, which can help guide cost-conscious decisions.
“Given the size and growth of the Texas economy, the challenges facing our employers most likely reflect the concerns of all U.S. businesses,” said Marianne Fazen, chief executive officer of the Texas Business Group on Health and the Dallas-Fort Worth Business Group on Health. “This should be a wake-up call to the health services industry to focus on what’s most important to employers to help them continue to sponsor health benefits to their employees.”
Matt Robbins, director of compensation and benefits, Atmos Energy and DFWBGH president, said, “DFWBGH’s mission is to help DFW area employers and their employees make informed healthcare-related decisions. We do this by providing employer members, including myself, access to useful resources, education, and peer-to-peer interactions that help us develop comprehensive solutions that benefit our employees and their families. This survey is a good example of the type of valuable information that will help local employers and our healthcare partners focus on the issues that matter most.”
Steve Jacob is founding editor of D Healthcare Daily and author of the book Health Care in 2020: Where Uncertain Reform, Bad Habits, Too Few Doctors and Skyrocketing Costs Are Taking Us. He can be reached at [email protected]