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As costs rise, employers dial up digital wellness tools to keep afloat
By Kathryn Moody
From HR Dive on Thursday, August 18, 2016
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Overall cost increases of healthcare benefits will hold steady at 6%, the National Business Group on Health announced—but increases that are held in place are, alas, still increases. Sustainability of healthcare may be under threat, and if prices continue to rise at current rates, it could put serious pressure on healthcare affordability for employers, the CEO and president of the NBGH, Brian Marcotte, said.

The NBGH annual report provides employers an outlook on the direction the change may be going. For the first time since the report began, specialized pharmacy was considered the No. 1 cost driver for healthcare spend, reflecting a general industry focus on specialized healthcare issues overall. To tackle these problems, employers are reaching for new tools that serve their general populations and provide high-touch care to their employees with more specific and specialized healthcare problems.

Specialty prescriptions tend to be the very expensive drugs that cost $1,000 or more per dose, are challenging to dispense and have complex care management needs, Marcotte explained.

In turn, more employers are trying to manage the high costs as well as employee needs by creating specialty pharmacies, creating certain specialty tiers in pharmacy plans and generally paying more attention to employees who require such services, the NBGH report said. In particular, there is renewed focus on paying attention to where employees go for treatment, and potentially pushing employees to cheaper high-quality locations instead (a stand-alone clinic versus a hospital, for example).

One powerful tool that has emerged as more employers adopt wellness programs is the telephonic consult. Telehealth is "commonplace" now for most large employers, NBGH reports. By 2019, 97% of large employers are projected to have some form of telehealth in play. That rise is explained due to its cost-effectiveness. A $150 urgent care visit can be reduced to a $40 teleconsult, Marcotte noted, especially if an employee has a simple care need, like a cold or sinus infection.

Telehealth has also seen use in mental and behavioral benefit spaces, alongside the usual suspects of EAPs and self-help electronic resources, the NBGH report adds.

As always, wellness and healthcare programs struggle with engagement, Marcotte said. In turn, many of the new wellness technologies focus on grabbing employee attention and integrating all of an employer’s offerings. Consumer choice tools are a common example of this.

Another set of tools growing in popularity: concierge services. These tools are being used to address either specialty conditions or more broad health concerns, Marcotte said. Typically, concierge services provide employers with one phone number or access point that employees can use to gain information about their benefits and, in many cases, set up appointments. Trained nurses usually respond to the calls, and can assist in managing an employee's case.