COVID-19 has forever altered how employers and employees access and deliver healthcare. Some of these changes were well underway in human resources prior to the onset of the pandemic. But with COVID, what had been a moderately-paced paddle through change became a jet-propelled industry disruption. COVID threw up a huge wake in the healthcare administration and benefits industry, and its impact is likely to be felt for a long time.
The CDC notes that 90% of our nation’s $3.5 trillion in annual healthcare expenditures are for people with chronic and mental health conditions. COVID added new urgency to dealing with the prevention and management of these symptoms. It stressed the system. Along the way, it illuminated problems and opportunities within the healthcare access and delivery space in factors ranging from how we use and reimburse new technology to how we creatively address rising cost pressures and unwieldy, fragmented care.
1) The drive to more personalized and cost-effective healthcare will advance swiftly.
Employers who’ve created thoughtful cost containment gameplans bringing care models into place that address specific chronic disease or comorbidities. At FirstPerson, we’re starting to build an ecosystem of targeted interventions, including:
- One Drop (diabetes reversal)
- Omada (diabetes, weight management, other metabolic disorders)
- Livongo (digital management for chronic conditions; recently merged with Teladoc Health)
- Virta (diabetes reversal)
Rather than treating all employees in a blanket fashion, employers are starting to focus their spend and their energy on employees who truly need the intervention most so they can meet them where they are and take them through a care continuum.
With more available technology and data, employers are aligning with this “Triple Aim” strategy—that is, improving the patient experience, improving population health, and reducing the cost of care.
2) Virtual care (including telemedicine) is here for the long haul.
By necessity, telehealth use is more widespread than ever. It’s convenient. It’s safe. Cheaper. And it’s a better experience in many regards.
Many insurers and third-party administrators have embedded telehealth solutions, and there have been incentives to use those for a long time. COVID has forced consumers to take greater advantage of virtual care options. In fact, 46% of patients used telehealth to replace canceled in-person visits in the first six months of 2020, according to a June study by the American Medical Association.
At the same time, COVID has forced providers to pivot and offer more telehealth solutions.
3) Employee engagement is not just a laudable healthcare goal, but an imperative.
As we’ve pivoted to remote work and more of a virtual healthcare environment, employers are finding it imperative to engage their employees who aren’t physically present in the office.
We’re seeing this digital model accelerate with a $12 billion investment into digital health tech in the first half of 2020 alone. Platforms like HealthJoy that connect members to care are innovating the most rapidly. HealthJoy is a great example of the digitization of employee engagement, and it has seen a 10x average increase in the use of telemedicine for those who use HealthJoy over those who don’t—a stat that even preceded COVID.
4) The COVID exit will have its own bumps.
Deferred or avoided treatment has been a factor in hospital losses in 2020 and will be a factor in employee health at some point going forward. It’s unknown exactly how avoided care will impact plan experience in the coming years, but expect it to add complexity and cost to potentially undiagnosed care.
The cost of fully insured renewals is increasing faster than we would have normally expected based on the last twelve to twenty-four months of performance.
Effects on the self-funded are more nuanced. Many self-funded employers saw a trough in costs at the peak of COVID, but the question is: will employees who avoided treatment get into a new habit of not seeking routine or preventive care? The jury is still out, but underwriters—particularly on the fully insured side—are starting to reserve for that risk.
5) Those hospital losses in 2020 could place upward pressure on prices for commercial (non-plan) prices.
Hospitals are facing a projected loss of $323 billion in 2020, according to the American Hospital Association. This has been caused by the loss of higher-margin elective treatments such as knee replacements or hip surgeries. (Meanwhile, insurers have been enjoying record profits due to significantly lower claims.)
Now, hospitals and health systems are investing heavily in advertising to get patients back in. They could also be looking to make up for these losses when they renegotiate with major network providers.
Being efficient and proactive in employee health management will be crucial to offsetting these losses and maintaining care. Additionally, there will be continued efforts to drive members to the best quality, lowest cost providers by utilizing pricing transparency technology or narrow network options.
6) COVID has underscored the importance of health and well-being to macro-economies and individual business.
This strikes a chord with Paul Ashley personally as he’s been transparent about his struggles with depression in order to help reduce the stigma around mental illness. Fortunately, FirstPerson has been active in providing employer resources that drive awareness and support for mental well-being in the workplace.
The silver lining of COVID is that we have all shared an acute experience that’s related to mental health. That is, we all experienced some anxiety about the future in March and April as we experienced disruptions in our work and personal lives. This created a platform for others, including Paul, to feel comfortable speaking about their mental health journey.
As leaders, we need to think more critically and talk more openly about mental health in the workplace, and we’re already starting to see progress unfold. Our friends in Canada are 15 to 20 years ahead of us in this area, so that’s a model we can emulate going forward.
7) This COVID experience won’t leave us with a ‘new normal’ in healthcare and benefits.
All of this will settle down eventually. However, we’ll still be left with some residue—and much of that residue will be positive.
- Comfort around digital and mental health utilization by consumers and providers
- Personalized healthcare
- Open discussions around mental health and well-being
Those who adapt and change during this unique year are those who are going to win. The same is true for healthcare.
To gain full access to Paul’s talk and resources he shared at RESOLVE Increments Week One, enter your info below.
Uncertainty calls for resilience
Now that we’ve surveyed the impact of the pandemic and the election year on healthcare, we’re going to shift our focus. Next week at RESOLVE Increments, we’ll go beyond healthcare to talk about building a comprehensive well-being strategy for your employees.
Join award-winning researcher Dr. Lisa Penney for How to Fuel Resilience in Yourself and Others. You’ll also hear FirstPerson VP, Total Rewards Practice Megan Nail discuss Reimagining the Workforce of the Future. Don’t miss it!
Get your virtual pass at resolveindy.com.