Consumer-centric plan designs and programs—such as account-based designs, pay-for-performance programs and evidence-based medicine—are still new and emerging concepts for most employers. However, the survey shows a significant number of companies plan to look toward these initiatives in the future, as they explore leading-edge approaches that control near-term costs while influencing the patient-provider relationship for longer-term outcomes.
According to the survey, companies are exploring several different options to help influence the patient-provider relationship:
Account-Based Plan Designs: More than 20% of companies offer or plan to offer a high-deductible health plan with a health savings account (HSA) by the end of 2007, and almost half are considering offering one at a future date. And while just 3% of employees elected these plans last year, most companies anticipate that enrollment will grow to 20% in five years. When health reimbursement arrangements (HRAs) are considered, companies anticipate enrollment in either an HSA or HRA to grow to 31 percent.
Quality Performance Information: While only 11% of employers currently require health plans and providers to disclose quality performance information to employees today, more than 75% of companies plan to do so in the future.
Evidence-Based Medicine: Nineteen percent of companies include or plan to include, by the end of the year, benefit designs based on evidence-based medicine and appropriate care protocols, such as waiving copayments for prescription drugs that are proved to be effective and appropriate to treat certain diseases. Another 60% are considering implementing them at a future date.
Pay-for-Performance Programs: Nine percent of companies require or plan to require health plans to have pay-for-performance programs in place by the end of the year, and another 56% are considering it at a future date. There are still barriers to effective pay-for-performance strategies, including the cost of the ‘rewards’ to higher-performing providers, as well as the measurement that defines performance.
According to the survey, companies that plan to take a more active role in the health of their employees report being more focused on health care quality than other employers and are more likely to select plans based on accreditation by organizations such as the National Committee for Quality Assurance (NCQA). They also tend to participate in initiatives such as Leapfrog and Bridges to Excellence, and use high-performance networks.
This enthusiasm also generated interest in a number of other initiatives driven by data and health IT. While 72% of companies do not anticipate investing time or resources in implementing health IT programs this year, most plan to consider adopting programs such as computerized order entry and computerized clinical decision support tools in the future. In addition, 43% believe health plans should provide employees and dependents with portable electronic health records as part of their standard services.
Source(s): Hewitt Associates