HR, Employment, & Benefits
EMPLOYER PRIORITIES FOR HEALTHCARE IN 2023
Employers are recognizing that virtual care has not fully eliminated barriers to access, and that an exclusively virtual strategy can fragment the care experience and lead to wasteful spending. In articulating priorities for 2023 during the Fall 2022 roundtable session with One Medical, organized by the Employer Health Innovation Roundtable, more than 1 in 4 employers cited lack of access to care as a primary concern, and 1 in 4 employers expressed concern over fragmented care. A fragmented care experience is characterized by disorganization, poor communication, and/or general incoherence, all of which can compromise cost-effectiveness and create negative health outcomes.
While most employers anticipate that virtual care will continue to be important in the future of healthcare delivery, they also agree that combining virtual with in-person delivery will be essential to designing successful and equitable health benefits strategies moving forward.
As a result, employers are now in a moment of examining, refining, and supplementing virtual health care options.
THE IMPORTANCE OF PRIMARY CARE TODAY
Primary care, which accounts for about 35% of patient visits, is a key area of focus among employers as they work to assess the effectiveness of delivery strategies. However, primary care currently accounts for only a threadbare amount of total medical spending in the United States, estimated at 5%. To the detriment of many communities, as well as individual health outcomes, most hospital systems in the U.S. view providing primary care as unprofitable in the short term, and employees on corporate health care plans report having to wait about six months for primary care appointments.
Employers reported that one third to one half of their workforces haven’t been able to access a primary care provider. These employers expressed concern about the serious risks and costs that problem poses. They noted that the stakes are high for both employees and payers, as timely, solid engagement with primary care is essential to the early detection of health problems and especially to effective cancer screenings and cancer care.
Without reliable primary care, employees can’t address their health proactively; they can only react to symptoms, often after expensive problems have already developed and compounded. Conversely, investing in effective primary care leads to long-term savings and improved health outcomes. The California Health Care Foundation estimates that if commercially insured HMOs in California were to fully fund primary care services, the shift would result in around $2.4 billion in annual savings and 89,000 avoided ER visits.
Given the extensively documented human and financial costs of compromised primary care, as well as increasing awareness and demand for better primary care among employees and prospective hires, determining the most effective delivery strategy for primary care is central to employer priorities in 2023. The employers who spoke with One Medical reported that workers value access to primary care so consistently that including strong primary care options in benefits packages has become an important tool for recruitment and retention.
Polling has found that 42% of EHIR members expressed that their biggest priority in offering primary care benefits is to increase access to care among employees.
According to the same poll, 25% of employers are prioritizing the need to reduce fragmented care, and around 17% of employers are primarily concerned with preventing duplication of services. Successfully addressing all three of these concerns–expanding access, reducing fragmentation, and preventing duplication–would improve employee health outcomes and improve cost-effectiveness over time.
An integrated, advanced primary care solution that incorporates both virtual and in-person components addresses all three employer priorities head-on:
Fortunately, successful models have proven that it is possible to seamlessly integrate a virtual
strategy with in-person options. With an integrated model, a wrap-around virtual care program can supplement in-person services at brick-and-mortar primary care facilities.
As distinct from urgent care facilities, primary care facilities provide ongoing, longitudinal services and enable patients to build relationships with providers. The integration of virtual care reinforces those in-person services and strengthens patient-provider relationships over time. An integrated, advanced primary care strategy therefore leverages technological advances from the past several years to optimize patient outcomes; attract, retain, and support employees; and boost overall access to primary care.
This article is designed to give general and timely information about the subjects covered. It is not intended as legal advice or assistance with individual problems. Readers should consult competent counsel of their own choosing about how the matters relate to their own affairs.