Evolving the benefit mindset: Mapping out a blueprint for the health plan of the future (Part 7 in series)

woman at a table in a colorful meeting room holding a pen and having a discussion with colleagues holding pens and tablets

Part 7 in a 7-part series: Evolving the Benefit Mindset

In this series, experts from Willis Towers Watson identify areas of focus critical for the successful implementation of a benefits strategy in a time of increased automation, uncertainty and changing employee expectations.

From the need for agility as business-as-usual to the role of organizational purpose (including the attraction and sustainability of human capital through employee wellbeing and inclusion and diversity programs) and much more – these components are essential tools for any leader in today’s climate.

When it comes to health care benefits and overall employee wellbeing, it’s time for greater value in the form of better outcomes, better cost and a better experience employers and employees alike.

Today, employers are focusing their attention on the health and wellbeing of their workforces as they seek to optimize worker engagement, productivity and effectiveness. Employees are being asked to be more agile each day and to cope with stress, heavier workloads, automation, workforce diversity and constant business challenges. Employer-provided benefits must evolve to deliver more in new and varied ways – especially when it comes to health care benefits.

The health care problems

When it comes to our health care system, employers know what needs to be fixed. Nearly 50% recognize there is widespread cost variability for a procedure or service within a given market, according to the 2018 Willis Towers Watson Health Care Access & Delivery Survey. What’s more, 40% of employers say they are challenged by outcome variability for the same procedure across facilities within a market.

Nearly 40% also report that the data and tools they need to help employees make quality-based health care decisions and manage a hospitalization or surgery are either unavailable or ineffective.

The sharp rise in account-based health plan offerings to near-universal levels among employers has been marked by a steep increase in unit costs for most services (especially facility-based) and an outcry for navigation assistance among patients who are confused and on the hook for large deductibles.

Good health – physical and emotional – is an essential part of employee wellbeing. Employees across all generations value health care benefits and want to be confident they have the coverage, decision support and access to the right care when it’s needed. Employers are constantly seeking greater value and opportunities to improve the status quo, including better navigation and decision support, improved behavioral health solutions and a higher degree of integration with their broader wellbeing efforts.

Health care solutions

We believe these opportunities will be found in the seamless integration of complementary solutions such as technology-enabled navigation, targeted clinical solutions and high performing providers – all connected with the right data at the right time. These approaches also require new payment models that reward how well physicians and hospitals perform, both clinically and financially.

There is one important paradigm shift that needs to occur. While more than 50% of employers plan to make changes in how health care is delivered to employees within the next two years, only about 30% say they will tailor health plan solutions by local market (based on availability and workforce needs), according to our research. This number needs to double or triple.

Health care is more local than ever. A number of emerging health care delivery solutions are based on a smaller, high-performing network of providers coordinating care more effectively within a local market.

It‘s important for an employer to have health plan analytics not just on a national level, but also for key local markets. Employers willing to pilot new medical plan options or networks in specific markets stand to reap benefits sooner for their employees and their organizations.

So what is the blueprint for the health plan of the future?

The future health care experience may begin with a technology-enabled, concierge-like outreach to connect you to resources based on your profile. This may include establishing a relationship with a primary care provider you can reach virtually or in person. Data will be safeguarded but coordinated across multiple providers caring for you. You will be guided to specialists, as needed, but without losing the connection to your primary care team.

You can expect one consolidated place for digital app reminders, pharmacy connectivity and other sources of online support to help you take care of yourself on a daily basis. Your health plan may have different costs for different types of services and may work with a more exclusive set of providers, but you will be able to track your financial responsibility all in one place and be proactively guided to the right providers connected with your plan.

Technology, innovation and new payment models are paving the way. National health plans as well as third-parties, ranging from technology companies to hospital systems, are bringing forward solutions. National health plans should note that more than 60% of employers say they are more inclined to work with their primary health plan on networks or center-of-excellence strategies.

We encourage the major health plans to take advantage of these collaborative opportunities, organize their experience and assets and provide actionable options for employers with financial guarantees. Third parties that can fully integrate the health care experience stand to make a big impact. Armed with data in their key markets, employers have the opportunity to test new solutions locally, evaluate performance and drive the integration needed to build value.

To optimize the health of workers and help ensure sustainability for employer plan sponsors, health care benefit offerings need to evolve in terms of design, delivery, decision support and value, taking advantage of technology and leveraging local market solutions in new and different ways.

This post was adapted from the Willis Towers Watson article, “Evolving the employee benefit mindset and strategy: The future arrived yesterday” by Randall K. Abbott, senior strategist emeritus for Willis Towers Watson’s Health and Benefits practice, John M. Bremen, managing director, Human Capital and Benefits, and Amy DeVylder Levanat, director Human Capital and Benefits. Read the full article.

Previous in series: Optimizing and aligning the benefits experience

Courtney Stubblefield head shot

Courtney Stubblefield, ASA, MAA, serves as national practice leader for Health Care Delivery for Willis Towers Watson Health and Benefit business. She has nearly 25 years of benefits consulting experience. Courtney helps assess and organize information and insights about health care delivery and network solutions for our consultants and staff.

Courtney has experience working with employers across many industries facing different priorities and challenges, but she has extensive experience with technology, oil and gas, and retail companies. Some of her areas of specialization include the study of account-based plan impact, high performing network strategies, health care reform, retiree medical, and the design and measurement of health improvement and incentive programs. 

Prior to her current role, she recently worked for Shell Oil Company in Houston as a senior advisor developing benefit marketing strategies, evaluating longer-term benefit recommendations, and streamlining global policies.

Courtney earned a B.A. degree in mathematics with a concentration in actuarial science from the University of Texas at Austin. She is an Associate of the Society of Actuaries, and a Member of the American Academy of Actuaries.


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