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The biggest flaw in employers' 2021 healthcare plans

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As we look to the benefits and resources we’ll provide employees next year, cutting costs is an all-too-easy focus. We’ve seen this year how our employees’ health and well-being are in jeopardy like never before. In these crazy times, it simply doesn’t make sense to place the pressure of reducing costs in the hands of overwhelmed employees.

Yet that’s what employers are doing. As HealthJoy’s recent 2021 State of the Benefits Experience Report revealed, employers plan to lean heavily on employees to make cost-effective healthcare decisions next year.

Our survey asked HR professionals how they plan to contain costs in 2021. Fifty-nine percent reported that “creating better healthcare consumers” was their top strategy, above other options like managing high-cost claimants (27%) and eliminating or reducing benefits (7%). Yet an equal 59% revealed they did not offer nor plan on offering a solution to help employees find better healthcare.

What’s more, 80% said they did not expect to expand benefits in 2021. That’s not to say that HR is planning to leave employees hanging in the wind. Instead, they’re leaning on education in the hopes they can teach employees how to choose high-quality, low-cost healthcare on their own.

That’s a losing proposition.

As employers planned for 2020, we heard that healthcare costs were expected to top $15,000 per employee. The pandemic changed that calculation. Instead, so far, we’ve seen typical employer costs go down, as employees put off care during the public health crisis.

According to a PWC report, money saved by employers this year is likely to be offset by COVID-19 testing costs. What’s more, we may see costs skyrocket next year when delays in care for chronic conditions come home to roost. One report from the University of Washington estimated as many as 28.4 million elective surgeries will be canceled or postponed in 2020.

Flooded hospitals and high employer costs could very well be the reality of seeking care in 2021. Worst of all, we’re still talking about employees who have no idea how to find high-quality, low-cost care. In the middle of this pressure cooker, could we blame employees for going to a doctor who makes them feel comfortable instead of finding one with lower costs?

Or, even worse, could we blame them for rushing to the emergency room with COVID-19 symptoms instead of carefully planning a telemedicine or urgent care visit? If we don’t get ahead of the healthcare consumerism crisis now, it will only be exacerbated in 2021.

It’s not clear how we’ll actually help employees become better healthcare consumers. It’s tempting to try to solve this by adding more benefits. Take telemedicine, for example. A study published in the American Journal of Emergency Medicine found that patients save between $19 and $121 per visit when choosing virtual care. Yet many employees don’t know they could be saving that much. In fact, they may not even know their virtual medicine benefit exists. By most estimates, carrier averages for telemedicine are under 10%.

A benefit that saves money only accomplishes that goal if employees use it. Employees lack the guidance to first understand how they can save money, and then how to go about doing it. So, without tools or support, “creating better healthcare consumers” is a strategy built around employee benefits education. We know from long experience that it simply doesn’t work.

Education doesn’t help employees understand how to find better care at a better price. No amount of education will tip those scales, because healthcare doesn’t happen in a vacuum. We all know healthcare has a transparency problem.

We can’t expect employees to effectively maneuver through an opaque healthcare system—in this case, one that is also swamped by a pandemic—armed only by a few PDFs and presentations. As consistently rising healthcare costs show, it didn’t work last year or this year, and it won’t work in the years to come.

It will never be easy to stop and plan for healthcare when you’re in an accident, helping an injured spouse, or worried about a feverish kid. In these moments, employees don’t have time to research, and we shouldn’t ask them to. This is why they need to be provided with on-demand help, not just education.

We must help them find the best care at the lowest possible price, assist them in navigating procedure scheduling, and help them check for lower-cost prescriptions. We must provide tools that are mobile, constantly accessible, and unlike our healthcare system, easy to navigate.

It’s our duty as employers to make benefits simpler and more supportive in the year to come. That means equipping employees with better tools. As this crisis drags on into another plan year, we must do everything we can to remove the complexity from being healthy.

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