As we enter the halfway point in the year following the year of the pandemic, by now most of us are familiar with the term “return to work.” Many businesses have brought their employees back to the workplace, while some have adopted a more hybrid model of maintaining some people on-site and allowing others to remain remote work employees.
Even though we have begun to return to a pre-COVID way of life, the way of 2021 is not the same as that of 2019. According to writer, Amy Quarton, “Trying to make the workplace what it used to be before the pandemic is not only impractical and untenable for many reasons, it is just as (if not more) disruptive than the initial work-from-home transition.”
Post-Pandemic Employee Benefits Trends
The way employees view benefits has changed. Some benefits that were high priority a year and a half ago are no longer as important as they once were, while benefits that may have seemed unnecessary or less important have made their way to the top of the priority list for many employees.
Reporter, Kristen Beckman states, “This shift in the work environment is an ideal time for employers to begin thinking about how they want to work with employees to help them recover financially and emotionally from the disruptions and stress of the pandemic.”
With this new perspective on benefits in mind, here are a few that will have an impact on how employee benefits evolve moving forward.
Employee Financial Health Benefits
For most employees, the financial impact brought by the pandemic was heavy. While some were fortunate enough to have retirement or emergency savings to fall back on, they likely had to use a good portion of those funds to maintain their lives. According to Beckman, “The resulting financial instability can cause a strain on employees that can impact productivity especially at a time when they are transitioning back to work.”
Here’s what we are seeing as a result:
Increasing numbers of providers are offering education and coaching, budgeting and savings tools, and financial advising and planning.
Various emergency savings programs are now offered by payroll vendors, retirement plan providers, and others, but no matter the vendor, the key feature is easy employee access to those funds.
Typically administered through a third party, student loan repayment assistance benefits are enabling employers to make regular contributions directly to workers’ student loan servicer.
More Benefits Options
For several employees, there was a realization of just how flexible the workplace could be when businesses were forced to begin working remotely. Flexibility in the workplace and having more options provides the employee to have more control of their daily life and the work/life balance.
Here’s what we are seeing as a result:
Flexible work hours ”will likely be made widely available and be in high demand as physical workplaces reopen,” writes Quarton, and many new scheduling tools have been launched to help employers maintain social distancing.
The most helpful option for addressing mental health is to offer better insurance coverage for mental health care. Other options include adding more visits via EAPs and providing apps for meditation, mindfulness, and stress relief.
Help with caretaking includes reimbursements for or assistance finding daycare, elder care, after-school care, remote tutoring, remote safety monitoring, and more.
Vendors have brought telehealth capabilities not just to computers but to phones, and virtual appointments are remaining an option, post-pandemic.
Tech at the Center
Many have become far more comfortable interacting virtually whether it be through zoom meetings, virtual schooling, and even online court appearances. And while occasional technical difficulties can be problematic, reliance on tech is becoming more and more acceptable and even preferred for many tasks.
Here’s what we are seeing as a result:
Going virtual can be made interesting and informative with the use of interactive tools such as webinars, virtual booths, and live chats. David Karlin writes that being able to access virtual open enrollment at home “allows family members, like spouses, to be easily included in the decision-making process.”
“The range of digital health apps, platforms, services, and new products spawned or accelerated by the pandemic can hardly be mapped,” according to writer Dan Cook. Hundreds of employee benefits apps and tools are readily available, with new ones launching weekly for benefits and health monitoring and management, provider and pharmacy searches, 401(k) funds monitoring, wellness tracking, and more.
While some trends will come and others go, one thing we know for sure is that as we continue to define what normal looks like, employers and the benefits they offer to their employees will certainly have a pivotal role.
Amongst all the things that 2020 brought to the foreground of our attention, the importance of having a benefits plan that puts employees first is more important than ever. In a recent study, research showed that COVID-19 has had a major impact on how important the majority of employees view their benefits plan. In fact, more than 77% of employees claim that their benefits plan is an important part of their overall compensation, with approximately 73% claiming that benefits play a major role in their decision to stay with their current employer. And with 75% of employees claiming that being provided benefits from their employer is more important than ever, the effects that COVID-19 has had on the way employees view benefits are clear.
Employee benefits are now viewed in ways unlike ever before. For example, benefits that in the past have seemed more like rewards than necessities (i.e. remote work) are now seen as essential by employees. While healthcare benefits are clearly a top priority, the list doesn’t stop there – including those benefits that don’t always get the most attention.
In today’s article we’ll explore several tax-advantaged benefits programs that must be on the radar for modern employers in 2021 and beyond.
Tax-Advantaged Benefits
1. HSAs
Did you know that more than 28 million Americans had a health savings account last year? Health savings accounts or HSAs are accounts that are designed to help employees with higher deductible health plans better save for their medical expenses, and the number of employees that have HSAs has been steadily growing for years. In fact, 95% of employers now provide HSAs to their employees. Because they give employees the opportunity to set aside pre-tax dollars to better manage healthcare costs that are unexpected, HSAs have become increasingly more popular.
2. FSAs
Additionally, flexible spending accounts or FSAs have also become more popular in the last decade, with a reported 32 million Americans currently having an FSA. FSAs, like HSAs, give employees the opportunity to set aside pre-tax dollars for unexpected healthcare costs. The difference being that FSAs allow employees to access the entire amount that they decide to set aside from the first day of their plan year.
3.HRAs
Another increasingly popular tax-advantaged benefit is health reimbursement arrangements or HRAs, with approximately 14 million Americans having an HRA. HRAs are self-insured arrangements that help to minimize premiums and allow employees to have more control of their healthcare expenses. They are also completely funded by the employers and reimbursements are not taxable.
Pros of Tax-Advantaged Benefits
1. HSAs Remain After a Lost Job
As we endured the worst of the COVID-19 pandemic, HSAs certainly helped many American employees. While many people were laid off due to closures and downsizing, many Americans lost their jobs. However, because they did not lose their HSAs, they were able to use their existing funds on qualified medical expenses.
2. Feminine Care Products are Included
The CARES Act allowed for HSAs and FSAs to include feminine care products for the first time ever. This allowed women to spend tax-free dollars on all feminine products (i.e. tampons, pads, liners, cups).
3. FSAs Continue to Update
Last year was full of all kinds of unforeseen changes and with it, FSAs continued to update. For example, employees with FSAs were able to open or close accounts and change their contributions last year, without the stipulation of having a life-changing event. Additionally, for the purposes of maintaining their FSAs, furloughed employees were able to be considered full-time employees.
4. Over-the-Counter Meds
Another major pro of HSAs and FSAs is the eligible expenses with over-the-counter medicines. Thanks to the CARES Act, individuals no longer have to have a prescription for over-the-counter meds in order to use FSA or HSA money.
5. New HRAs
HRAs helped employers maintain their benefits throughout the worst of COVID-19. In 2020, the US Government gave employers an opportunity to offer employees a new type of HRA called an ICHRA or individual coverage health reimbursement arrangement.
Cons of Tax-Advantaged Benefits
1. Ensuring PPE is Considered a Qualified Medical Expense
While medical professionals have recommended the use of PPE and sanitizers in order to slow the spread of COVID-19, it remains unclear if they fall under qualified medical expenses under current provisions of the tax law.
2. Dependent Care Needs to Be Improved
Dependent care FSAs allow individuals to set aside pre-tax dollars to balance work-related dependent care costs (i.e. preschool, before and after school programs, etc.). Unfortunately, their effectiveness is diminished due to the fact that limits have not been updated in over 20 years. Because they have never adjusted for inflation, their amounts do not meet the dependent care needs in most areas of the country. Throughout the COVID-19 pandemic, several parents had to leave their jobs or significantly reduce their hours due to a lack of childcare, though, many essential workers didn’t have that option and were left scrambling for childcare.
3. COBRA is lacking
With unemployment still rampant across the country, several Americans are left wondering how they will manage to pay for their medical expenses this year. Most of those who were furloughed or lost their job in 2020 were placed in the Consolidated Omnibus Budget Reconciliation Act or COBRA. Not only is COBRA expensive, but it is also confusing for both employees and their employers. COBRA is simply not working for several Americans and is a high-priority health care concern in an economy ravished by COVID-19.
Every year, the US spends $3.8 trillion on healthcare. What’s more, 90% of this goes to caring for chronic conditions. In an effort to reduce costs, improve the quality of life for their employees, and improve employee retention, for years, employers have shown support for five major chronic conditions: high blood pressure, diabetes, lack of physical activity, obesity, and smoking. These chronic issues cost employers an estimated $36 billion annually. Therefore, making advances towards addressing these issues can result in a significant impact financially. This is more important than ever because – the inconvenient truth is – that $36 billion is only expected to increase.
The pandemic revealed many issues facing employers. Among them is employee behavioral health. While behavioral health has often been ignored by employers, it’s all but certain that it will emerge as a sixth vital chronic care condition. With all of the challenges brought on by the pandemic, it’s no surprise that employees are reporting higher levels of stress, anxiety, and depression than ever before. Research shows that the pandemic could result in a 50% increase in behavioral health issues. This would mean that one-third of all Americans would be in need of care in 2021 and is projected to cost an additional $100-140 billion this year alone.
With healthcare costs on the rise, the list of conditions growing larger, and the increasing demand for a remote workforce, many employers are turning to technology for solutions. With a growing list of mobile apps that offer guidance for cognitive behavioral therapy in a market that is rapidly expanding, tech solutions are more available than ever before. Here are a few considerations that employers need to be making as they address these new issues:
Behavioral Health is a Chronic Condition
It can no longer be ignored. Behavioral health issues are at an all-time high with 67% of Americans reporting to have increased stress levels in 2021. This comes with a significant financial impact. The global economic losses related to behavioral health are estimated at $16.3 trillion between 2011 and 2030, almost equal to that of cardiovascular disease and surpassing other chronic conditions. In addition, research shows that employees with these behavioral health conditions spend roughly $6,500 more annually than employees without.
Regardless of the growing awareness of this critical issue, studies revealed that there is a looming disconnect among employers. When asked to rank chronic conditions by importance, only 33% ranked behavioral health as being a significant concern, putting it seventh on the list overall. Meanwhile, diabetes was ranked number one for 61% of employers surveyed, despite the fact that data shows behavioral health to have a significantly higher impact financially. In a recent study, research showed that behavioral health conditions cost employers $17 each year per employee in disability wage replacement costs. The next most costly chronic condition is diabetes, costing employees $2 each year per employee. In another study, research showed that lost productivity for those experiencing behavioral health issues cost employers roughly $109 per employee, compared to those with diabetes, costing employers $9 per employee.
With the knowledge of the financial and personal impact that behavioral health conditions have on both employers and employees, employers need to identify solutions for the most prevalent diagnoses. As mentioned above, the solution may be found in tech for chronic care management. Studies have revealed that digital screenings, teletherapy, and digital CBT tools are effective for mitigating both symptoms and costs. Additionally, providing care early on has a significant impact, with the average cost for employees taking leave for a mild form of a condition like depression can be up to 52% lower than the average cost for a severe form of that same condition.
Traditional vs Modern Solutions
A recent analysis of the digital app space showed that there were roughly 300,000 health-related apps available for download on mobile devices. This market is projected to grow to over $230 billion in value by 2023. While new tools are welcomed and many of them show promise, the swift expansion of digital options can make it difficult to know which tools are worth utilizing. It is important that employers are thorough when selecting which tools they will use as it is likely that the more mature digital solutions will become the most robust and engaging tools, ultimately, making them the most effective.
That said, the focus of employers is to find a singular solution. In a recent study, research showed that 71% of employers said that a singular digital solution to behavioral health management was of high importance. The same is true for enterprise-level solutions, with each solution promising mitigated chronic conditions, optimized personal management, and a decrease in employer healthcare costs.
However, regardless of these solutions, the disintegrated nature of behavioral health management creates a significant challenge for employers. The single-issue solutions struggle to have widespread engagement among employees which has a significant impact on the long-term success of their adoption. Studies show that 47% of employers attribute lack of employee engagement as the main obstacle to the adoption of digital solutions. Another study revealed that engagement rates for health insurer’s behavioral health management programs were only 13% on average.
This is why it is important for employees to prioritize more mature digital solutions. The next few years are likely to see many large consolidations as the more mature solutions buy out the single focus tools, creating more robust solutions that deliver better returns. By sticking with more mature solutions, employers will see more engagement as the market and the tools within it grow.
Prevention Over Cures
The obvious real return on behavioral health solutions is that they are positive for both employers and employees. Not only do they improve the health and well-being of employees, but that, in turn, improves the employer’s bottom line. In a recent study from Harvard, research showed that effective workplace wellness programs resulted in a return of $2.37 for every dollar spent on average. Emerging tech solutions help treat behavioral health conditions in ways that were unimaginable before. Teletherapy can connect employees to licensed practitioners with just one click. While they might be costly upfront, immediate returns shouldn’t be the primary focus of employers. The long-term reduction in the cost of behavioral health treatments, drugs, and therapy will undoubtedly result in healthier, loyal employees.
Digital management solutions provide an opportunity to make a significant and real change for your employee’s mental well-being. While it’s easy to be discouraged by growing healthcare costs and troubling statistics on American mental health, now is the appropriate time to provide your employees with a comprehensive behavioral health management solution. In doing so, you will be making progress towards a healthier workforce and a brighter future for all.
The trajectory of behavioral healthcare might be daunting and more unpredictable than ever before, however, digital solutions bring promise. These tools not only help improve the health of your employees, but they can also have a positive impact on costs, retention, and resilience. Employers that embrace the behavioral health concerns, seek out a singular solution, and focus on long-term employee health will be better equipped to handle the issues of rising healthcare costs and the evolving needs of their employees.
The events of the past year have altered many aspects of daily life, with none more jarring than the switch from in-person to remote work. As organizations of every size and industry have pivoted to accommodate this “new normal”, they and their workforce have come to intimately understand the benefits and drawbacks of a remote working environment. Whether your organization chooses to adopt this practice in perpetuity, or offer remote work as an option to your employees after it’s safe to return to the office, your organization should consider altering its benefits package to meet the health-related changes presented by a remote work setting.
With a new environment come new challenges, and your employee benefits should both reflect and seek to address those new challenges in order to retain your current talent, entice new talent, and save on healthcare costs at both the individual and organizational level.
In this post, we’ll cover:
New difficulties to employee health presented by a remote work setting
Benefit adjustments that address these difficulties
How to meaningfully implement these changes
New Environment, New Challenges
While there are many advantages to working from home, there are also several critical obstacles that can negatively impact employees. The most immediate threat is, namely, stress. Workers are currently inundated with uncertainty, from concerns about their own health and the health of loved ones to unexpected financial strain. Employees may also be feeling alienated from their coworkers, friends, and family, causing a decrease in both happiness and productivity in multiple areas of their lives. According to recent research emanating from the CDC, Americans reporting feelings of anxiety, depression, and loneliness in 2020 have tripled in comparison to the previous year.
While some of these feelings may eventually be alleviated by the widespread adoption of a vaccine for the virus that causes Covid-19, remote work environments still present many obstacles that can lead to increased emotional and mental strain. A lack of social interaction with coworkers and misunderstandings stemming from inadequate or poor communication are just some of the hindrances that can increase feelings of anxiety, estrangement, and hurt job performance.
There are numerous studies outlining the direct, negative impact that emotional and mental stress can have on one’s physical health, including heart disease, high blood pressure, and abnormal cholesterol levels. Better mental health advocacy and the increasing amount of evidence that directly links mental and physical health are leading many organizations to offer additional or better benefits that seek to address mental and emotional health in order to drive down healthcare costs now and in the future.
Adjusting Benefits to Meet New Needs
Remote work environments, while convenient, can be mentally and emotionally isolating. These feelings of isolation can often progress into chronic health conditions that can be expensive to both the employee and the employer provided health plan. Mental and physical health are inextricably linked, and the effects of the pandemic have only accelerated the acceptance of this fact and the adoption of programs to address it. As more and more organizations are making the partial or full switch to an entirely remote workforce, employers are simultaneously beefing up their benefits that address the mind-body connection.
One of the simplest, most cost-effective ways to redesign your benefits to include mental and emotional health resources is to adopt a single solution that combines mental wellbeing and chronic condition management through preventative wellness. According to recent research, employee wellness programs provide a 6:1 return on investment in healthcare cost savings.
Chronic diseases often emerge through poor preventative care, costing employers millions of dollars every year. By refocusing your benefits to be employee-centric and encouraging your employees to adopt healthier mental and physical lifestyle habits, employers can achieve monumental cost savings now and in the future. Some examples of wellness programs are those that incentivize employees to keep track their own health data through general physical assessments and friendly competitions. Stimulate your employees to discover and improve their body mass index by offering them a financial reward or paid time off if they complete an annual physical each year. Additionally, creating some friendly competition between employees to engage in healthy habits in exchange for a prize is another great way to engender adoption of good lifestyle choices. By incentivizing employees to participate in preventative care, they may discover they are at risk for certain chronic conditions early enough to redirect the path they’re on.
Support the Transition to Yield Best Results
Open and honest communication is always important in the workplace, but it is especially critical in a remote environment. Most employees are currently working remotely, and there is an increasing likelihood that many companies will decide to go fully remote for the foreseeable future.
One of the most important things that your HR team and organizational leaders can do during the adoption of new benefits programs in any setting is to maintain transparency and open lines of communication between themselves and their employees. Providing employees with the freedom and safety to discuss the obstacles they may be struggling against can help employers to understand the needs of their employees and the resources they may need to be connected to, such as mental health counseling or a one-on-one meeting with your company’s benefits specialist. In addition, open and authentic lines of communication between employees and leaders helps to engender a deeper level of trust. Getting on your employees’ level and being receptive to their needs will increase the likelihood that employees will take advantage of new wellness programs that your organization will offer.
Key Takeaways
Remote working environments present unique challenges, but these challenges also offer new opportunities to encourage employee self-care that can save everyone time, effort, and money. Employees that understand and use the resources available to them are more likely to be productive, long-term members of your team-and will act as great ambassadors to new prospective talent. By offering employee-centric benefits that address both the mind and the body, employers can ensure the wellbeing of their employees. Remember:
Employers should acknowledge the new challenges to employees presented by remote work environments and adjust their benefits packages accordingly to meet these challenges.
Employer benefits packages should include wellness programs that offer incentivized programs and resources for those struggling with mental and emotional health issues, as these issues often manifest as chronic physical conditions. Studies have shown that preventative care programs save employers millions of dollars healthcare costs.
Facilitate and encourage the regular use of the wellness program and other new employee resources through open and honest communication between leaders and employees.
In the year 1970, per capita annual health care costs averaged around $1,848 (in today’s dollars). In 2019, that number increased to $11,582.
Over the last forty years, this increase in health care costs has reached the pockets of employers—on average health care costs are more expensive now than they have ever been before.
This change has led company CFO’s to take a much more active and expended role in health plan design. In this post, we’ll discuss this trend.
Specifically, we’ll talk about:
The Ongoing and Increasing Trend of CFO Involvement in Health Plan Design
What Is Causing This Trend
What Should Business Leaders Do About This
The data covered in this article was collected by cutting-edge benefits firms that collectively support thousands of employers across the U.S.
The Ongoing and Increasing Trend of CFO Involvement in Health Plan Design
A recent survey has produced significant evidence that supports the idea that CFO involvement in health plan design will continue to increase. Consider the following findings from the survey:
Over the past three years, only 32% of organizations have made changes to manage health care costs. However, 55% of organizations expect to make changes over the next three years.
74% of business leaders indicate that their finance department has had an active role in making decisions related to their health care program over the last three years. However, this number increases to 87% when asked if their finance department will have an active role in the health care program over the next three years.
48% of business leaders stated that their finance and HR departments shared responsibility for the organization’s overall health care management and strategy over the last three years. When asked the same question about what they expect over the next three years, the number increased to 58%.
The data is clear. Health care costs are increasing, and organizations will be making changes in the near-term future to adapt. These changes will involve an increased role of the CFO (and the finance department in general) in the management of the organization’s health care program.
What Is Causing This Trend
The driving forces behind the trend explained in the previous section are both simple and complex at the same time.
From a simple perspective, the trend is being caused by a decades-long increase in health care costs for employers. In order for company leadership to manage the rising costs of their health care plan, they must instruct the CFO and the finance department to have an increased role in decisions related to the plan.
However, recent events have made this trend even more complex. The COVID-19 pandemic has created many questions about the future of health care around the globe and the associated costs. Unfortunately, many of these questions remain unanswered. CFOs must become increasingly involved in health care plan management in order to brace for whatever storm lies ahead in the industry.
What Should Business Leaders Do About This Trend?
It may seem as if an increased role of the CFO in what has traditionally been an HR realm will be sure to cause contention within many organizations. The minds of CFOs and HR managers functions differently, there is no doubt about that.
Fortunately, there are many trusted sources of support to help organizations adapt to these structural and responsibility changes.
According to findings from the same survey that was cited earlier, “Nearly all employers think strategic conversations and innovative solutions are valuable in their relationship with a consultant or broker.” In other words, business leaders are becoming increasingly willing to work with benefits consultants and brokers to help them navigate the uncertain future of the health care industry.
The following solutions which are traditionally provided by benefits consultants and brokers were specifically mentioned in the survey:
Innovative solutions
Strategic conversations
Benchmarking
Market developments and industry trends
Actuarial and financial advice
Fully bundled services and solutions
Business leaders who took the survey overwhelmingly indicated that they will find significant value in discussing the above items with benefits consultants or brokers moving forward.
If you and your business find yourself in need of a more hands-on benefits consultant, be sure that you know what to look for when considering different options. Consider the following tips:
Make sure the broker offers services that can be adapted to your specific needs and business model.
Consider the broker’s approach to cost-savings. Will they offer your business cutting-edge plan design options in order to control benefits spend?
Take a close look at the pricing model of the consultant or broker. Do they work on a commission or fee only basis?
Key Takeaways
Health care costs are increasing, both for individuals as well as businesses. A result of this trend is that company CFOs and finance departments are becoming increasingly involved with the management and decisions related to the company’s health care program. As we soon will enter the post-pandemic world, there is much uncertainty related to what effect the lingering effects of COVID-19 will have on the global health care system. Due to this uncertainty, it will become even more important for the CFOs to be involved moving forward. Businesses can adapt to this trend in healthy ways by working with a more hands-on benefits broker.
COVID-19 changed the landscape in just about every aspect of our daily lives, including the way we work, the way we live, and, as employers, the way we provide access to healthcare to our teams.
This year, we expect to see the continued growth of many themes and trends at a pace that before seemed impossible. COVID-19 shook the healthcare industry, disrupting the normal course of innovation in unimaginable ways. However, this set a new precedent – one in which no aspect of our healthcare structure is seen as unchangeable.
Rapid Growth in Telehealth
Last year, mandatory shutdowns due to COVID-19 created considerable demand for telehealth services. However, although the majority of mandatory shutdowns have since been lifted, the utilization of telehealth services remains higher than ever before. Before the pandemic, telehealth visits made up only 1% of total visits. While this number jumped to nearly 50% amidst shutdowns in April of 2020, telehealth visits now make up roughly 11% of total visits.
In the past, telehealth was hampered by skepticism and its impersonal regulatory environment. While it was gaining popularity due to its convenience, the progress was slow. One main issue prohibiting the wide adoption of telehealth services was the fees associated with it. However, the Centers for Medicare & Medicaid Services (CMS) most recent fee schedule made temporary changes to reimbursement permanent, making it more accessible.
Improved accessibility and reduced variability of care allow telehealth to offer better population health outcomes – creating buy-in from both providers and consumers. It’s not a matter of if telehealth is a viable method of healthcare, but how it fits into the current system. What is the appropriate mix of remote and in-person care?
While the new reimbursement structure solidified the concept for many, the popularization of telehealth was gaining momentum with both providers and patients before its implementation. In a recent study conducted by The Harris Poll, research showed that roughly 80% of patients who tried telehealth during the pandemic plan to continue utilizing it.
Aside from primary care – which is poised to be both a long-term and high-volume use for telehealth – other procedures are also vamping up their utilization. For example, mental health services have increased their accessibility through telehealth. This couldn’t come at a better time, given the rising issue of mental health in the U.S. amidst the pandemic. And, telepsychiatric services have become more popular for hospitals and clinics that have limited or no psychiatric staff when treating more severe mental health conditions.
In 2021, if an employee has a phone or computer, they can have access to on-demand healthcare. While more in-depth services might require you to be in-person, the realization that certain parts of the healthcare process can be managed remotely is growing expeditiously.
Technology Driven Healthcare
One place that is often overlooked as a viable clinical setting is an employee’s own home. However, in-home care can be incredibly valuable to many. Those who are able to receive care in-home will benefit from lower costs, and they might even prefer it over the traditional healthcare setting. In turn, many providers are showing an increased interest in an in-home approach to healthcare. This would provide a more holistic list of services including preventative care, ancillary care, and support solutions.
COVID-19 and the impact of the pandemic have permanently shifted the standards of primary healthcare. It has fast-tracked innovation and the embrace of telehealth. With the lack of resistance to this market and the digitization of the entire world, there are several technology-driven trends that you can expect to grow in 2021.
1. Remote Patient Monitoring
In 2019, roughly 88% of hospitals invested in remote patient monitoring technology. In 2021, remote patient monitoring is expected to continue to grow. As technologies that can monitor vitals become more popular (i.e. smartwatches), monitoring and treating patients suffering from chronic conditions such as diabetes and heart disease.
2. Telehealth
In March of 2020, the CMS began allowing expanded telehealth services through Medicare. As a result, many major insurance providers such as Blue Cross Blue Shield, Humana, and UnitedHealthcare expanded their coverages. At the end of 2020, the CMS completed the permanent expansion of telehealth. In 2021, the utilization of telehealth will continue to grow.
3. Telemedicine
In a recent study by the JAMA Network, research showed that the use of telemedicine in the U.S. increased by nearly 2000% between January and June of 2020. As care delivery to the home continues to grow, providers will also continue to virtually prescribe medications, while relying on remote patient monitoring to help make better care delivery decisions.
Rising Government Populations
In 2020 we saw rapid growth in the popularity of Medicare Advantage plans. This trend will continue to grow in 2021 as the popularity of managed care and value-based contracting increases. Total enrollment for Medicare Advantage plans in 2020 was nearly 25 million or 40% of all beneficiaries – a 6% increase from the number of enrollments in 2019.
Now that we have a new president and administration in the White House, we can expect to see new priorities with government-sponsored healthcare programs. Possibly the greatest of these shifts in government programs is Medicaid. Between 2017 and 2019, Medicaid enrollment declined consecutively. However, since COVID-19 and its impact on the economy, enrollment is on the rise. In fact, 2020 saw an additional 5 million Americans added to Medicaid.
There is an apparent need for revisions to how we manage and pay the Medicaid population. Low reimbursement rates result in hesitant providers when treating Medicaid patients. This often means extended wait times for Medicaid patients seeking care. It’s no secret, Medicaid patients have long struggled to receive good health outcomes compared to those under commercial healthcare (Medicare), and in some instances, those who are uninsured.
More than 90 million Americans are now covered by Medicaid. That’s up from roughly 75 million before the outbreak of COVID-19. Additionally, the pandemic caused state budgets to tighten, forcing them to look to risk-based contracting arrangements to pay for it. As a result, budgets have become more predictable and the financial risk is moved to the managed care organizations that manage the Medicaid population.
These risk-bearing arrangements bring significant advantages in terms of financial savings due to the co-morbidities and the impact of Medicaid enrollees that have multiple conditions. Better management of these high-cost Medicaid patients could remove considerable amounts from the system. In addition, it increases the possible productivity for the working-age population who need less care.
Self-Funded Employers Will be Empowered to Control Healthcare Costs
While many attempts to curb healthcare costs have been made by providers, employers, and insurers alike, one thing is still apparent – The way that healthcare is both priced and paid for in the U.S. is unsustainable and costs continue to increase across the country. In 2020, both single and family premiums increased by 4% while wages increased by only 3.4% and inflation saw an increase of 2%.
That said, one group has the power to improve the affordability of healthcare for both companies and their employees; self-funded employers. In 2020, 67% of workers with health coverage were enrolled in self-funded healthcare plans. That’s a 6% increase from 2019. Additionally, there were roughly 25 key mergers and acquisition transactions in 2020 in the healthcare space – a 92% increase over 2019. They included reference-based pricing companies, population health applications, care navigation, pharmacy benefits management, and more healthcare plan services. In 2021, we expect to see more growth in these and similar trends.
1. Physician Quality
Avoiding network friction creates limitations to health plans and their ability to guide individuals to physicians based on quality. In response, employers are now searching for ways to navigate members through the use of independent vendors. In 2021, the expectation is that these vendors will continue to utilize quality metrics such as second opinion solutions, physician quality scoring, and centers of excellence to improve their solutions.
2. Pharmacy Cost Containment
The rapid growth of pharmaceutical drug costs continues to be a significant component of healthcare spending, particularly in employer-sponsored health plans. In addition, mid-size and smaller employment groups are receiving poor member and utilization management services from large pharmacy benefits managers. In response, employers are doing more to define pharmacy benefits and participating in aggregation models to create both purchasing power and more focused clinical services.
3. Specialty Condition Management
There has been an increase in popularity for niche solutions, solutions that are built around small yet high-cost employee populations that account for a portion of total healthcare spending. With advanced tech foundations and data analytics, specialty condition management platforms create individualized solutions for employees while offering ROI tracking to employers so they can differentiate from more traditional solutions.
4. Benefit Utilization and Navigation
Better healthcare benefits aside, there is substantial demand for better access, education, and comprehension of the resources that employees have at their disposal. From the physician quality navigation listed above to ecommerce for products and services under the health plans, employers are finding ways to create engagement of the benefits while also managing costs effectively.
Behavioral Healthcare Demand Will Continue to Rise
In 2020, as the stigmas around mental health decreased, the behavioral healthcare market gained momentum. During the pandemic, the demand for behavioral healthcare services saw unprecedented highs as substance abuse, alcoholism, and suicide rates increased across the board. In 2021, we expect the demand for these services will remain strong.
According to a study by Acumen in 2019, research showed that the annual behavioral health market is projected to surpass $240 billion by 2026. Considering that roughly 80% of Americans reported having experienced significant stress due to COVID-19, we expect to see continued growth in individuals seeking behavioral care. In addition, there is a shortage of behavioral health providers in the U.S., and the shortage is expected to grow significantly over the next decade. With this in mind, we expect to see certain trends continue in 2021.
1. Improved Access to Healthcare
With the growing focus on behavioral health, we expect sustained efforts from both the government and private sectors to improve awareness and access to care. With the increased utilization of telehealth and telemedicine services, access to behavioral healthcare is increasing, allowing us to meet the growing mental health crisis in America.
2. Demand for New Solutions
There has been a considerable amount of capital invested into digital health platforms for providers, employers payers, and direct-to-consumer. Expansion of specific segments of behavioral health services is creating a heightened demand for IT solutions with behavioral health technologies. In 2021, we are expecting even more interest in this space from strategic and financial buyers alike.
3. Private Equity Investment
Since 2018, roughly 60 new behavioral health private equity platforms have formed. In 2021, the expectation is that private equity investors will continue to play an increasingly large role in behavioral healthcare.
