A global pandemic certainly throws a wrench into an employer’s health benefit strategy! Employee needs have changed and continue to evolve with the pandemic, and employers have reprioritized actions and areas to focus on to meet the challenges faced by their employees and plan members. They have opted to break the traditional open enrollment cycle of visiting health strategy once a year, instead implementing programs year-round to address employee concerns, promote appropriate care to address the ballooning impact of missed preventive care, and provide much-needed attention to health and wellbeing.
What does this mean for this year’s open enrollment? Surprisingly, apart from virtual delivery of open enrollment, we haven’t seen much in the way of plan changes or disruption for plan members. We note significantly fewer changes in plan designs, network optimization, and traditional levers to address the rising cost of healthcare.
Instead, many employers are focusing this year’s open enrollment on adding clinical support to members who need it the most. When over 50% of claims are attributed to less than 5% of plan members, helping them receive high-quality appropriate care will improve their health outcomes as well as the employer’s bottom line.
Employers are also reviewing specialty drug utilization because of the wide variety of costs for the same treatments given at different sites of care – an opportunity for employers to improve trend while not interfering with the member’s treatment. Musculoskeletal continues to be a focus for many employers and some will roll out new programs to address this – both virtually and onsite.
Finally, if not already implemented or improved, employers are upping members’ access to virtual care in different areas and removing barriers to receiving that care. Virtual care has exploded in light of social distancing measures.
We see a rise in three major areas that are being addressed to support employees.
Addressing preventive care and chronic care management
Healthcare is being deferred and avoided and people are not getting the care they need. Routine exams and preventive screenings are down due to shelter-in-place and COVID-19 fear factors. Cancer screenings have dropped and people with chronic diseases are not up to date with their appointments. Vaccination rates show a steep decline in the U.S. It means that missing early detection and not managing conditions will lead to future cost increases and less-healthy employees in 2021 and 2022. As a result, employers are applying new tactics to get employees back on track – promoting and reinforcing preventive screenings and needed care. Some are including incentives as well. The flu shot is a staple benefit but is being pushed in new and different ways – if it can’t be onsite this year, they’re making sure employees receive the right communication to know where they can receive a flu shot as well as incentives to do so.
Supporting wellbeing
Survey data from the Leading Indicator Systems Workforce Listening series (April 27, 2020) shows that one-third of employees are “very” or “extremely worried” about the ability to care for their family needs as a result of COVID-19, and this same group feel they don’t have access to essentials like food and medicine. One in six admits to being vulnerable to an addiction as they cope with the increased stress.
Thus, many employers are stepping-up their support of employees who are clearly struggling. Physical and mental stressors are shifting employers into more of a patient advocate role. Some employers are expanding and reinforcing voluntary benefits with expanded wellbeing programs to address the emotional, physical, and financial stressors on employees. These organizations are acting to:
- Offer Digital therapeutic programs to combat stress, anxiety and social isolation
- Expand EAP
- Invest in addiction recovery and substance abuse virtual solutions
- Offer benefits to improve ergonomics for virtual employees
Supporting working parents
The same survey asked employees about their specific needs; one in three employees reported being very or extremely worried about the ability to care for their family needs as a result of COVID-19, while 67% find working from home substantially challenging.
With school “in session” (in class or online), flex time, work-life balance, and childcare factor heavily in benefits delivery for working parents.
More employees are at higher risk of burnout and looking to their employers for support. Many employers are stepping up with benefits like
- Leave and flexible scheduling
- Childcare, including subsidy reimbursements
- Virtual childcare benefits including learning, academic support and activities
Year-round communication, the new tradition
As with so many aspects of life changed – possibly forever – by the pandemic, the traditional annual enrollment is no longer traditional. Employers aren’t waiting for the regular enrollment season – they are helping employees adapt to the pandemic throughout the year.