What should employers keep in mind when developing health care offerings that address the post-pandemic needs of their employees?

ProspHire’s Mike Yetter, Managing Director, offers insight into what employers should keep in mind when developing health care offerings that address the post-pandemic needs of their employees.

The COVID-19 pandemic has been a once-in-a-century event that few of us could have predicted. We mourn the tragic loss of life globally and in the U.S., while we also manage through the surge in the Delta variant and continue forward with optimism as our children return to schools. Adversity has also driven perseverance, ingenuity, and adaptation. There is no question that the impact of the pandemic has changed how we work, socialize, shop, and how we consume health care. For example, a study from the Journal of the American Medical Association reported that telemedicine services grew by more than 1000% in March of 2020 and more than 4000% in April of 2020.

While these numbers were early in the pandemic, many professionals expect the use of telehealth services to continue, with notable hospitals such as UCLA anticipating that about 20% of volume will continue via telehealth. Reinforcing this future trend are the positive impacts from telehealth, such as increased access to specialists, avoided hospitalizations, and improved outcomes, as noted by the American Hospital Association in a letter to the U.S. Senate. Through necessity, the pandemic has rapidly advanced adoption of telehealth in a short time. As we move ahead, we also hear about increasing needs for post-pandemic behavioral health and we must still address rising healthcare costs that predated the pandemic.

So, how do health plans, employers, and health systems plan for post-pandemic needs?

At ProspHire, our research and our experience with health plan and hospital system clients shows the need to focus in three key areas:

  1. Increase support for telehealth.
  2. Prepare for behavioral health needs.
  3. Use data to manage costs to narrow networks and value-based arrangements.

Increase Support for Telehealth

As employers, health plans, and health systems consider strategies for the post-pandemic needs of their employees, members, and patients, it is important to encourage and support access to telehealth options across all types of care. Telehealth serves to reduce barriers to care and serves an important role in augmenting rather than replacing traditional care. In January 2021, U.S. News cited a 2020 JAMA study in stating that “the increase in telemedicine only offset about 40% of the decline in office visits” suggesting that both traditional visits and telehealth are important tools. The article further cited a common scenario in which a diabetic patient missed a visit due to transportation issues, which is a common social determinant factor. Telehealth helped the care provider to engage the patient and to continue monitoring overall wellness and compliance with a prescribed course of care … potentially avoiding more acute and higher-cost issues in the future. Employer and health plan support for telehealth coverage will encourage providers to continue and even to expand telehealth options.

Prepare for Behavioral Health Needs

Our ability to use telehealth for care needs, to continue work and school safely via virtual meetings, or even to attend social events through Zoom or other platforms has saved us time and money that we previously spent commuting or traveling. However, all these virtual connections don’t fully replace the in-person relationships and interactions that we enjoy, potentially leading to feelings of isolation, stress, or other factors. Better integrated behavioral health was already identified as a need prior to the pandemic, addressing whole-person wellness, and helping to avoid hospitalizations or unnecessary ER visits. A 2019 study by BlueCross BlueShield of Kansas City (BCBSKC), and reported by the National Institute of Health, showed 10.8% savings in costs for a group of BCBSKC members with integrated behavioral health. Employers and health plans should embrace the opportunity to integrate behavioral health services and improve outcomes and costs.

Use Data to Manage Costs with Narrow Networks and Value-Based Arrangements

Balancing the “quadruple-aim” of better outcomes, better patient experience, better provider experience and lower costs is a challenge. Managing this effectively means using data-driven insights to seek out opportunities to control costs and align incentives without compromising quality or creating administrative burden. Value based contracting combined with narrow network arrangements can help to achieve this balance. A 2018 Change Healthcare study cited in Health Payer Intelligence quoted an average of approximately 5.6% savings because of value-based arrangements. Aligning employees and members in partnership with health systems can shift risk, cap costs, and align care incentives.

The pandemic has created a leap forward in health care – driving adoption in telehealth and bringing focus to behavioral health that may have required years of change and regulatory intervention. Employers and health plans can embrace and amplify these trends through benefit designs, care programs, and value-based incentives in partnership with health systems. These measures will drive a more integrated care model that delivers on the promise of better outcomes, better experience, and more affordable care,

This blog was featured in Member Perspectives by The Chamber of Commerce for Greater Philadelphia.