already starting to see focus shift toward full-stack health care companies that leverage technology as an important component, but not
the only one,” he says.
Don’t iterate the old plan, give me innovation
Next year will be a big one for design as more benefits advisors and
employers break away from incremental additions and subtractions
and begin to move in very new directions. Sure, there will still be
some of the usual enrollment song-and-dance of an
incremental increase of coverage costs to employers,
followed by a “new plan” that often takes away yet
more from employees. But employers, consumers and
brokers are getting smarter faster, and 2019 will see
another big shift toward plan design innovation.
Voluntary benefits’ inclusion will grow as plan
design seeks customization to plan member needs. Susan L. Combs,
of Combs & Company, predicts the emergence of more creative
benefits, such as college loan repayment companies; the inclusion of
loss of life advocates in plans to help those who have lost
a family member but still need to remain present at
work; and a greater range of benefits for females.
Wellness programs will be expanded where metrics
support it or where they are seen as cost-effective.
Marissa Costonis, a health change coach and author,
says plans will focus more on health coaching, low-
cost, on-site wellness practices such as massage,
meditation rooms and desk-based workouts, and using healthy food
as an incentive or reward to improve employee satisfaction
Radical departures from the old ways will be on the
rise, such as direct contracting for various services
(primary care, mental health services, routine medical
procedures); plans built to handle employer/provider
partnerships; and new ways for managing pharmaceutical costs. Brokers at the cutting edge will be advising
their clients on such plan designs, as more adopt the role of consultant and advisor rather than sales person.
Says Dave Chase of Health Rosetta: “I foresee a backlash against
blunt-instrument high deductibles, creating an explosion of the
‘functionally uninsured’—that is, with more than 50 percent of U.S.
households having less than $1,000 in savings and more than half of
the workforce having a deductible greater than $1,000, millions of
Americans are a bad stubbed toe away from financial ruin.”
PPO networks will decline, he predicts, as design follows two
divergent paths: One toward narrow networks, the other a move
away from traditional networks altogether—using either refer-
ence-based pricing or transparent open networks, the successor to
Better data means better management
skills will be required to survive
As plan design shifts rapidly, employers, health care system managers and
brokers will need to develop new skills
and think creatively to meet the demand for someone to manage these
new arrangements. The driver: Better
control over relevant data. As employers insist on more control over data,
they are crunching it more effectively.
Those who can master data management will soar.
The key here will be the rise of managers on the employer side whose role is
to manage and understand their health
care data and the cost components of
their insurance and health care services.
These new managers will
be innovators, seeking the
right partnerships that
improve outcomes on the
health side while reducing cost on the provider
side. More companies will
either have a Chief Medical Officer on
staff or one on retainer to collaborate
with brokers and providers.
Here’s something else to keep an eye
on for 2019: Health care supply chain
management will become a profession.
So says Nelson Griswold, president of
agency-growth advisory Bottom Line
Solutions, who serves as managing director of the NextGen Benefits Mastermind Partnership.
“This will be a new job description
for employee benefit advisors,” he says.
“Health care supply chain management
is a brand new concept. This allows you
to take a typical self funded plan based
on hope and turn it into a high perform-
ing health plan because you are man-
aging the costs. This is not about the
lowest price. It is ensuring the highest
quality at the lowest price.”
As these managers emerge, we will
see formation of more creative employ-