As the average total health benefit cost per employee increased 3.0% in 2019 to reach more than $13,046, following a rise of 3.6% in 2018, health benefit cost management remains imperative for companies, the results of an annual survey conducted by human resources consultancy Mercer indicated.
The survey findings were based on a national probability sample of public and private employers completed by 2,558 employers in the summer of 2019. According to researchers, although 2019 marks the eighth consecutive year of health benefit cost growth in the low single digits, and employers expect costs to rise at a similar pace next year, cost increases continue to outpace overall inflation.
When asked about their priorities for the next five years, 42% of the large and midsize employers (500+ employees) surveyed identified addressing healthcare affordability for low-paid employees as an important strategy. The survey found that in 2019, most large and midsize employers did not hold down premium costs by requiring members to pay more out-of-pocket for health services. For example, researchers noted, the average individual deductible in a preferred provider organization (PPO) grew just $10 in 2019, to $992. However, the survey also showed that the average deductible increased by more than $250 among small employers (10-499 employees).
The findings further indicated that in 2019 some larger employers that had offered a high-deductible plan with a health savings account (HSA) as the only medical plan changed strategies and added a traditional PPO or health maintenance organization (HMO) as an option. But the survey also found that enrollment in high-deductible account-based plans has been rising steadily, to 36% of all covered employees in 2019, up from 33% in 2018, 23% in 2014, and just 9% in 2009.
Researchers observed that as employers search for cost management strategies that do not shift cost to employees, many are turning to innovative tech-enabled programs that help employees manage chronic conditions or other health needs, such as musculoskeletal conditions, infertility, and insomnia. The survey indicated that in 2019, 58% of all large and midsize employers, and 78% of employers with 20,000 or more employees, offer one or more such targeted health solutions. The survey also found evidence of the growth in telemedicine, with 88% of large and midsize employers offering a telemedicine program to their members in 2019, up from 80% in 2018, and only 18% in 2014.
Moreover, the survey indicated that spending on all prescription drugs increased 5.5% in 2019 among large and midsize employers, down from 6.5% in 2018 and 8.0% in 2015. Researchers noted, however, that spending on specialty drugs rose 10.5% in 2019, down only slightly from 11.9% in 2018. The results also showed that 52% of all large and midsize employers and 78% of employers with 20,000 or more employees now steer employees to a specialty pharmacy that typically provides enhanced care management.