Just Released! Two Employer Health Care Studies Show Major Issues and Initiatives Heading into 2020

health careTwo of the largest and most revealing studies on the state of employee benefits in 2019 have recently been released. Here, we provide highlights from both surveys, as well as links to the full reports.

Highlights from the 2019 Kaiser Family Foundation Employer Health Benefits Annual Survey

This annual survey of employers provides a detailed look at trends in employer­ sponsored health coverage, including premiums, employee contributions, cost­sharing provisions, offer rates, wellness programs, and employer practices. The 2019 survey included 2,012 interviews with non­federal public and private firms.

The average annual premiums for employer-sponsored health insurance in 2019 are $7,188 for single coverage and $20,576 for family coverage.

The average annual dollar amounts contributed by covered workers for 2019 are $1,242 for single coverage and $6,015 for family coverage.

Worker contribution percentages for family coverage are skyrocketing. The average dollar contribution for family insurance has increased 25% since 2014 and 71% since 2009.

Deductible costs are rising quickly. The average annual deductible among covered workers with a deductible has increased 36% over the last five years and 100% over the last ten years.

The rate of worker contribution increases is falling. In the 5-year period of 2009-14, there was a 37% increase in worker premium contributions, and from 2014-2019, there was a 25% worker contribution increase. So the rate of increase dropped from the first 5-year period by 32%.

Health insurance premiums are still outpacing raises and inflation. The average single premium increased 4% and the average family premium increased 5% over the past year. Workers’ wages increased 3.4% and inflation increased 2%. The average premium for family coverage has increased 22% over the last five years and 54% over the last ten years, significantly more than either workers’ wages or inflation.

What types of employees pay the most? Covered workers at private for-profit firms on average contribute a higher percentage of the premium for both single and family coverage than covered workers at other firms for both single and family coverage.

Plan types by enrollment for 2019 were PPOs (44% of workers), HDHP/SO (high deductible with savings option 30%), HMO 19%, and POS (7%).

Health and wellness promotion programs are popular with 50% of small firms and 84% of large firms offering a program in at least one of these areas: smoking cessation, weight management, and behavioral or lifestyle coaching. Among large firms offering at least one of these programs, 41% offer workers an incentive to participate in or complete the program.

Highlights from the Willis Towers Watson 24th Annual Best Practices in Health Care Employer Survey

This survey was completed by 610 U.S. employers between June and July 2019, and reflects employers’ 2019 health program decisions and strategies.

Curbing the cost of health care and increasing its affordability remain the top priorities for almost all employers over the next three years (93%). 95% are confident their organization will continue to sponsor health care benefits to active employees in 5 years. Yet 63% of employers see health care affordability as the most difficult challenge to tackle over that same period. On a positive note, 68% believe they have made progress in tackling costs over the past 3 years.

Employers expect health care cost increases of 4.9% in 2020 compared with 4.0% in 2019.

Employers know employees are concerned, with 89% of employers believing rising health care costs are a significant source of financial stress for their employees.

Employers are nudging their employees toward higher value, appropriate care that is sourced efficiently and away from overused, potentially wasteful services. A subset of employers is delving into new strategies that could help improve access to care beyond the approaches of high-performance networks (growing from 16% to 52% adoption by 2021) and the use of centers of excellence within the health plans (growing from 45% to 74% by 2021). The proportion of employers slashing out-of-pocket costs to steer employees toward proven services that produce positive health outcomes at a lower price tag will nearly triple over next few years (from 17% today to 46% by 2021).

More employers are attempting to offset specialty pharmaceutical costs by influencing the site of care — as the location where care is given can dramatically affect prices. The number of employers that say they plan to implement coverage changes to influence site of care over the next few years is more than doubling from 21% today to 55% by 2021.

Wellbeing is a huge focus, with 83% of employers investing in this area, and only 41% believing their current programs meet employees’ needs. 85% sponsor physical wellbeing programs and 74% have redesigned their programs to better address emotional wellbeing. 55% have a formal technology strategy to support wellbeing programs and 70% offer apps and connected devices for condition management and reducing health risks.

Mental/behavioral health ranked as the top clinical area of focus over the next three years, selected by 66% of employers. 65% plan to enhance navigation services, making it easier for employers to find a path to mental wellbeing. Employers are redesigning their employee assistance programs to better address emotional and financial wellbeing (expected to jump from 33% to 74% in 3 years) and building an organization-wide behavioral health action plan (from 25% to 68%).

If you would like to learn even more about the state of employer-sponsored healthcare, learn about the highlights of the SHRM Employee Benefits 2019 Survey and EBRI The State of Employee Benefits Findings from 2018 Survey in Two New Studies Reveal Surprising Findings About Employee Benefits.