Looking to Cut Health Plan Costs? It Takes a Network.

How employers can cut health plan costs and meet employee needs without compromise.

Where does your healthcare budget stand in 2024? For many employers and their health plans, the year ahead is clouded with unique financial challenges and rising costs—a storm that’s been building since 2020. Currently, health costs are forecasted to spike between 7% and 8.5% over 2024, nearly double that of 2023 1 . Behind this seemingly sudden uptick in healthcare costs, however, are a variety of factors dating back to the pandemic and further including:

• Post-COVID plan utilization.

• A changing prescription marketplace.

• Provider contracts ending and rising costs.

While the peak of the COVID-19 pandemic has passed, its long-term effects are still impacting employers’ health plans years later, and in the form of rising costs. But why? During 2020, many Americans did not use their coverage to its full extent because of an aversion to doctors’ offices and COVID-19, plus the related rise in costs for provider care. Now, as this trend is reversing years later, many employees are only now actively seeking preventative care or treatment for worsened conditions, all of which have become more expensive. Ultimately, this overutilization becomes a growing burden for employers. And, going forward, as two-year fee contracts between plans and providers expire in 2024, more groups will be affected by this cost inflation 1 .

Beyond the pandemic, other cost-driving changes are occurring in the healthcare industry as well. In just the last few years, numerous specialty and non-specialty drugs and treatments have entered the consumer marketplace, delivering promising results for patients with chronic conditions. Most notably, GLP-1, a weight loss and diabetes management class of drugs, has exploded in popularity. But, for employers, the price tags of these newer treatments pose serious concerns of affordability and risk 1 .

Now, in 2024, employers are faced with a growing dilemma. With healthcare costing more than ever before, and employees needing more robust benefits than ever before, how and with whom can businesses chart a course of long-term success?

Balancing employee needs with budget resources is at the forefront of many employers’ minds, and for good reason. By cutting back on employee wellness and benefits, employers are risking absenteeism, higher turnover, loss of talent, and poor recruitment. On the other hand, shouldering these unsustainable costs jeopardizes business and makes these same benefits even more unaffordable 2 .

With over 66% of employers making this health spending dilemma a priority, no two businesses are approaching today’s healthcare marketplace with the same values or strategy. Currently,

• Over 37% of employers are partnering with cost-containment vendors or solutions and 50% are doing so within the next two years.

• 19% of employers are planning to use centers of excellence within health plans.

• 16% are planning to contain costs through specialty carve-outs.

• And 24% are narrowing or refining their provider networks.

Across these different solutions, aimed at maximizing employee value and plan savings, 63% of employers prioritize mental health and wellness programs, 40% prioritize stronger member communications, 38% prioritize more equitable and inclusive services, and 34% prioritize member savings 2 .

Through their networks, employers can put a wider range of affordable services in members’ hands.

Affordability and accessibility are key in balancing plan and member needs. But, with many providers billing up to 9x than Medicare charges for the same services, members can be dissuaded from pursuing care by intimidating out-of-pocket costs and deductibles. Instead, businesses need a network that reduces costs and uncertainty.

Here’s where Health In Tech’s HI Performance Network comes in. With a network of over 4,700 hospitals and nearly 1.6 million provider locations, the HI Performance Network connects employers and members with deeply discounted, transparent, and consistent care through Medicare-based reimbursement pricing. Now, groups can start saving more on premiums and stay ahead of rising medical inflation.

For employers, Health In Tech’s HI Performance network offers easier plan management and long-term savings in over 50 states. For members, this network makes seeking care less confusing with lower premiums and out-of-pocket costs.

Plus, plugging right into the HI Performance Network, Health In Tech’s HI Card streamlines the healthcare process with secure billing, Reference-Based Pricing (RBP) negotiations, and savings opportunities, plus 24/7 access and transparency.

Ready to discover how Health In Tech’s HI Performance Network + HI Card can power on savings for your clients?

Sources:

• https://www.benefitspro.com/2023/10/10/155876/

• https://www.benefitspro.com/2023/11/06/employers-seek-to-balance-employee-needs-health-care-costs-as-they-look-to-future/