Survey: Employees Are Employers Top Challenge in Offering Health Benefits

Towers Watson and the National Business Group on Health released their annual survey this month.

The report delves into cost trends, employers’ commitment to offering health care benefits, strategies to increase employees’ sense of accountability for their health and well-being, and challenges to those strategies.

I culled a few interesting points from the full report.

Are employers in or are they out?

In terms of whether employers will continue to offer health care benefits, the news is mixed. Only 3 percent say they’re likely or very likely to drop health care plans for active employees with no financial subsidy in 2014 or 2015 (2014 is when health exchanges will be available.). However, 45 percent are somewhat or very likely to offer these plans to a core group of employees and direct ineligible employees to the exchanges.

So, in reality, things could change for a number of employees. In a bigger shift, the number of employers that confidently report they’ll continue offering health care benefits for the next 10 years dropped precipitously from 73 percent in 2007 to 23 percent today.

Greater personal accountability from employees?

Employers continue to focus on developing “a workplace culture where employees are accountable and supported for their health and well-being.” Employers cite this as the number-one area of focus in their 2013 health care strategy, and they’re using a variety of techniques to get this culture of personal accountability in place:

More employers are using account-based health plans (ABHPs), another word for consumer-directed health plans with health savings or health reimbursement accounts. Nearly 12 percent of companies will offer only these types of plans.
They’re also continuing to use carrots and sticks, with more than two-thirds offering incentives and 20 percent using penalties.
The shift to outcomes-based wellness — a carrot or a stick, depending on your viewpoint — is on the rise, too, with 10 percent adopting this approach.

Affordability

The report identifies the affordability struggle both employers and employees face. More employers are looking broadly at health care affordability, considering how lower health care costs translate into more money to pay top talent and keep them happy, something that’ll be increasingly important as the economy improves and employees skedaddle. Some of the changes employers made put an increased financial burden on employees, even while their wages are suppressed, leaving employees in a jam:

In fact, wages have been rising between 2.0% and 3.5% annually for much of the last decade, dipping to 1.5% over the last three years. The slower pace of health care cost trends, then, does not diminish the growing affordability challenge for active employees, who see an increasing share of their total rewards going to health care benefits.”

We know from other reports that this jam results in trouble paying medical bills and delaying or avoiding health care treatment.

Same bat-time, same bat-channel

As before, employers cite employees’ poor health habits as their top challenge to maintaining affordable benefit coverage. Their biggest obstacle to changing these habits is employees’ lack of engagement. The second-biggest obstacle is too many other demands on employees. (It’s gratifying to see work demands noted.) These two are only part of the obstacle cascade.

Next in the series is lack of evidence, which precedes a lack of budget, which precedes a lack of financial incentives and organizational support. So, without employees making changes, we have no ROI. Without any ROI, we have no budget or support. It’s a chicken-and-egg debate for the wellness age.

Games, social technology recognized as viable tools

Employers are beginning to realize the value social technology such as online discussion groups, games and other personal technology can offer. If all respondents deliver on their statements, 36 percent of companies will use social media tools as part of their health engagement strategy. iI’s exciting to see both online discussion groups and multiplayer games recognized in the survey, though company use of these tools is still low.

Side note: Shapeup and I are partnering on a more comprehensive exploration of employers’ use of technology to promote employee health and well-being. We’ll be launching the survey in April and expect to have results to share by the third quarter of 2012. This month, we released an update on the effectiveness of health games and their use by health plans and employers. You can download it here.

This was originally published on Fran Melmed’s free-range communication blog.