The Business Group Blog was created to share and discuss information about challenges and solutions to the health care benefits issues that large employers face today and tomorrow — such as controlling health care costs, reforming the health care delivery system, and engaging employees in their health and benefits — and will provide insight into national health policy issues. We hope you find this information useful and will consider subscribing to the blog and sharing any thoughts or ideas with us at firstname.lastname@example.org.
For the first time in 2010, the number of specialty drugs approved by the FDA surpassed that of traditional drugs, kick-starting a trend that we're continuing to see year after year. While only a small fraction (approx. 4%) of the patient population uses specialty medications, these costly drugs now account for 25% of total US drug spending and is the fastest growing cost in most employers' health benefits.
A recent federal appellate court decision upholding a 2011 Michigan law that imposes a 1% tax on health care claims raises concerns for employer plans. In the court's view, the Michigan law is not preempted by ERISA, which generally exempts employer plans from similar law.
Compounding pharmacies lost a big stream of revenue in the last few years when large employers, working closely with their PBMs, implemented caps and exclusions on compounded medications to better manage costs. While these control measures addressed a significant portion of unnecessary compounding, there are new creative compounding billing practices that are slipping through the cracks.
Leading employers are changing their focus from offering benefits and programs centered on improving employees’ physical health to deploying holistic wellbeing strategies whose purpose is to enhance all the various facets of employees’ lives. This shift is taking place as evidence mounts that physical health is only one of a number of factors contributing to outcomes valued by employers. These include improved health, greater productivity and higher performance, accompanied by decreased health care costs and a lower turnover rate.
The #1 issue keeping employers up at night is engagement. Only one in four employees consider themselves engaged in their health and well-being. However, engaged employees are healthier, more productive and are better able to contain health care costs.
Despite the benefits of EAPs, low engagement rates mean employers are struggling to demonstrate how the program provides value. In response, new trends are driving changes in EAP design and delivery to better support many aspects of an employee’s life.