How Mid-Sized Health Plan Sponsors Get Big Results  

Mid-sized employer health plan sponsors have a tough assignment. As Mercer’s National Survey has consistently found, health benefit cost falls in a curve, with mid-sized employers spending more than either smaller or larger employers. It makes sense: Small employers typically keep cost down by offering less generous benefits, and very large employers have more market leverage and staff dedicated to program management. Mid-sized employers are caught in the middle – they need to offer competitive benefits but don’t have the same leverage or internal resources to devote to cost management.

That’s why I was thrilled when a trio of mid-sized employers took center stage at 2020 HLTH VRTL to talk with me about their successes in “Delivering Engagement and Savings”. All three organizations were members of Mercer’s Health Transformation Collaborative (HTC), an initiative that lets mid-sized employers offer plan members an integrated platform, a streamlined healthcare experience and access to best-in-class digital solutions. At the center of the member experience is high-touch advocacy service. With one phone call to a qualified, empathetic health professional, an employee or family member can be guided to a quality health care provider in their network; discuss the possibility of getting a second opinion; or be connected with a digital program that can help them better manage a chronic condition at home – whatever they need. This one-on-one assistance enhances patient experience, reduces waste, and improves healthcare outcomes.

The panelists, representing companies ranging in size from 2,000 to 6,000 employees, appreciated being able to offer an array of programs – at discounted pricing – without taking on the responsibility of vendor management. Of course, none of that would matter if the programs didn’t produce measurable positive results. The employers shared stories about enhanced member experience and engagement, improved quality of care, and cost reductions – and had numbers to back them up. Some highlights:

• Meaningful savings. Year 1 claims decreased 6.5%; and the trend was flat the next 3 years. The company reinvested the savings in employees by reduced deductibles and removing the eligibility waiting period. Employee out of pocket spending dropped 4%.
• Enhanced experience and engagement. 100 plan members moved from a high-risk stratification to moderate or low-risk.
• Member engagement and quality of care. 92% of high-risk members engaged with a care coordinator in the first year. Over 200 employees moved from high-risk to moderate or low-risk categories. Readmission rate dropped to 2% versus a benchmark of 8%.

The panelists talked about the added benefit of participating in a collective and learning from each other, and made the point that they would not have been able to do all this on their own. They emphasized that the key to the program’s success is that it “meets plan members where they are” by offering a personalized and meaningful experience. And, they added, communicating the program to employees was delightfully simple: Just make one call.

For these mid-sized employers, HTC allowed them to “punch above their weight” in offering best-in-class programming. To hear their stories directly, checkout the video of the session.

The second annual HLTH conference on innovation in healthcare took place in October, and Mercer again sponsored a series of sessions for employers. We encourage you to explore these 30-minute sessions. They begin with a short introduction from an industry CEO, followed by an interactive discussion between two to three employers.

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