Expect employers to get more picky about who you see for care

[October 15, 2024]  By TOM MURPHY

A health care spending surge looms in the new year, and Business Group on Health is helping employers understand it.

The nonprofit found in a recent survey that large employers expect the cost to treat patients will jump nearly 8% next year before they make coverage changes to address it. That’s the highest growth rate in a decade.

Business Group on Health CEO Ellen Kelsay expects employers to react by being more selective about the care that people receive. They also will try to manage the use of expensive treatments for obesity and diabetes.

Kelsay’s nonprofit advises employers on health care cost and policy issues. The CEO spoke recently with The Associated Press.

Q: Big employers expect a jump in health care costs next year. How will they address it?

A: They’re going to be focused on the quality of services provided to their workforce. You might hear of high-performance networks or centers of excellence. Those are efforts where employers are looking for the highest quality providers and trying to encourage their workforce to seek services through those providers.

Q: Does this mean employees might see fewer choices for care?

A: They’ll see more curated, designed networks with perhaps fewer providers in them. But they will be higher quality.

Q: Your annual survey also found that better mental health care access is a big priority for large employers. Why do they care about this?

A: It’s foundational. A human being who is struggling with an issue at work or outside of work is not going to be as engaged, as productive or as healthy.

(AP Illustration/Jenni Sohn)

Q: How will employers manage expensive and popular weight loss drugs like Wegovy?

A: Most view them as a tool in their overall weight management strategy … not the only tool. (They) are going to be really focused on who is the appropriate population to be receiving these medications. Is a provider recommending this? Does the individual have certain co-morbidities? Does the individual have a (body mass index) that meets a certain threshold? And then also is the individual taking part in a lifestyle and behavioral modification program to ensure long-term success?

Q: Eight out of your 10 company leaders are women. How does that shape vision or direction?

A: I think we’re highly collaborative. We focus on inclusion of belonging, constructive discourse, encouraging different perspectives.

Q: You have studied employee benefits trends for more than 20 years. What has surprised you the most?

A: It’s this sobering continued increase in fundamental health care costs. It’s something we have been talking about for decades. There’s certainly a lot of good work happening, but it’s not enough.
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