Employer Healthcare Benefits: A Look Back at 2018

By: Innovu, Sashi Segue.

A Kaiser Family Foundation Employer Health Benefits 2018 Annual Survey looks at key statistics for Employer Health Benefits in 2018. The survey provides great data to highlight the current state of the employer-paid healthcare benefit market.

Some notable statistics about employer insurance coverage in 2018:
  • 61% of covered workers were enrolled in plans that were either partially or completely self-insured
  • 57% of employers offered health benefits to at least some of their workers
  • 90% of employees worked for companies offering at least some level of insurance
  • 99% of large firms and 97% of small firms offered coverage to spouses
  • 100% of large firms and 97% of small firms offered coverage to dependents
Premiums Deductibles

Average premium costs varied by region of the country, industry, size, and type of businesses that offered employee coverage. Workers in the Northeast paid higher premiums for single and family coverage, while those in the south experienced relatively low family premiums. On average, covered workers contributed:

  • 18% of the premium for single coverage ($6,896)
  • 29% of the premium for family coverage ($19,616)

Most employees (85%) were required to meet an annual deductible before the plan picked up the tab (see Figure 4). Employees responsible for meeting deductibles in 2018 paid, on average:

$1,573 for single coverage

$2,132 for family coverage for workers in small firms

$1,355 for family coverage for workers at large firms

US Healthcare is the Most Expensive in the World

According to a recent study by the Institute for Health Metrics and Evaluation at the University of Washington:

  • The average inpatient stay cost was $22,000+
  • The average outpatient office visit cost was nearly $500
  • Employers and employees are paying more and more for healthcare.

Cost Control Measures

Even with the dire numbers, employers and health plans have made an impact on the medical trend, reducing it to 5-5.7% a year over the past 5 years (Medical cost trend: Behind the numbers 2019, PWC). Some programs have been successful, including those that accomplish the following :

  • Improving health by Identifying health issues, eliminating unhealthy behaviors, and managing chronic conditions
  • Making care more accessible
  • Managing provider networks
Improving Health

Employers offered 3 types of programs aimed at improving overall employee health:

Improving Health
Making Care More Accessible

Many large employers that offered benefits in 2018 covered care provided in alternative settings, increasing member accessibility to services. Employer also saved money from care provided in less costly settings than traditional sites of care.

Making Care More Accessible
Managing Provider Networks

A percentage of large employers offering health insurance in 2018 began or continued the following measures to better manage their provider networks:

  • High performance or tiered networks: 17%
  • Narrow networks: 5%
  • Eliminated hospitals or health systems from their provider network: 3%

The chart below summarizes the cost controlling measures large employers took in 2018:

Managing Provider Networks

How Do You Compare?

Whether you’re a large firm or small, located in the east or in the west, the statistics provided can help you assess how your programs compare to your peers, at least at a very high level.

  • If you’re offering more than most employers, you need to understand why that is. Is that part of your competitive strategy or a reflection of the location or industry you are in?
  • If you’re offering less coverage, that could be causing recruitment and retention issues.

Benchmarking is a step in the right direction. But to get true insight into how your programs compare and identify cost savings opportunities such as site of care redirection, you need to integrate data across your human capital programs. At the very least, you need to understand the correlation between medical and pharmacy costs, two of your biggest benefits program cost drivers. To learn more about how you can improve your employer-sponsored health program, contact a trusted RCM&D advisor today.

The above blog was provided in full, or in part, by Innovu— RCM&D’s data analytics platform and partner.