The Health Care Challenges Employers Will Face In 2020
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Employers face significant health care challenges in 2020, including rising drug spending, chronic disease prevalence, and employee affordability issues. Notably, new costly therapies are expected, and high deductible plans deter care utilization. Employers are urged to encourage lower-cost care options and improve communication about benefits to help employees navigate the system effectively.
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Who is managing your health care delivery
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![Cost
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2Execute
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THE HEALTH CARE FLYWHEEL
Create your
GamePlan
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Build your
Strategy
How can we begin managing our health care delivery
supply chain?](https://image.slidesharecdn.com/benefitswebinar1-200130184638/85/The-Health-Care-Challenges-Employers-Will-Face-In-2020-23-320.jpg)
The Health Care Challenges Employers Will Face In 2020
- 1. The Health Care Challenges Employers Will Face In 2020 part of the STOP THE INSANITY webinar series
- 2. AGENDA 1. What to expect in 2020 2. Health Care Economics 3. The next webinar
- 3. What to expect in 2020
- 4. Drug spending will grow faster. • Between 2020 and 2027, retail drug spending is projected to increase at a rate of 3 percent to 6 percent a year. • The impact of generics will plateau • Biosimilars will continue to see slow uptake • 300 new costly therapies will enter the market by 2021 • 2/3 are specialty drugs • Many cost over $100k; one costs over $2M Trend #1
- 5. Trend #1
- 6. Trend #1
- 7. Chronic diseases will continue to plague the United States. • 60% of adults have a chronic disease. • 40% are managing two or more. • Since 2005, prevalence of obesity and diabetes increased by 26%. • Per capita health spending on an individual with a complex chronic illness is 8X that of a healthy individual. Trend #2
- 8. Trend #2
- 9. Employee affordability will continue to be a concern. • 40% of consumers who have high deductible plans said they would rather not have one. • 28% of consumers who have high deductible plans have $500 or less in emergency savings. • The average deductible tripled between 2008 and 2018. • High deductibles have led to low utilization trends because employees are delaying or forgoing care due to their deductible. Trend #3
- 10. Trend #3
- 11. Employers and payers will nudge people toward lower-cost sites of care. • Payers are designing plans to encourage members to choose free- standing facilities and in-home care, rather than more expensive sites. • How those benefits are designed and how employees perceive the costs will shape the effectiveness of site of care strategies. Trend #4
- 12. More employers will help employees maximize their benefit packages. • More employers will improve communication to help employees navigate the system and make the most of their benefits. • The goal is an experience that is more seamless with the rest of the traditional health plan networks. Trend #5
- 13. Trend #5 AboveAveragePlan BelowAveragePlan Effectively Communicated Ineffectively Communicated 83% Favorable 76% Favorable 26% Favorable 22% Favorable Percentage of employees that feel favorably about their employer’s health care plan
- 14. Overall Health care trend will increase slightly Trend #6
- 15. Health care trend will be driven by price (not utilization) Trend #7
- 16. • Utilization decreased by .02% from 2013 to 2017 • Prices rose 17% during that same time • Driven by Provider megamergers and physician consolidation • CMS projects price growth will continue through 2027 driven by: • Higher health care sector wages • Improving economy where consumers are less sensitive to prices Trend #7 Health care trend will be driven by price (not utilization)
- 19. Health Care Economics 101
- 20. THE HIGH-PERFORMER GAP Top performers get annual increases that are 10%-15% less than the average company.
- 21. Cumulative 10-year health care cost per $1,000,000 in spend today: $10,462,000 $15,937,000 $20,303,000 THE HIGH-PERFORMER GAPTHE HIGH-PERFORMER GAP
- 22. Cost [ P x U ] Who is managing your health care delivery supply chain?
- 23. Cost [ P x U ] 1 2Execute and measure your progress 3 THE HEALTH CARE FLYWHEEL Create your GamePlan and choose your tools Build your Strategy How can we begin managing our health care delivery supply chain?
- 24. AVOIDING THE TRAPS IN THE HEALTH CARE SYSTEM THE NEXT WEBINAR: FEBRUARY 25 – HNI.COM/UNIVERSITY
Editor's Notes
- #5: Retail prescription drug spending growth Will pick up from 2020 to 2027. Generic competition Will not affect 46% of the estimated sales revenue of the top 100 drugs through 2023. Less opportunity for generics to dampen drug spending The value of branded drugs coming off patent exclusivity decreases from 2018 through 2020. Generic utilization rates hovering around 86% means little room to grow. Of the almost 300 drugs to be launched between 2019 and 2021 Nearly two-thirds are specialty drugs. By 2020 Specialty drugs will account for 55% of the U.S. drug spending. Pipeline: life-altering Rxs and come with a price tag of $1 million to $2 million per treatment. Zolgensma : one-time treatment to halt the progression of spinal muscular atrophy Certain pediatric patients younger than 2 years of age, Was approved by the FDA in May 2019 at a wholesale cost of $2.125 million.