Considering Digital Health Solutions to Reduce Benefits Spend

Employers see a business case for investing more in health and well-being, but overall cost savings is a benefit as well.

Health and well-being programs are important for employers to retain and attract talent in a competitive labor market.

Survey results from Mercer indicate that corporate investment in workforce health will grow over the next five years. More than half of the surveyed U.S. senior decision makers say health and well-being investment will be a greater priority for their organization in the future compared to where it is today, while just 6% expect it to be a lower priority.

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Employers believe that these investment plans have a clear justification. The survey asked senior decision makers to rank their objectives for their organizations’ health and well-being programs. The top three all have a direct impact on business results: (1) improving productivity, (2) attracting and retaining workers, and (3) improving worker morale and engagement. By comparison, those surveyed rank cost containment far lower among objectives for investing in health and well-being programs.

Employers believe that digital health solutions will help advance their objectives for health and well-being programs. When asked specifically about digital health solutions, more than seven in 10 U.S. senior decision makers surveyed believe they will have a lot of or some impact on staff energy levels, and four out of 10 believe they will help them retain staff.

Though cost containment was not ranked high on employers’ objectives for investing more in employee health and well-being, digital health solutions can create cost savings—for both employees and employers.

The global survey found employees in the U.S. are less interested in digital solutions that employ AI (artificial intelligence) or virtual solutions than employees globally. However, nearly one-third or more expressed interest in a number of digital health solutions.

Nearly four in 10 (39%) said they would value an app that helps people find the right doctor or medical care when and where they need it. Kate Brown, Center for Health Innovation leader with Mercer in Houston, Texas, says apps for steering people to the right level of care provide a direct cost savings for employers and employees. “It could mean that instead of going to the emergency room, an employee is steered to a lower level acuity of care for which the claim cost would be lower,” she explains.

Brown says there is an emergence of apps that not only direct employees to the right doctor or level of care but offer guidance about symptoms and what the care solution is. For example, she says, rather than spending money on a medical appointment for a sprained ankle, an employee could act on an app’s recommendation to elevate it and ice it.

Thirty-six percent of U.S. respondents indicated they would value telemedicine—a remote video-chat or text with a doctor or nurse—for a simple health issue like a rash or a cold. “The financial benefit to an employee is clear, especially if he is enrolled in a high-deductible health plan (HDHP)—because the copay is lower for telemedicine than going into a doctor’s office, urgent care or emergency room,” Brown says. It seems logical that employers will see lower claim costs as well.

Another 36% of U.S. respondents to Mercer’s survey said they would value self-managing health conditions using wearable technology. “Employers can put this in the bucket of long-term cost avoidance,” Brown says. “It’s about creating and promoting a culture of health and engaging employees in health. They get healthy and avoid later medical costs. It’s harder to measure the return on investment [ROI] for this one, but the benefit is keeping employees healthy.”

Further down the list, 32% of U.S. respondents indicated they would value customized treatment and medicines using algorithms based on a person’s genetic sequence. Thirty percent said they would value tools that predict the likelihood of certain illnesses based on data automatically collected about a person.

Brown says, theoretically, there are companies that use large data sets to make inferences about treatment paths and what goes into different treatment pathways. “It will be interesting to see where those will go and whether they can deliver the best treatment plan for an individual that has gotten them to the right clinical outcomes,” she says. “There is the potential to treat an individual the right way the first time and offer them the correct maintenance care, which would save them money on multiple doctor visits or medicines, and reduce claim costs for employers.”

However, Brown notes, there is still a question of who pays for individual treatments—would it be employers? “Is there a way to do so at scale so it doesn’t create a huge cost burden? We haven’t yet seen the impacts to cost,” she says.

As for tools to predict the likelihood of illness, Brown says, “If there is data to deliver more personalized treatment, or treat a disease earlier in its progression, employees would avoid unnecessary care.”

Brown notes that the collection of individual data in an employee population can be used for strategic purposes by employers to select proper health plans for their employees. “It can help employers make better decisions about how to deploy their benefit dollars on programs that are best for employees,” she says.

Brown found it interesting that the top three reasons employers are investigating digital health are improving productivity; employee attraction and retention; and engagement. “It is interesting that cost is not first. It speaks to the fact that digital health has the potential to impact cost but employers are not yet counting on it or underestimating digital health’s play in cost,” she says.

But, if offering digital health solutions will reduce employee turnover, that is a cost savings in itself.

Mercer’s Health on Demand study surveyed more than 16,500 workers and 1,300 senior decision makers in seven mature and six growth markets across North America, Europe, Latin America and Asia. To download the U.S. report, visit https://www.mercer.us/our-thinking/health/mercer-marsh-benefits-health-on-demand.html.

Roth Is Not Just a Young Man’s Game

Erica K. Johnson, BOK Financial, discusses why Roth retirement plan contributions may be beneficial to a wider group of employees than previously thought.

At 26 years old, I often hear about how making Roth after-tax contributions to my retirement plan will aid in my retirement savings.

I have frequently been told how fortunate I am to have multiple decades to accumulate tax-free earnings on my Roth contributions. And I agree. Roth contributions will play a significant role in my retirement savings, and I am fortunate to make Roth contributions at such a young age.

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What I do not understand is why Roth is considered to be almost exclusively beneficial for young workers, when those who are midway, or even well into their careers, may benefit as well. I frequently hear mature workers lament about how they missed out on Roth contributions. Since Roth contributions only became available at a time when they were in a high tax bracket, they decided Roth cannot benefit them. Once, when advising a client to add a Roth option to her firm’s 401(k) plan, she said, “Most of our employees are older than 45. Roth wouldn’t help them.” I disagree.

For example, a $10,000 Roth contribution made by a 50-year-old taxed at 35% will generate $3,500 in taxes today. Assume that the contribution grows at 5% each year for 20 years, up to $26,532.98, and the individual is now in a 20% tax bracket. If the contribution had been made on a pre-tax basis, this individual would pay $5,306.60 in taxes at the time of distribution. The individual would realize an overall tax savings of $1,806.60 by instead making a Roth contribution at 50. Even with a significantly lower tax bracket, Roth contributions would produce overall tax savings.

The math gets even more favorable if we consider Roth contributions growing through retirement instead of just to retirement. Using the previous example, assume the 50-year-old did not touch the $10,000 contribution until age 80 and that they were in the same 20% tax bracket. Growing at an average of 5% for 30 years, this contribution would now be worth $43,219.42. Had the contribution been made on a pre-tax basis, this individual would pay $8,643.88 in taxes at age 80. If they made Roth contributions, they would realize $5,143.88 in tax savings by paying 35% in taxes at age 50.

In fact, using the same figures as the previous example, it takes only 12 years before paying the 35% tax upfront costs less than paying a 20% tax later. That makes Roth contributions beneficial to a far more wide-reaching group than those who are lucky enough to have several decades until retirement.

There is also a common misunderstanding about who qualifies to make Roth contributions in a 401(k) plan. Many individuals believe that if they are not able to make Roth IRA contributions, they are also not able to make Roth 401(k) or 403(b) contributions. That’s not accurate. In 2020, anyone younger than 50 can make up to $19,500 in Roth contributions to a 401(k) or 403(b) plan, and those older than 50 can contribute up to $26,000.

A devastating reality once hit a client of mine when I confirmed that he was eligible to make Roth contributions—including catch-up contributions—into his 401(k) plan. “I wish I would have known” he said quietly. As part of his 401(k) plan, he had invested $100,000 in a lucrative investment which appreciated significantly in 10 years. Had the initial investment been made using Roth contributions instead of pre-tax contributions, the property he sold for more than $700,000 would have been tax free.

This is an extreme example that shows the need for each individual to consider whether their retirement plan contributions should be made as pre-tax or Roth contributions. There is no cutoff age for Roth contributions. Roth contributions may benefit you even if you have been saving longer than some of us new workers have been alive.

 

Erica K. Johnson is a Qualified 401(k) Administrator and an account manager with BOK Financial. Erica maintains a book of retirement plans, managing all aspects of ERISA compliance, recordkeeping, and investment management for institutional clients.

This feature is to provide general information only, does not constitute legal or tax advice, and cannot be used or substituted for legal or tax advice. Any opinions of the author do not necessarily reflect the stance of Institutional Shareholder Services or its affiliates.

 

About BOK Financial Corporation

BOK Financial Corporation is a more than $40 billion regional financial services company headquartered in Tulsa, Oklahoma with more than $80 billion in assets under management and administration. The company’s stock is publicly traded on NASDAQ under the Global Select market listings (BOKF). BOK Financial Corporation’s holdings include BOKF, NA; BOK Financial Securities, Inc., BOK Financial Private Wealth, Inc., and BOK Financial Insurance, Inc. BOKF, NA operates TransFund, Cavanal Hill Investment Management, Inc. and BOK Financial Asset Management, Inc. BOKF, NA operates banking divisions across eight states as: Bank of Albuquerque; Bank of Oklahoma; Bank of Texas and BOK Financial (in Arizona, Arkansas, Colorado, Kansas and Missouri); as well as having limited purpose offices Nebraska, Milwaukee and Connecticut. Through its subsidiaries, BOK Financial Corporation provides commercial and consumer banking, brokerage trading, investment, trust and insurance services, mortgage origination and servicing, and an electronic funds transfer network. For more information, visit www.bokf.com.

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