Innovative Health Cost Saving Strategies Paying Off for Employers

Mercer projects that health benefit cost per employee will rise by 4.1% on average in 2019, down from 6.5% and 5.3% in previous years.

Based on the first 1,566 responses to the Mercer National Survey of Employer-Sponsored Health Plans, Mercer projects that health benefit cost per employee will rise by 4.1% on average in 2019.

Mercer notes that the underlying medical plan cost trend has cooled from 6.5% to 5.3% heading into 2019 (the underlying trend is the estimated increase in medical plan cost if employers made no changes). In past years, common employer cost-control tactics included raising deductibles and offering less generous plans. For 2019, however, fewer than half of the responding employers (44%) will be making these types of changes. But many employers are adopting new technology-enabled tools and solutions to address the root causes of the high cost of health care without cutting benefits or increasing the financial burden on employees.

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“The improvement in the underlying medical plan trend is encouraging because those savings are not solely coming from shifting cost to employees,” says Tracy Watts, senior partner and Mercer’s leader for Health Reform. “It suggests that there is a ‘quiet revolution’ going on in organizations as they deploy more innovative health benefit strategies—and that these have started to pay off.”

Mercer has found three technology strategies are key in driving higher-value health care:

  • Target specific health problems. More than half of mid-size and large employers with 500 or more employees (58%) now offer one or more “point solutions,”—high-tech, high-touch programs designed to help members with specific health issues ranging from insomnia to infertility. A targeted program for diabetics, for example, might offer both coaching and an interactive glucose monitor that can transmit data to a provider. Success is measured in quality of life improvement and fewer trips to the emergency room.
  • Make it easy to engage. Today 18% of mid-sized and large employers make all or most of their benefit offerings accessible to employees on a single, fully integrated platform. Another 19% say they are working towards full integration. Like the modern, online shopping experience, an integrated platform helps employees more easily engage with health and well-being vendors and find the resources they need.
  • Mine health plan and employee data for actionable insights. Most employers with 500 or more employees (77%) already use a data warehouse or get the data they need from plan vendors to inform their health plan strategy. But some of these employers (16%) are further ahead, using predictive analytics to identify future opportunities to improve health plan performance—or even health outcomes. For example, claims data can be continuously scanned for clusters of services that indicate a plan member might be heading toward a back surgery, such as multiple trips to a chiropractor followed by a low-back MRI. Timely outreach could help this member avoid unnecessary back surgery—or undergo surgery in a high-quality, cost-efficient setting.

“Employers have realized that it’s up to them to solve the problems of high cost, inconsistent quality, and low satisfaction that plague the U.S. health care system,” says Renya Spak, leader of Mercer’s Center for Health Innovation. “Without question, technology is going to be part of just about every meaningful solution.”

The complete survey results based on responses from nearly 2,400 employers will be released later this year and will look at the full range of strategies employers are using to manage cost.

Have Risk Lessons Been Learned From Financial Crisis?

Industry observers fear that 10 years following the collapse of Lehman Brothers, many investors, including retirement plan investors, may have forgotten lessons that should have been learned.

PLANSPONSOR this week received a number of written commentaries highlighting the 10th anniversary of the collapse of Lehman Brothers; while some lessons have been learned, experts still worry about the “brittleness” of the U.S. and global financial system.

The clearest and most pressing common theme presented in the commentaries is unmitigated concern that many lessons seemingly learned in the months leading up to and following the collapse of Lehman Brothers are already being forgotten.

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Brad McMillan, chief investment officer for Commonwealth Financial Network, writes that the anniversary is in fact an important date for investors to mark around the world. Here in the U.S., reflecting on the shock of the Lehman Brothers collapse for many on Wall Street and Main Street is “valuable for bringing a sense of perspective to the present moment,” he suggests. “But it’s not all that useful in outlining what we should really be thinking of today in light of that history.”

“The real lesson of the financial crisis, to my mind, was that the system was more vulnerable than anyone thought,” McMillan warns. “Because of that, investors did not realize the risks they were taking.”

Unrecognized risk is a theme regular readers of PLANSPONSOR will be familiar with. Unacknowledged risk in target-date funds (TDFs) is a prime example; despite the fact that target-date funds suffered significantly in the Great Recession, experts commonly warn that today’s TDF investors tend to seriously underestimate the amount of downside risk they are taking. This includes many Baby Boomers who are in the “retirement red zone” and seriously exposed to sequence of returns risk. 

While far from predicting an eminent sequel to the Great Recession, McMillan writes that “there are echoes of previous pre-crisis periods” clearly visible in the global marketplace today. “Confidence, both business and consumer, is very high,” he notes. “Investor complacency is also high.”

What’s the bottom line? “I don’t believe we can’t have another crisis,” McMillan concludes. “I also, however, don’t believe we have to have another crisis. The point here is that we simply don’t know and can’t know.”

McMillan’s prescription for investors is to set realistic objectives, remain humble and “remember the real lesson” of the Great Recession: “Risk, in the form of asset allocation, debt, or what have you, is what gets you into trouble. Even if our models and predictions fail, if we simply are not that exposed, the damage will be limited.”

Another commentator to write this week to PLANSPONSOR is David Lafferty, chief market strategist for Natixis Investment Managers. Like McMillan, he fears that investors are already letting the hard-earned lessons of the Great Recession go to waste.

“As we approach the 10 year anniversary of the seminal event of the Global Financial Crisis—the collapse of Lehman Brothers—investors may wonder if we’ve learned anything from past mistakes,” Lafferty muses. “Through the varying lenses of policymakers, investors, and markets, the answer is decidedly mixed.”

Lafferty credits policymakers around the world with making “some headway” in the area of bank vulnerability.

“While concentration risk among the major global banks has actually grown since the crisis, broadly speaking, leverage and trading risk are down while equity and capital ratios are up,” he explains. “Large bank failures remain a risk, particularly in the European periphery and emerging markets, but the gradual de-risking of banks should make the system less vulnerable to contagion in the next Lehman-like crisis.”

Where policymakers have made less progress is on the monetary front, Lafferty posits.

“Other than the U.S. Federal Reserve, the other major central banks remain in crisis mode today, unable to lift rates or unwind their massive quantitative easing programs,” he warns. “Balance sheets are bloated to the tune of $15 trillion with still close to $8 trillion in negative-yielding sovereign bonds, reducing the stimulative firepower of the major central banks to counteract the next recession or crisis. In the end, it may be fortunate that banks have ramped up their ability to absorb losses because central banks certainly have less power to prevent them.”

Echoing McMillan, Lafferty agrees that Millennial investors coming of age in the 2000s “may never look at equities the way the Baby Boomers did growing up in the bull market of the 1980s and 90s.”

“While some scar tissue has built up, investors have been forever altered. Ten years of [extremely low interest rates] have pushed them grudgingly out the risk spectrum and back into equities, but there is little doubt investor risk tolerance has been fundamentally altered,” he writes. “Investors are more skittish and therefore more likely to bail when volatility rears its head again.”

Lafferty concludes that “there can only be so much learned from looking back when every new crisis is sewn from different seeds.”

“All participants and policymakers can do is hope that the system is more flexible and therefore less fragile when the next crisis hits,” he warns. “On this score, we can only conclude that things have changed very little from the days of Lehman.”

In some ways, the Lehman Brothers collapse is actually still ongoing, as pointed out by another commentator this week. There are actually nearly 350 former employees of Lehman Brothers, with an average age of 77, still fighting in federal bankruptcy court to recover pension assets they say they are entitled to. According to lead attorney Rick Scarola, the former employees deferred up to half of their annual income into a pension plan that has been at least partially liquidated to satisfy creditors. 

“While this is hardly the first case where employees of private companies lose money when a company goes under, it does highlight the unusual structure,” the litigants suggests. “Like the securities that Lehman and other investment banks sold decades later, it was designed to maximize profit for the company (partly through tax loopholes) while leveraging the assets and handing many of the risks to the people who bought the financial products—partly by financial misconduct that was only uncovered much later and amplified in the Valukas Report.”

According to Scarola’s team, this issue is in fact the only remaining matter being litigated in the broader Lehman bankruptcy case. In other words, it is the only issue to be resolved before the bankruptcy can be fully closed. Scarola predicts a “three to five or more year timeline” for the conclusion of the litigation.

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