Mercer Offers Framework and Scorecard for Improving Employer Health Benefits

There’s a disconnect between what employees and employers spend on health care and what is received in terms of high-quality outcomes and a good patient experience, and employers have the power to change that, according to Mercer.

Mercer’s Vitals for Change framework calls on employer health plan sponsors to demand more for their employees and their families in four key areas that target systemic problems in the health care system and drive positive disruption and innovation. To amplify this message, Mercer and the nonprofit organization Catalyst for Payment Reform partnered to create the Vitals for Change Scorecard, a free assessment and benchmarking tool that takes 20 minutes and helps employers identify how to optimize their health benefits programs.

The framework includes:

Pay for value – Reimburse providers based on quality and outcomes, not volume.

• Of eight forms of alternative provider payment methods, the one used most commonly by respondents’ health plans (47%) is shared savings, in which there is an upside-only financial incentive for providers to reduce unnecessary health care spending for a population of patients or episode of care.
• Over half of the Scorecard respondents (56%) use benefit incentives to steer employees to high-value providers.
• About a fourth (28%) offer a narrow network of high-value providers.

Drive to quality – Steer members to high-quality care using data, technology and user insights.

• The most common way these employers encourage plan members to refer to quality information before selecting a provider is by listing the highest-quality providers and facilities first in directories (45%). Just 10% provide a one-time incentive to members that review and use provider quality information—and none require that members review quality information before accessing benefits.
• Nearly half the employers (47%) provide employees with a health advocacy service to steer members to high-quality providers. And over one-third will only cover certain services if they are obtained in a specified center of excellence or other high-quality setting.

Personalize the experience – Build engagement by providing choice and customizing member interactions.

• The Scorecard asks whether senior leadership considers programs encouraging employee engagement with health and well-being to be an important means of achieving overall HR and business objectives. Over half of the respondents (58%) say senior leadership considers these programs very or moderately important. Just 10% believe senior leadership doesn’t see a connection.
• About one-third of Scorecard users make efforts to understand what the different workforce segments or demographic groups value in terms of benefits, programs and policies.

Embrace disruption – Seek out opportunities in the rapidly changing health care ecosystem to work together to change the status quo.

• Over half of Scorecard participants (55%) are members in a local or regional business health group that has the goal of improving health care affordability and quality, and 23% say they are highly engaged in the organization.
• The Scorecard lists about a dozen disruptive innovations, ranging from genetic therapies to companion robots, and asks users to rate their potential for positive change. The two most highly rated were medical devices in the home connected for remote monitoring and blockchain technology.

“We are just beginning to delve into the data to understand how employers today are serving as change agents. Taking the Vitals for Change Scorecard will give employers a quick tutorial on transformative health care strategies. Many of the practices listed are only just now becoming actionable, so employers, be forewarned: If you take the Scorecard, don’t expect to check most—or even many—of the boxes! But you will come away with a better sense how your organization’s approach fits with where the market is going, and how you compare with your peers,” Mercer says.